Variations of Blood Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease
Virginija Šileikienė, Jolita Norkūnienė, Loreta Bagdonaitė, Edvardas Danila
Background. Chronic obstructive pulmonary disease (COPD) is one of the a major cause of illness and death throughout the world. Exacerbations of COPD are common, they have a significant effect on mortality and disease progression. COPD can be considered a disease with organ-specific characteristics and systemic manifestations. Besides an increase in airway inflammation, COPD exacerbations are associated with an increase in systemic inflammation. Therefore it is useful to detect the blood inflam- maiory markers, which can be used in daily clinical practice and enable reliably distinguish COPD exacerbation from remis sion.
Material and methods. 73 patients with moderate and severe COPD were evaluated (55 of them COPD was stable, 18 - COPD exacerbation) and 26 healthy control subjects. The following markers have been investigated: leukocytes count, C-reactive protein (CRP), fibrinogen, erythrocytes sedimentation rate (ESR), hemoglobin, procalcitonin. The neutrophil nitroblue tetrazolium tests (NBT) and neutrophil phagocytosis activity (NFA) tests were performed. 32 COPD paiients underwent flexible fibrobronchoscopy and their aspirates from bronchi were investigated microbiologically.
Results. CRP, fibrinogen, leukocytes count, ECR values were statisticaly significant higher during COPD exacerbation (p<0.01), compared with remission group. We found the positive correlations between CRP and fibrinogen (r=0.8, p<0.01), CRP and ESR (r=0.6, p<0.01), CRP and leukocytes count (r=0.7, p<0.01), CRP and possitive bacteriologic culture (r=0.6, p<0.01). Similarly, the possitive correlations were founded between fibrinogen and ESR (r=0.5, p<0.05), leukocytes count (r=0.4, p<0.05) and presence of bacterias in bronchial aspirate (r=0.4, p<0.05). Neutrophil NBT test directly correlated with neutrophil functional acrivity (NFA), however neither NBT test nor NFA test values didn’t elevate significantly during COPD exacerbation. Moreover, we did not find difference of NBT and NFA values between COPD patients and healthy persons. We also did not find elevated procalcitonin concentration during COPD exacerbation.
Conclusions. Our investigation confirmed proposition that airway inflammation partially reflect in blood. Classical blood inflammation activity markers, such as CRP, ESR, fibrinogen, leukocytes count and possitive bacteriologic culture reflect the intensification of airway inflammation during COPD exacerbation. Neutrophil NBT, NFA tests and procalcitonin did not have diagnostic value to determine airway inflammation worsening during COPD exacerbation.
Keywords: COPD, CRP, fibrinogen, procalcitonin, NBT test.
