The Correlationship Between Cytokines Level In Serum And Lung Function In Patients With Chronic Obstructive Pulmonary Disease

Background and objective: Chronic obstructivepulmonary disease (COPD) is a condition charactered bychronic, progressive airways obstruction, it is a major healthproblem across the world and its medical, societal and economicimpacts continue to grow. There were several hypothesesregarding the pathogenesis of COPD and important newinformation on airway inflammation, oxidative stress andproteolysis in the lungs were important for the development ofeffective treatments. However, which on earth thepro-inflammatory cytokine play a role in the procession among(TNF-α), (GM-CSF), as wll as (IL-8) were not determined.What is relationship these cytokines and pulmonary functionwere few reports. The aim of the present experiment was tostudy the relationship between cytokines and pulmonaryfunction in patients with chronic obstructive pulmonary disease(COPD).Methods: 56 healthy persons were randomly chosen as apopulation control group from check-up people in Tian Jin.They were also evaluated by thorough medical history andcomplete physical examination, which may exclude diseases toensure the results true.The patient group consisted of 56 COPD patients frompopulation investigated in outpatient of TanJin General Hospital.The patients had been clinically stable for at least 3 monthes,and lacked clinical signs of exacerbation. Patients who hadconditions known to affect serum TNF-αlevels, IL-8, GM-CSFsuch as infection, heart failure, cancer, or collagen vasculardiseases were strictly excluded. There were not significant formatched age and sex at statistic level. According to the criteriaof GOLD, the patients were divided into three groups. Fromevery team in GOLD degress, we optionally selected 10 patientsused as treated groups.Lung function testsLung-function tests included FEV1, FVC and FEV1/FVC.The measurements were performed in accordance with ChineseMedical Association recommendations [1]. The results of FEV1and FEV1/FVC are expressed as percent of predicted values.The lung function tests were performed after inhalation ofbronchodilatator terbutaline.Assayment of TNF-α, IL-8, GM-CSF in serum.Fasting blood samples (approximately 10 mL) were collected byvein-puncture and put into plain tubes, left at room temperturefor an hour, blood serum were obtained by centrifugation at3000g/min for 10 min at below temperature. The samples werestored at -70oC until analysis. The serum was analyzed todetermine the level of TNF-α, IL-8, GM-CSF by ELISAaccording to manufacturer's instruction. Absorbance wasmeasured spectrophotometrically at 450 nm using microplatereader (Belgium).In treatment groups, the patients were performed byfiberbronchialtroscope, and the six samples of pulomonarytissue were taken for Optic Microscope. Then, all patients weretreated by taking bailing at 5 pills/time/day for 30 days. After 30days, they accepted lung function examination andhematological as well as biochemical investigations for thesame parameters to contrast with the former. In the meanwhile,the patients received test by fiberbronchialtroscope, and the sixsamples of pulomonary tissue were taken in the same pulmonarytissue to compare with the former under Optic Microscope.Result: the mean TNF-α, GM-CSF, IL-8 level in thecontrol were respectively 14.70±6.95 pg/ ml, 26.70±1.40pg/ml,46.33±16.20 pg/ ml. In comparison, the mean TNF-α, GM-CSF,IL-8 level in patients(n=56) were respectively 22.65±9.51pg/ml,83.86±5.86 pg/ml, 111.21±12.8pg/ml. In patients team thelevel of TNF-α, GM-CSF, IL-8 were higher than the control,there was significant at satistic level (p<0.01). Among treatedteam , before being treated ,TNF-α, GM-CSF, IL-8 level inⅠgroup were respectively 18.36±7.79 pg/ ml, 70.31±2.29 pg/ml, 91.07±17.38 pg/ ml. TNF-α, GM-CSF, IL-8 level in Ⅱgroup were respectively 22.56±8.78 pg/ ml, 84.49±5.61 pg/ml, 106.78±11.98 pg/ ml. TNF-α, GM-CSF, IL-8 level in Ⅲgroup were respectively 28.46±9.47 pg/ ml, 100.37±4.90 pg/ml, 146±18.85 pg/ ml. The responsible cytokines in the patientgroups were significant (P<0.05). However, the amout of FVC,FEV1, FEV1/FVC in Ⅰwere respectively 2.40±0.49 L,1.99±0.39L/S, 0.690±0.134. The amout of FVC, FEV1,FEV1/FVC in Ⅱwere respectively 1.91±0.41 L, 1.53±0.55.L/S, 0.512±0.171. The amout of FVC, FEV1,FEV1/FVCin Ⅲwere respectively 1.72±0.47L,1.45±0.44L/S, 0.413±0.172. FEV1, FVC, FEV1/FVC in patients team were graduallylow with the increased level of TNF-α, GM-CSF, IL-8 in serum(P<0.01). The level of TNF-α, GM-CSF, IL-8 were negativecorrelation with lung function in patients.After treated by taking bailingjiaonang, in these treatmentgroups, the level of serum TNF-α, IL-8, GM-CSF inⅠT groupwere respectively 11.05±2.90 pg/ ml,41.26±3.27 pg/ ml,35.37±9.98 pg/ ml. The level of serum TNF-α,IL-8, GM-CSFinⅡT group were respectively 15.39±4.23 pg/ ml, 79.48±5.64pg/ ml, 62.19±12.83 pg/ ml. The level of these cytokines in ⅢT were respectively 20.07±5.20 pg/ ml, 93.12±7.71 pg/ ml,70.72 ±18.98 pg/ ml. The level of these cytokines weresignificantly decreased after treated by bailingjiaonang(P<0.05).In the meanwhile, in the treatment groups, the amout ofFVC, FEV1, FEV1/FVC inⅠT were respectively 2.96±0.42L,1.99 ±0.39L/S, 0.80 ±0.14. The amout of FVC, FEV1,FEV1/FVC inⅡT were respectively 2.45±0.29L, 1.53±0.55L/S, 0.72±0.11. The amout of FVC, FEV1, FEV1/FVC in ⅢT were respectively 1.99±0.33L, 1.45±0.44L/S, 0.66±0.12.The level of FEV1, FVC were increased significantly (P<0.05),the enhanced arrange of FVC, FEV1 were the most significantinⅠT group, ⅡT group was second, ⅢT group was final. Thelung tissues were not changed under optical microscope afterbeing treated.Conclusion:(1) TNF-α, GM-CSF, IL-8 in serum were thought to playan important role in the pathogenesis as well as progress inCOPD, the level of TNF-α, GM-CSF, IL-8 in serum in COPDpatients were higher than the control. Furthermore, there wassignificantly different among the different degress of COPDpatients.(2) With the level of these cytokines in serum in COPDpatients increased, FVC, FEV1, FEV1/FVC of these patientswere significantly decreased. FVC, FEV1 were negativelycorrelation with these cytokines in COPD patients.(3) After treated, with the level of TNF-α, GM-CSF, IL-8in serum decreased, FVC, FEV1, FEV1/FVC of COPD patientswere significantly improved. The more early treatment wastaked, the more significantly FVC, FEV1 were improved. Toprevent the deterioration of lung function as well as improve thequality of COPD, the level of TNF-α, GM-CSF, IL-8 in serumshould be decreased early. In clinical works, the new drugs such...