Correlational Study Between Levels Of Serum IL-17, IL-8, CRP And BODE Index In The Patients With COPD

ObjectiveChronic obstructive pulmonary disease (COPD) is a disease state characte-rized by airflow limitation that is not fully reversible and often with a progressi-ve development.The disease is associated with an abnormal inflammatoryresponse of the lung to noxious particles or gases. However COPD also is asystemic disease with significant extrapulmonary effects confirmed by numer-ous studies recent years. Extrapulmonary effects make the treatment of COPDmore complicated and obviously influence the prognosis of the patients.How toevaluate the condition and prognosis of patients with COPD has become one ofthe important problems to which current respiratory medicine face.Currentassessment of COPD severity classification is based primarily on the level ofFEV1, and can not fully evaluate the patient’s condition and prognosis.BODEindex combines the body mass index (the body mass index, B),the degree ofairflow obstruction (the degree of airflow obstruction,O), dyspnea (dyspnea,D)and exercise capacity (exercise capacity index,E),was considered morecomprehensive evaluation of COPD patient’s condition and prognosis. Thepathogenesis of COPD is not clear but chronic inflammation is one of the majorpathogenesis of COPD. This study aimed to observe level characteristics ofserum interleukin (IL-17)17, IL-8and CRP in patients with stable COPD,and toanalyse the relation between the three kinds of serum inflammation cytokineslevels and BODE index, in addition to probe into the clinical significance ofevaluation of COPD disease severity and prognosis with the cytokines.Materials and MethodsA group of40stable COPD patients was selected from Respiratory medicine department,Dong’e county people’s hospital of Shandong provincefrom May2010to June2011, including29males and11females, age of from53to84years, average (68.45±8.68)years old, according with diagnostic criteria ofCOPD guideline revised in2007by the Chinese medical association. Controlgroup was40healthy persons from the hospital physical examination center,including26males and14females, age of58to82years, average (67.13±5.75)years old. All selected objects were collected peripheral blood whose serum keptby-40℃frozenafter centrifugation and separation. The serum concentrationsof IL-17, IL-8and CRP were measured by ELISA method together. The levelsof serum IL-17， IL-8and CRP were respectively compared with COPD andcontrol group, smokers and non-smokers in COPD group. Related indicators forthe assessment of BODE index including pulmonay ventilation test,6MWT,BMI and MMRC were performed routinely in COPD group.Correlation analysiswere executed between serum IL-17，IL-8,CRP level and BODE index includingits different variables in patients with COPD.All the data were made statisticsanalysis with SPSSl3.0software.The results were expressed by mean±standarddeviation(x s).According to condition, two sample t-test and Pearson corr-elation analysis were executed, with P＜0.05for differences with a statisticalsignificance.Results1.Level of serum IL-17was114.02±34.84pg/ml in COPD group and73.22±14.66pg/ml in control group(t=6.827, P＜0.001),which showed statisti-cally significant difference. Also level of serum IL-8examined was102.67±31.55pg/ml in the COPD group and35.36±5.04pg/ml in control grouprespectively(t=13.324,P＜0.001),which showed statistically significant differe-nces. Level of serum CRP was respectively4.52±0.59mg/l in COPD group and2.63±0.84mg/l in control group (t=11.594, P＜0.001), which showed statisti-cally significant differences.2.The serum IL-17Level of23smoking patients in the COPD group was117.38±39.62pg/ml and109.47±27.61pg/ml in the other17non-smoking pati-ents respectively. The data shows higher IL-17serum level of smoking patientsthan the non-smoking patients, but no statistical significance(t=0.705，P＞0.05).The serum IL-8level of smoking patients in the COPD group was106.44±33.18 pg/ml and was97.58±29.41pg/ml in the non-smoking patients. The data showsthat IL-8serum level is slightly higher in the smoking patients than in thenon-smoking patients, but no statistical significance between two gro-ups(t=0.875，P＞0.05). The serum CRP level(4.73±0.53mg/l) is significant hig-her in smoking petients than that(4.23±0.56mg/l) in non-smoking case(t=2.870，P＜0.05).3.The serum IL-17and IL-8in COPD group was positive correlationobviously（r=0.840， P＜0.001）.There was no significant correlation betweenIL-17and CRP（r=0.288， P＞0.05）.4. Significant positive correlation between serum IL-17level and BODEindex in COPD group（r=0.782， P＜0.001）, and significant negative betweenIL-17and FEV1%pred,6MWD (r=-0.361，P＜0.05；r=-0.621，P＜0.001), andsignificant positive between IL-17and MMRC（r=0.699， P＜0.001）,while nosignificant correlation between IL-17and BMI（r=-0.184， P＞0.05）.5. In COPD group, correlation between serum IL-8level and BODE indexappeared significant positive（r=0.924， P＜0.001）， and FEV1%pred,6MWD,BMI significant negative（r=-0.569，P＜0.001；r=-0.643，P＜0.001；r=-0.333，P＜0.05）, and MMRC significant positive（r=0.757， P＜0.001）.6. Correlation between serum CRP level and BODE index in COPD groupappeared significant positive（r=0.636，P＜0.001）, and FEV1%pred,6MWD wassignificant negative(r=-0.397， P＜0.05； r=-0.359， P＜0.05), and MMRC wassignificant positive（r=0.487，P＜0.01）, while it was no significant correlationwith BMI（r=-0.256， P＞0.05）.Conclusions1.IL-17,IL-8and CRP serum levels even in the stable stage of COPD stillremained at a high level compared to the healthy control group. It show thatcytokines involve in the disease development process of COPD.2. As Serum IL-17level was related to serum IL-8, It is guessed that IL-17participates in the inflammatory process through promoting the release of CXCchemokines especially IL-8.3.The production of CRP was more obvious in smoking COPD patients thanin non-smoking COPD patients compared with IL-17and IL-8release. The serum CRP level in smokers of COPD patients was higher than in non-smokers,with statistical significant difference.4.IL-17and CRP in patients with stable COPD all had significantcorrelation with the BODE index of which constitutes variables includingFEV1%pred,6WMD, MMRC whereas no correlation with BMI. The IL-8weresignificant correlation with BODE index all variables. It shows that the morelevels of serum IL-17,IL-8,CRP, the worse the patients’ disease severity andprognosis.5.Detection of serum IL-17，IL-8and CRP levels may be a valuable markersto estimate disease severity and prognosis in patients with stable COPD.