The Research Of The Response Relationship Between Serum Adiponectin And Inflammation During The Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To detect the serum concentrations of adiponectin (adiponectin, APN) between the patients of chronic obstructive pulmonary disease (COPD) with smoking history in the different stages and smokers with normal lung function and simultaneously measure the concentrations of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and high sensitive C-reactive protein (CRP). To compare the differnces between APN and TNF-α, CRP, IL-6, IL-8, IL-10 in different stages of disease in COPD patients and smokers with normal lung function and the relevance of the serum concentrations of the above five cytokines and the lung function separately. To discuss the role and significance of APN in the process of COPD systemic inflammatory response caused by smoking. Methods:1.The subjects1) Subjects Source:Acute exacerbation of COPD: 45 patients admitted to hospital respiratory ward in City People's Hospital from May 2010 to December 2010; Stable COPD group: COPD patients recieved the treatment of oxygen, anti-inflammatory, wheezing suppression and eliminating phlegm, symptomatic relief for 4 weeks; The control group (smokers with normal lung function): City People's Hospital Health Center for examination of 45 healthy volunteers.2) Entry criteria:Acute exacerbation of COPD group: symptoms of male patients with acute COPD meet the criteria for GOLD.Stable COPD group: COPD patients who recieved the treatment of oxygen, anti-inflammatory, wheezing suppression and eliminating phlegm and whose symptoms were relieved meet the criteria for GOLD patients with stable COPD. Control group: healthy persons of age and sex matched with smoking history.3) The exclusion criteria:Confusing complications,such as tuberculosis or other lung diseases other than COPD; cancer;heart failure;metabolic syndrome;serious endocrine disorders;liver and kidney disease; other parts of the infection;coronary heart disease; diabetes mellitus; systemic autoimmune or connective tissue disease and recent surgery etc.2. The assessment of the subjects: Assessment of lung function:All subjects recieve pulmonary function testing and bronchial dilation test, detection of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1), accounted for measured values predicted according to the normal number expressed as a percentage of reference.3. Measurement of test indicators:(1) sample collection: to take fasting blood 6 ml of whole blood samples from subjects in each group and Infuse tube at 15℃~ 20℃with centrifuging 2500rpm(10 ~ 20min)and conservating in ependoff tube( - 70℃).(2) Use double antibody sandwich specimens of ABC-ELISA method for the determination of blood APN, TNF-α, IL-6, IL-8, IL-10; detected CRP by automatic biochemical analyzer.Analyse the parameters of each group with the SPSSl3.0 statistical software.compare group parameters with multivariate analysis of variance and difference between two groups with Dunnett t test. Analyse the correlation between parameters with linear correlation. Results:1. Serum levels of APN in three groupsAcute exacerbation of COPD group, COPD group and control group with stable serum APN concentration was: 6.28±0.86 ng / ml, 8.24±0.89 ng / ml, 8.33±0.81ng/ml, COPD with acute exacerbation of serum APN concentration was lower than Stable COPD group and control group.Thoughing statistical analysis, the difference was statistically significant (ANOVA, F= 99.39 P<0.05). Further line of three pairwise comparisons between the groups discloses serum APN of COPD with acute exacerbation and Stable COPD is lower than the control group (P<0.05). 2. Studied three groups of serum CRP levelsAcute exacerbation of COPD group, COPD group and control group with stable serum CRP concentrations were: 8.32±1.99m/L, 4.89±1.94mg/L, 0.52±0.31mg/L, COPD with acute exacerbation of serum CRP concentrations was higher than Stable COPD group and control group, Thoughing statistical analysis, the difference was statistically significant (ANOVA, F = 264.71 P<0.05). Further line of three pairwise comparisons between the show, COPD with acute exacerbation of higher serum CRP levels, statistical analysis, the difference was statistically significant (P<0.05). Stable COPD higher serum CRP levels, statistical analysis, the difference was statistically significant (P<0.05).3. Studied three groups of serum TNF-αlevelsAcute exacerbation of COPD