Longitudinal follow-up of systemic inflammation after acute exacerbations of COPD
Longitudinal follow-up of systemic inflammation after acute exacerbations of COPD
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DOI：
10.1016/j.rmed.2007.05.026
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发表时间：
2007-11-01
影响因子：
4.3
通讯作者：
Wouters, Erniel F. M.
中科院分区：
文献类型：
--
作者：
Groenewegen, Karin H.;Dentener, Mieke A.;Wouters, Erniel F. M.
背景：急性加重在COPD的临床过程中很重要，但其潜在机制尚不清楚。全身性炎症现在被认为是疾病过程中的重要组成部分。在这项研究中，我们纵向评估了急性加重住院治疗期间和临床恢复后的全身炎症。研究方法：在第0、1、4和8天以及出院后1个月、3个月和6个月，对21例因COPD急性加重而入院的患者采集血液。通过测量促炎标志物白细胞介素（IL）-6、可溶性肿瘤坏死因子（TNF）受体sTNFR 55和sTNFR 75、抗炎介质sIL-1RII和作为中性粒细胞活化标志物的杀菌渗透性增加蛋白（BPI）来确定全身炎症。此外，测定血浆Trolox抗氧化能力（TEAC）水平。在一个时间点测量年龄匹配的健康对照的相同标记物。结果：与健康对照组相比，COPD急性加重入院第一天分析的所有炎症标志物均升高。在治疗期间，IL-6和sTNFR 75的水平迅速下降，而sTNFR 55和BPI保持升高。此外，sIL-1RII和TEAC在治疗的前8天内升高。在稳定状态下，所有炎症标志物恢复到与健康对照相当的值，但BPI除外，与健康对照相比，BPI保持持续升高。
Background: Acute exacerbations are important in the clinical course of COPD, yet the underlying mechanisms are poorly understood. Systemic inflammation is now considered as an important component in the disease process. In this study we evaluated longitudinally the systemic inflammation during hospital treatment for acute exacerbation and after clinical recovery. Methods: Blood was collected on day 0, 1, 4 and 8 in 21 patients admitted for an acute exacerbation of COPD and at 1 month, 3 months and 6 months after discharge. Systemic inflammation was determined by measurement of the pro-inflammatory markers interleukin (IL)-6, soluble tumor necrosis factor (TNF) receptors sTNFR55 and sTNFR75, the anti -inflammatory mediator sIL-1RII, and bactericidal permeability increasing protein (BPI) as a marker of neutrophil activation. In addition, plasma level of Trolox antioxidant capacity (TEAC) was determined. Healthy age-matched controls were measured for the same markers at one time-point. Results: ALL inflammatory markers analyzed were elevated on first day of admission for exacerbation of COPD, as compared to healthy controls. During treatment, levels of IL-6, and sTNFR75 rapidly decreased, whereas sTNFR55 and BPI remained elevated. Moreover, sIL-1RII and TEAC increased during first 8 days of treatment. In the stable condition all inflammatory markers returned to values comparable to healthy controls, with the exception of BPI, which remained persistently elevated compared to healthy controls.