Study Of Neutrophil Inflammation Degree In Induced Sputum Of Patients With Neutrophilic Asthma(NA) And Chronic Obstructive Pulmonary Disease(COPD) Patients

Bronchial asthma is defined as chronic inflammatory disorder of the airways. Clinically, asthma is characterized by wheezing, chest tightness, breathlessness, coughing particularly at night or in the early morning. Airflow limitation of asthma patients is reversible. Chronic obstructive pulmonary diease(COPD) is characterized by irreversible airflow limitation that increases progressively during the natural course of the disease. Gradually increasing difficulty in breathing as its main clinical performance. Asthma and COPD are considered as two independent diseases, and affecting many patients of global, the morbidity and mortality are high. Menwhile, asthma and COPD are vary from the mechanism, clinical manifestation, treatment and prognosis. But Orie etc. put forward the “the Netherlands” theory which thought asthma and COPD have the common inflammation source, they belong to the same kind of chronic airway inflammtory disease. Neutrophilic asthma is an inflammatory phenotype of asthma, give priority to severe, refractory asthma. A study put neutrophilic asthma and COPD patients airway induced sputum leukocyte classification comparison, they have discovered that neutrophils in asthma and COPD are predominantly increased. It illustrates that NA and COPD have a similar airway inflammation. Therefore, we compare the neutrophil activation state and degree of inflammation in induced sputum of patients with neutrophilic asthma and COPD patients.ObjectivesTo compare the degree of neutrophil inflammation and activation in induced sputum of patients with neutrophilic asthma and chronic obstructive pulmonary disease patients. Inculde MPO, TIMP-1, respiratory burst, IL-8, IL-17.Methods:1. To collect 25 NApatients, 30 stabilization COPD patients and 11 healthy persons admitted to the Respiratory Department and Research Institute in Xinqiao hospitalfrom March 2014 to August 2014.2. Detected and compared Induced sputum leukocyte classification and counting.3. ELISA detect MPO, TIMP – 1, IL-8, IL-17 levels.4. Flow cytometry detect neutrophil respiratory burst.Results:1. Total number of induced sputum cells and neutrophils ratio in NA and stable COPD group were higher than those in healthy controls(P < 0.05), there were no statistical difference between the two groups(P > 0.05);2. Compared with healthy controls, the level of MPO, TIMP-1 in NA and stable COPD groups were significantly increased(P < 0.05); The level of MPO, TIMP- 1 and respiratory burst between NA and stable COPD groups have no statistical difference(P > 0.05).3. The level of IL-8, IL-17 in NA and stable COPD groups were significantly higher than those in healthy controls(P < 0.05); IL-8 and IL-17 levels in COPD group were significantly increased compared with NA group(P < 0.05).4.The FEV1% of NA and stable COPD patients correlated positively with FEV1/FVC%( r=0.66 、 r=0.75, P<0.05), no significant correlation between the rest indicators(FEV1%, FEV1/FVC%, MPO, TIMP- 1, respiratory burst, IL-8, IL-17) in both NA and stabilization COPD patients.Conclusions:1. Neutrophil in induced sputum in NA and stabilization COPD group were significantly activated.2. Inflammation of COPD patients may be more strong.