Systemic inflammatory profile in patients with chronic obstructive pulmonary disease

Abstract

Chronic obstructive pulmonary disease(COPD)is heterogeneous condition with various phenotypes that have their own pathogenetic mechanisms and certain inflammatory mediators, as C-reactive protein, interleukins, circulating leukocytes. Uncovering the inflammatory profile may identify disease biomarkers. We aimedto compare the values of systemic inflammatory parameters in patients with different clinical phenotypes and determine their correlation with clinical parameters.In 30 COPD patients weanalyzeddemographic and clinical data, history of allergies, cigarette smoking and history of exacerbations. We phenotyped them intonon-exacerbator, exacerbator and COPD with asthma phenotype. COPD assessment test, modified dyspnea scale and the BODE (Body mass index, Obstruction, Dyspnea, Exercise capacity) index werecalculated. Spirometry and lung X-ray were performed. Peripheral blood was taken for analysis of inflammatory parameters.There were 16 patients(53.33%) with phenotype of non-exacerbator, and 7 (23.33%) with exacerbatorand COPD with asthma phenotype each. COPD assessment testhadsignificantly lowestvalue in non-exacerbator and modified dyspnea scalesignificantly highest value in exacerbatorphenotype. Therewere no mild gradepatientsin exacerbator,andno very severe grade in nonexacerbatorphenotype. C-reactive proteinand interleukin 8 had significantly lowest value in non-exacerbator; leucocytes significantly highest value in exacerbator; eosinophyls and interleukin 4 significantly highest value in COPD with asthma phenotype. There was no significant difference among the three phenotypes in neutrophyls andinterleukin 18. The three clinical phenotypes: non-exacerbator, exacerbator and COPDwith asthma have their own specific clinical and inflammatory features that have clinical, prognostic and therapeutic implications