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[Etiology and biomarkers of systemic inflammation in mild to moderate COPD exacerbations].

Abstract：

BACKGROUND:The etiology of acute exacerbations of chronic obstructive pulmonary disease (COPD) is heterogeneous and still under discussion. Inflammation increases during exacerbation of COPD. The identification of inflammatory changes will increase our knowledge and potentially guide therapy. AIM:To identify which inflammatory parameters increase during COPD exacerbations compared to stable disease, and to compare bacterial and viral exacerbations. MATERIAL AND METHODS:In 85 COPD patients (45 males, mean age 68 ± 8 years, FEV1 46 ± 17% of predicted) sputum, nasopharyngeal swabs and blood samples were collected to identify the causative organism, during a mild to moderate exacerbation. Serum ultrasensitive C reactive protein (CRP), fibrinogen and interleukin 6 (IL 6), neutrophil and leukocyte counts were measured in stable conditions, during a COPD exacerbation, 15 and 30 days post exacerbation. RESULTS:A total of 120 mild to moderate COPD exacerbations were included. In 74 (61.7%), a microbial etiology could be identified, most commonly Mycoplasma pneumoniae (15.8%), Rhinovirus (15%), Haemophilus influenzae (14.2%), Chlamydia pneumoniae (11.7%), Streptococcus pneumoniae (5.8%) and Gram negative bacilli (5.8%). Serum CRP, fibrinogen and IL 6, and neutrophil and leukocyte counts significantly increased during exacerbation and recovered at 30 days post exacerbation. Compared to viral exacerbations, bacterial aggravations were associated with a systemic inflammation of higher magnitude. CONCLUSIONS:Biomarkers of systemic inflammation increase during mild to moderate COPD exacerbations. The increase in systemic inflammation seems to be limited to exacerbations caused by bacterial infections.

journal_name

Rev Med Chil

journal_title

Revista medica de Chile

authors

Saldías PF,Díaz PO,Dreyse DJ,Gaggero BA,Sandoval AC,Lisboa BC

doi

/S0034-98872012000100002

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

10-8

issue

1

eissn

0034-9887

issn

0717-6163

pii

S0034-98872012000100002

journal_volume

140

pub_type

杂志文章

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