Clinical Significance Of SCD14 In Serum Of Patients With Chronic Obstructive Pulmonary Disease

Objectives:Chronic obstructive pulmonary disease(COPD)is a common and frequently occurring disease of the respiratory system.It is characterized by persistent respiratory symptoms and restricted airflow,often resulting from respiratory tract and/or alveolar abnormalities caused by the inhalation of large amounts of toxic particles or gases.One of its important pathogenesis is chronic inflammation.Soluble CD14(sCD14)is considered as a marker of immune activation,which is involved in the immune regulatory response under inflammatory stimulation and stimulates the release of many inflammatory factors,including tumor necrosis factor-a(TNF-a)and interleukin-6(IL-6).The purpose of this study was to evaluate the changes in serum sCD14 levels in the acute exacerbations of COPD group,COPD stable group and healthy control group,and its correlation with PCT,CRP,WBC and NEUT.To evaluate the correlation between serum sCD14 level and CAT score,mMRC,FEV1 percentage of predicted value(FEV%pred),and FEV1/FVC in COPD stable group.To evaluate the correlation between sCD14 level and the number of acute exacerbations in the stable and acute exacerbations groups.To seek new indicators that can reflect the inflammatory status of COPD patients and predict acute exacerbation.Methods:1.A total of178 subjects were recruited from January 2019 to June 2019,including 63 healthy control subjects,59 COPD stable subjects,56 acute exacerbation subjects.The subjects were from 8 hospitals:qilu hospital of shandong university,shandong rongjun general hospital,shandong chest hospital,jinan fifth people’ s hospital,the pingyin county people’ s hospital,the pingyin county hospital of traditional Chinese medicine,jiyang district people’ s hospital,weifang hospital of traditional Chinese medicine.2.5ml whole blood samples of all subjects were collected,and the samples were centrifuged and frozen at-80 C in a refrigerator.Finally,the concentration of sCD14 in all serum samples was measured by elisa.3.Test data normality,the differences level of serum sCD14 was tested by Nonparametric rank sum test.Spearman correlation analysis methods to analyze each serum sCD14 levels with various clinical indicators including WBC,NEUT,PCT and CRP,analysis of STABLE group of sCD14 levels with FEV1/FVC,FEVl%pred,CAT scores,mMRC correlation,and more,the STABLE group and AE group were further divided into frequent acute aggravation phenotype group and infrequent acute aggravation phenotype group,and statistical difference in sCD14 level between the two groups was analyzed.Results:1、The serum levels of sCD14(median,interquartile spacing)of COPD acute exacerbations group(AE group),COPD stable group(STABLE group)and healthy control group(NORMAL group),respective-ly(2169.0,2313.75),(971.0,1330.0),(739.0,880.0),the unit for the ng/ml.The concentration of sCD14 significant differences between the three groups(P<0.001),The concentration of sCD14 significant differences between AE group and STABLE group(P<0.001),there was also significant differences between the AE group and the NORMAL group(P<0.001),and there was no significant difference in the STABLE group and the NORMAL group(P=0.0965).The total number of WBC,the number of NEUT of the three groups with(mean±standard deviation),unit(X 109/L).The total number of WBC levels respectively(7.36±0.356,5.52±0.181,5.73±0.134),NEUT level respectively(4.55± 0.314,2.91 ±0.114,3.32±0.068),they were significant differences among the three groups(P<0.001).PCT(unit ug/L)in the three groups were(mean± standard deviation):(0.115±0.014,0.0638±0.0084,0.0691 ±0.0036),and(P<0.001).CRP(unit mg/L)in the three groups were expressed as(mean±standard deviation),which were(25.64±4.84,5.78±0.66,5.74±0.47),and(P<0.001).2、Serum sCD14 level with AE group was positively correlated with CRP(P=0.016),WBC(P=0.040)and NEUT(P=0.047),with correlation coeffi-cients of 0.320,0.275 and 0.267 respectively.The sCD14 level was not correlated with PCT(P=0.057),with correlation coefficients of 0.256.3、Serum sCD14 level of patients in STABLE group was positively correlated with CRP(P=0.049),WBC(P=0.034),NEUT(P=0.043)and CAT score(P=0.043),with correlation coefficients of 0.257,0.277,0.265 and 0.265.There was negatively correlated with FEV1/FVC,and the correlation coefficient is-0.257(P=0.0496).There was no correlation with PCT,mMRC,FEVl%pred.Correlation coeficients were 0.224(P=0.088),0.244(P=0.062),-0.177(P=0.180),4、In NORMAL group,serum sCD14 level was positively correlated with NEUT(P=0.035),correlation coeficient was 0.266,which was not correlated with WBC(P=0.087),CRP(P=0.052),PCT(P=0.092),correlation coefficient was0.217,0.269and 0.230.5、The serum sCD14 level(2845.58+1805.96ng/ml)of patients with frequent acute exacerbations in the AE group was higher than that of patients with infrequent acute exacerbations(1835.64±963.95ng/ml),with statis-tically significant difference(P=0.0394).The serum sCD14 level(1457.54±923.33ng/ml)of patients with frequent acute exacerbations in STABLE group was higher than that of patients with infrequent acute exacerbations(989.83±779.50ng/ml),showing a statistical difference(P=0.0398).Conclusion:Serum sCD14 concentration was increased in COPD patients and more significantly in AECOPD patients.Serum sCD14 level in COPD patients was correlated with CRP,WBC,NEUT and the number of acute exacerbations.Serum sCD14 concentration in COPD stable period group was correlated with CAT score、FEV1/FVC,which could be used as a potential inflammatory marker for COPD and the risk of acute exacerbations.