INFLUENCE OF INFLAMMATORY CYTOKINES ON THE COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Summary. Chronic obstructive pulmonary disease (COPD) is one of the leading health problems worldwide, due to the high prevalence of this pathology, fairly high rates of disability and mortality, as well as large economic losses. This disease is the most common cause of disability and mortality among all lung diseases. According to experts, in 2020, mortality from COPD should have come in third place.

The aim of the study – to learn the effect of inflammatory cytokines on the course of chronic obstructive pulmonary disease (COPD).

Materials and Methods: The total number of exa­mined patients was 146 people, who were compared by age and sex. Group 1 consisted of 100 patients with COPD (38 patients had stage II bronchoobstruction, stage III – 43 patients, stage IV – 19 patients). Group 2 consisted of relatively healthy smokers with smoking experience ≥ 10 packs/year (24 people). Group 3 consisted of healthy non-smoking men with smoking experience ≤ 1 pack/year (22 people). Patients underwent spirometric examination; blood test for biomarkers of inflammation (BI), namely leukocytes, C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), fibrinogen; computed tomography of the lungs; body mass index (BMI) measurements; mMRC test, SGRQ and CAT questionnaires. The level of BI in patients with COPD was compared with those in healthy smokers with normal spirometry and non-smokers. Kraskel-Wallis tests were used to analyze the statistical significance of differences between groups. Significance of differences between quantitative traits with abnormal distribution was performed using the nonparametric pair U Mann-Whitney test. Comparison of qualitative indicators was performed using the criterion χ2 with Yates correction. In all cases, differences at p <0.05 were considered significant.

Results. The results showed that the level of BI, namely leukocytes, CRP, IL-6 and fibrinogen is statistically higher (p <0.001) in patients with COPD than in smokers with normal lung function and non-smokers, while the level of IL-8 is higher in the group of smokers without COPD (p <0,001). The mean levels of CRP, IL-6, and fibrinogen were almost indistinguishable between smokers and ex-smokers within the study groups, whereas the level of IL-8 in current smokers was statistically higher than in those who quit smoking as in patients with COPD (p <0.01) and in the group of smokers with normal spirometry (p <0.001). The percentage of people with elevated levels of BI was significantly higher in group 1 compared to group 2 (70 % and 62 %, respectively, p <0.05) and in group 2 compared to group 3 (62 % and 22 %, respectively, p <0.001). The percentage of patients who had an increase in 2 or more BI was also statistically higher in the group of COPD compared with smokers without COPD (p <0.05) and non-smokers (p <0.001). There is a direct correlation between the severity of BI and bronchoobstruction of COPD (r = 0.39, p <0.05). In patients with COPD, there were direct positive correlations between the severity of BI and smoking experience (r = 0.82; p <0.05), the severity of shortness of breath on the mMRC scale (r = 0.62; p <0.05), the presence of concomitant pathology (r = 0.51; p <0.05), the frequency of pulmonary emphysema and exacerbations during the year (r = 0.82 and r = 0.89, respectively; p <0.05).

Conclusions. The obtained results allow us to consider BI in patients with COPD as a factor that modifies the development of pathology.