Discussion On The Relationship Between Dendritic Cells And Chronic Obstructive Pulmonary Disease

Objective: To explore the characteristics, distributions and significances of Dendritic Cells(DCs) in the patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD), we detected the levels of DCs and its subsets in peripheral blood of patients with AECOPD and the healthy people. By comparing with the levels and changes of DCs and its subsets of two groups, to explore the roles of DCs on launching and participating in Chronic Obstructive Pulmonary Disease and deeperly understand the relationships between the content of DCs and the pathogenesis of COPD.Methods: There were 34 patients with AECOPD in the respiratory medicine department as experimental group and 15 cases of healthy subjects with healthy physical examination in the medical center as control group. They were all from Affiliated Hospital of Jining Medical College in March-August 2014. According to the Global Initiative for Chronic Obstructive Lung Disease(GOLD), the experimental group was divided into three subgroups: group I(GOLDI level); Group II(GOLDII level); Group III(GOLDIII-level IV).Using flow cytometry with four-color fluorescent analysis to detect the dendritic cells(mDCs and pDCs) levels of such subjects in the peripheral blood and comparing the levels of DCs in the COPD group and healthy controls group and in every subgroup of COPD group; Using spirometry to evaluate the lung function of all patients and make classification with these AECOPD patients according to the results of the pulmonary function test; Testing routine blood, blood sedimentation(ESR), C-reactive protein(CRP) and other detections, etc on all subjects.Results: The levels of dendritic cells in peripheral blood in patients with acute exacerbation of Chronic Obstructive Pulmonary Disease were significantly higher than that of healthy controls. Compared with the control group, the levels of mDCs and pDCs in AECOPD groups with GOLDI, GOLDII, GOLDIII and Class IV were significantly higher(P<0.05) than the control group, and with the severity of lung function in AECOPD patients, the levels of DCs were also increased(P <0.05). In addition, by detecting the levels of other systemic inflammation indexes such as the number of white blood cells, lymphocytes and monocytes in proportion, blood sedimentation and C-reactive protein etc, the levels of above indexes were higher in patients with COPD than that in healthy controls.Conclusion: We successfully applied four color fluorescence flow cytometry analysis to test the levels of dendritic cells and its subtype in the peripheral blood level of subjects in this study, and found that the contents of dendritic cells varied directly as the percentage of mononuclear cells in the peripheral blood. This study found that the levels of dendritic cells significantly increased in peripheral blood of patients with AECOPD of smoking cessation and associated with the severity of the disease obviously. Simultaneously, the disproportionality of DCs subsets and dysmaturity would aggravate the severity of COPD. This was further evidence that DCs may be involved in the pathogenesis of COPD, and starting and participating in the immune reaction process as currently known antigen presenting cells with the strongest function to activate the initiative of T leukomonocyte only. This research provides some effective reference indicators for evaluating and controlling the severity of COPD. The study also provides new directions and targets for immune therapy to patients with refractory COPD.