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Vol. 42. Issue 7.
Pages 332-337 (July 2006)
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Vol. 42. Issue 7.
Pages 332-337 (July 2006)
Original Articles
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Systemic and Lung Inflammation in 2 Phenotypes of Chronic Obstructive Pulmonary Disease
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José Luis Izquierdoa,
Corresponding author
jlizquierdo@sescam.org

Correspondence: Dr. J.L. Izquierdo. Servicio de Neumología. Hospital Universitario. Donantes de Sangre, s/n. 19002 Guadalajara. España
, Carlos Almonacida, Trinidad Parrab, Jaime Pérezb
a Servicio de Neumología, Hospital Universitario, Guadalajara, Spain
b Unidad de Investigación, Hospital Universitario, Guadalajara, Spain
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Objective

To study whether patients with chronic obstructive pulmonary disease (COPD) at the same level of flow limitation but with different clinical phenotypes present different degrees of systemic and/or pulmonary inflammation.

Patients and methods

We studied 15 male smokers without COPD (control group) and 39 males with COPD in stable clinical condition.

The COPD patients were assigned to 2 groups based on the ratio of carbon monoxide diffusing capacity (DLCO) to alveolar volume (DLCO/VA) expressed as a percentage as follows: a) mainly emphysema (n=15) and b) mainly chronic bronchitis (n=24). Classification was determined by comparing both clinical features and diagnostic images.

Results

Mean (SD) concentrations of interleukin 8 (IL-8) and 8-isoprostane in exhaled breath condensate (EBC) were significantly lower in patients with mainly emphysema (IL-8, 0.34 [0.70] pg/mL; 8-isoprostane, 0.07 [0.26] pg/mL) than in patients with chronic bronchitis (IL-8, 2.32 [3.10] pg/mL; 8-isoprostane, 1.77 [2.98] pg/mL) or in the controls (IL-8, 3.14 [4.59] pg/mL; 8-isoprostane, 1.92 [2.84] pg/mL); P<.05 for IL-8 comparisons and P<.01 for 8-isoprostane.

IL-8, leukotriene B4, and 8-isoprostano in EBC correlated significantly with DLCO/VA (% of predicted) (r=0.30, P<.05; r=0.29, P=<.05; and r=0.46, P<.01, respectively) but not with forced expiratory volume in 1 second. There was a negative correlation between EBC and serum levels of both IL-8 (r=−0.31; P<.05) and 8-isoprostane (r=−0.51; P<.001). The correlation between leukotriene B4 concentrations in EBC and serum was not significant, however.

No significant differences were found between smokers' and ex-smokers' serum levels of IL-8, leukotriene B4, 8-isoprostane in serum or EBC.

Conclusions

The results indicate that COPD patients with an emphysematous phenotype have a less intense inflammatory response and less oxidative stress in the lung.

Key words:
COPD
Phenotype
Inflammation
Oxidative stress
Objetivo

Investigar si los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) con un mismo grado de limitación ventilatoria, pero diferente fenotipo clínico, presentan diferencias en el grado de respuesta inflamatoria pulmonar y/o sistémica.

Pacientes y métodos

Se estudió a 15 varones fumadores sin EPOC (grupo control) y a 39 varones con EPOC en situación clínica estable. Usando la relación factor de transferencia de monóxido de carbono/volumen alveolar (TLCO/VA%), se dividió a los pacientes con EPOC en 2 grupos: a) EPOC de predominio enfisema (EPOC-A; n = 15), y b) EPOC de predominio bronquitis crónica (EPOC-B; n = 24). La correcta clasificación de los pacientes se confirmó analizando aspectos clínicos y técnicas de imagen.

Resultados

Las concentraciones medias ± DE de interleucina-8 (IL-8) y de 8-isoprostano en el condensado de aire exhalado (CAE) fueron significativamente menores (p < 0,05 para la IL-8 y p < 0,01 para el 8-isoprostano) en los pacientes con predominio enfisematoso (IL-8: 0,34 ± 0,70 pg/ml; 8-isoprostano: 0,07 ± 0,26 pg/ml) que en los pacientes con bronquitis crónica (IL-8: 2,32 ± 3,10 pg/ml; 8-isoprostano: 1,77 ± 2,98 pg/ml) o que en los controles (IL-8: 3,14 ± 4,59 pg/ml; 8-isoprostano: 1,92 ± 2,84 pg/ml). Los valores de IL-8, leucotrieno B4 y 8-isoprostano en el CAE se relacionaron significativamente con los valores de TLCO/VA % (r = 0,30, p < 0,05; r = 0,29, p = < 0,05, y r = 0,46; p < 0,01, respectivamente), pero no con el volumen espiratorio forzado en el primer segundo. Existió una relación negativa entre los valores de IL-8 (r = -0,31; p < 0,05) y 8-isoprostano (r = -0,51; p < 0,001) en suero y CAE. Sin embargo, esta correlación no fue significativa para el leucotrieno B4. No se observaron diferencias significativas entre fumadores activos y ex fumadores para IL-8, leucotrieno B4 y 8-isoprostano en suero y CAE.

Conclusiones

Los resultados de este estudio indican que en pacientes con EPOC la presencia de un fenotipo enfisematoso se acompaña de una menor respuesta inflamatoria y menor estrés oxidativo en el pulmón.

Palabras clave:
EPOC
Fenotipo
Inflamación
Estrés oxidativo
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This research was funded by Neuromadrid and SESCAM grant number GC03002.

Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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