Study On The Relationship Between IL-17 And The Phenotype Of Pulmonary Emphysema In Chronic Obstructive Pulmonary Disease

Objective:To study the relationship between interleukin 17(IL-17)and the phenotype of emphysema in chronic obstructive pulmonary disease(COPD),analyze the correlation between IL-17 and the degree of airflow limitation,dyspnea and the number of hospitalizations per year,and explore the correlation between IL-17 and the occurrence and severity of emphysema.Methods:Collected on June 2018 to December 2018 in the second affiliated hospital of kunming medical university hospitalized with respiratory medicine ward three frequent exacerbations of 24 patients with AECOPD,frequent exacerbations after treatment in patients with COPD in clinical alleviate the 32 cases,basic conditions for the healthy control group 22 cases,matching the detection level of IL-17,analyze differences in the levels of IL-17 between three groups;Patients with COPD underwent 16-slice spiral CT examination,emphysema volume and LAA%(Proportion of pulmonary emphysema volume to total lung volume in patients with CT value below a given threshold(-950HU)),and LAA%or more than 15%were assessed as emphysema.Patients with COPD in clinical remission stage were divided into two groups:COPD emphysema phenotype group(LAA%or more than 15%)and non-emphysema phenotype group(LAA%or less than 15%).The frequency of frequent acute exacerbation and dyspnea index(mMRC)were collected,and the lung function related indexes(FEV1,FEV1%Pred)and IL-17 were measured.The levels of IL-17 between the two groups were analyzed.The levels of IL-17,FEV1,FEV1%Pred,frequent acute exacerbation times and mMRC were analyzed.In the phenotype group of emphysema,the severity of emphysema was classified as grade 1 group(15%?LAA%<25%)and grade 2-3 group(25%?LAA%).The correlation between IL-17 and emphysema volume,LAA,FEV1,FEV1%Pred was analyzed.Results:1.There was no significant difference in sex and age between AECOPD group,COPD remission group and normal control group(P>0.05);the expression of IL-17 in AECOPD group and COPD group(remission period)was higher than that in normal control group(P<0.01);there was no significant difference in the expression of IL-17 between AECOPD group and COPD group(P>0.05).2.L-17 was significantly higher in COPD pulmonary emphysema phenotype group(223.45±74.03)than in non-pulmonary emphysema phenotype group(128.79±144.58),the difference was statistically significant(P<0.01).FEV1 and FEV1%Pred in non-emphysema phenotype group of COPD in remission stage(1.74±1.75?59.15±68.67)were higher than those in emphysema phenotype group(0.81±0.60?29.58±25.00),the difference was statistically significant(P<0.05).The number of acute exacerbations in the remission phase of COPD emphysema group(3±3)was higher than that in the non-emphysema phenotype group(4±1),the difference was statistically significant(P<0.05).There was no significant difference between emphysema phenotype and non-emphysema phenotype of COPD in remission stage of mMRC(P>0.05).3.The expression level of IL-1 7 in COPD patients with pulmonary emphysema in grade 2-3 group(290.32±84.04)was higher than that in Grade 1 group(212.83±66.40),the difference was statistically significant(P<0.05).4.IL-17,LAA%and emphysema volume had statistical significance(P<0.05),there was a positive correlation(r=0.726;0.674).FEV1,LAA%and emphysema volume had statistical significance(P<0.05),there was a negative correlation(r=-0.670;-0.669).FEV1%had statistical significance with LAA%and emphysema volume(P<0.05),there was a negative correlation(r=-0.599;-0.601).5.IL-17 and FEV1 had statistical significance(P<0.05),there was a negative correlation(r=-0.519).IL-17 and FEV1%Pred had statistical significance(P<0.05),there was a negative correlation(r=-0.472).Conclusions:1.The expression level of IL-17 was correlated with the severity of emphysema,and the degree of emphysema was gradually aggravated with the increase of IL-17 level,IL-17 is related to the occurrence and development of COPD emphysema..2.LAA%was correlated with FEV1 and FEV1%Pred,indicating that the degree of airflow restriction in COPD patients was correlated with the severity of emphysema.