group, COPD group and control group with stable serum concentrations of TNF-α, respectively: 27.77±7.21mg/L, 26.86±7.08mg/L, 7.52±3.94mg/L, COPD with acute exacerbation of serum levels of TNF-αand stable COPD were higher than the control group,Thoughing statistical analysis, the difference was statistically significant (ANOVA, F = 150.21 P<0.05). Further line of three pairwise comparisons between the show, COPD with acute exacerbation of TNF-αserum levels higher, statistical analysis, the difference was statistically significant (P<0.05). COPD in stable serum levels of TNF-αcontrol group, statistical analysis, the difference was statistically significant (P<0.05).4. Studied three groups of serum IL-6 levelsAcute exacerbation of COPD group, COPD group and control group with stable serum IL-6 concentrations were: 11.86±2.91mg / L, 7.24±0.89mg / L, 6.53±1.30mg / L, COPD with acute exacerbation of serum IL-6, stable COPD was higher than the control group, Thoughing statistical analysis, the difference was statistically significant (ANOVA, F =103.50 P<0.05). Further line of three pairwise comparisons between the show, COPD with acute exacerbation of serum IL-6 levels higher, statistical analysis, the difference was statistically significant (P<0.05). Stable COPD serum IL-6 levels higher, statistical analysis, the difference was statistically significant (P<0.05).5. Studied three groups of serum IL-8 levelsAcute exacerbation of COPD group, COPD group and control group with stable serum IL-6 concentrations were: 86.30±15.47mg/L, 42.69±9.42mg/L, 28.72±6.77mg/L, COPD with acute exacerbation of serum IL-8 and stable COPD were higher than the control group, Thoughing statistical analysis, the difference was statistically significant (ANOVA, F =325.61 P<0.05). Further line of three pairwise comparisons between the show, COPD with acute exacerbation of serum IL-8 levels higher, statistical analysis, the difference was statistically significant (P<0.05). COPD in stable serum levels of IL-8 higher, statistical analysis, the difference was statistically significant (P<0.05).6. Studied three groups of serum IL-10 levelsAcute exacerbation of COPD group, COPD group and control group with stable serum concentrations of IL-10 were: 41.51±7.95pg/L, 44.41±9.63pg/L, 54.53±10.92pg/L, COPD with acute exacerbation of serum IL-10 and stable COPD were higher than the control group, Thoughing statistical analysis, the difference was statistically significant (ANOVA, F =22.93 P<0.05). Further line of three pairwise comparisons between the show, COPD with acute exacerbation of serum IL-10 levels lower than the control group, statistical analysis, the difference was statistically significant (P<0.05). COPD in stable serum levels of IL-10 than the control group, statistical analysis, the difference was statistically significant (P <0.05).7. Studied three groups of FEV1/FVC levelsAcute exacerbation of COPD group, COPD group and control group with stable lung function testing in the FEV1/FVC values were 0.74±0.66,0.78±0.61,0.79±0.06, compared with three groups (P<0.05) was statistically significant; COPD Acute exacerbation group and the control group (P<0.05) was statistically significant; COPD in stable group and the control group (P> 0.05) was not significant.8. Correlation Analysis(1) Serum APN of COPD with acute exacerbation were negatively correlated with TNF-α, IL-6, IL-8 and CRP levels and positively correlated with IL-10 and FEV1/FVC, the related coefficient (r) were: -0.629 (P<0.01), - 0.381 (P<0.01), -0.375 (P<0.01), -0.383 (P<0.01), 0.549 (P<0.01 ), 0.106 (P= 0.49).(2) Serum APN of COPD with stable were negatively correlated with TNF-α, IL-6, IL-8 and CRP levels and positively correlated with IL-10 and FEV1/FVC, the related coefficient (r) were: -0.395 (P<0.01), - 0.294 (P<0.01), -0.411 (P<0.01), -0.329 (P<0.05) r = 0.024 (P= 0.87).(3) Serum APN of COPD with control were negatively correlated with TNF-α, IL-6, IL-8 and CRP levels and positively correlated with IL-10 and FEV1/FVC, the related coefficient (r) were: -0.315 (P<0.01), -0.324 (P<0.01), -0.630 (P<0.01), -0.299 (P<0.05) , r = 0.268 (P= 0.07).Conclusions:1.Serum concentrations of APN of patients with COPD reduce and acute exacerbation of COPD is more lower . 2.APN may be involved in the inflammatory mechanisms of COPD pathogenesis process.3.APN may play role in anti-inflammatory procession by inhibitting synthesis and releasing of TNF alpha, CRP, IL - 6, IL– 8 and promoting the generation of IL-10.