Correlation of Inflammatory Cells in Induced Sputum and Peripheral Blood of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a major chronic respiratory disease worldwide. Inflammatory cells reflect the inflammatory situation both in peripheral blood and induced sputum. Their correlation has not been reported. The correlation between neutrophils (Neu), eosinophils (Eos), and lymphocyte (Lym) in induced sputum and that in peripheral blood of COPD patients was evaluated to explore the consistency of inflammatory cells in peripheral blood and induced sputum. Peripheral blood and induced sputum were collected from 437 patients with acute exacerbation of COPD (AECOPD) who were hospitalized in the Department of respiratory and critical care medicine, Inner Mongolia People’s Hospital. The correlation analysis was performed by Spearman correlation analysis. The ratios of Neu, Eos, and Lym in induced sputum were (79.15 ± 22.60)%, (5.23 ± 12.74)%, and (1.69 ± 2.66)%. The ratios of Neu, Eos, and Lym in peripheral blood were (63.29 ± 11.44)%, (2.99 ± 3.60)%, and (25.16 ± 10.19)%. The results showed that the ratios of Neu and Eos in induced sputum were significantly correlated with the proportion of corresponding cells in peripheral blood (P < 0.05). There was no correlation between the ratio of Lym and Leu in induced sputum and corresponding cells in peripheral blood (P > 0.05). In patients with AECOPD, the tendency of Neu and Eos in induced sputum was consistent with the corresponding cells in peripheral blood. Neu and Eos in induced sputum and peripheral blood reflected the degree of inflammation to guide the individualized medication of patients.

A new in ammation marker of chronic obstructive pulmonary disease– adiponectin

BACKGROUND： This study was undertaken to measure the concentration of adiponectin （APN） in serum and induced sputum in patients with chronic obstructive pulmonary disease （COPD during acute exacerbation （AECOPD） and at stable stage and to determine the role of APN as a marker of in？ ammation in the pathogenesis of COPD.METHODS： All the patients in this prospective study were enrolled from October 2008 to October 2009, including 30 male AECOPD patients from the emergency department, 30 male stable COPD patients from the department of respiratory diseases, and 30 healthy non-smoking male controls from the department of medical examination. The serum and induced sputum were collected from each patient. All of the patients had normal weight （BMI range 18.5-24.9 kg/m2）. Patients with severe bronchial asthma, bronchiectasis or autoimmune disease were excluded. Cell count and classi？ cation was performed for the induced sputum. The concentrations of APN, IL-8, IL-6 and TNF-α were measured by ELISA. Pulmonary function was tested among the three groups. Comparisons between the groups were conducted by Student＇s t test, ANOVA analysis or nonparametric test. Correlation analysis was carried out by Pearson＇s product-moment correlation coef？ cient test or Spearman＇s rank-order correlation coef？ cient test.RESULTS： The concentrations of APN in the serum or induced sputum in AECOPD patients were signi？ cantly higher than those in stable COPD patients or healthy non-smoking controls （P〈0.01）. The concentration of APN in stable COPD patients was signi？ cantly higher than that in healthy non-smoking controls （P〈0.01）. For the AECOPD patients, APN was positively correlated with IL-8 and TNF-α in the serum and induced sputum （r=0.739, 0.734, 0.852, 0.857 respectively, P〈0.05）. For the stable COPD patients, APN was also positively correlated with IL-8 and TNF-α in the serum and induced sputum （r=0.751, 0.659, 0.707, 0.867 respectively, P〈0.05）. In addition, for the AECOPD patients, APN was positively correlated with the percentage of neutrophils in the induced sputum （r=0.439, P〈0.05）.CONCLUSIONS： APN is involved in the process of systematic and airway inflammation ofCOPD. This process is related to neutrophils in the airway, IL-8 and TNF-α. APN could be used as a new marker for in？ ammation of COPD.