| Objective:Chronic obstructive pulmonary disease(COPD)is a group of chronic airway inflammatory diseases mainly characterized by the increase of inflammatory cells such as neutrophils,macrophages and T lymphocytes.The pathogenesis may be related to airway inflammation and oxidative stress.The high prevalence and mortality rates of COPD impose a heavy economic burden on our society,especially when COPD becomes acute,hospitalization is often required.Therefore,it is of great significance to find a simple and easy biomarker for diagnosis and evaluation of COPD patients.In this study,the serum IL-23 and IL-27 of patients with COPD were studied,and the correlation between IL-23 and IL-27 and inflammatory indicators such as total white blood cell count(WBC),neutrophil percentage(NEU%),and hypersensitive C-reactive protein(hs-CRP)was analyzed,aiming to explore the role of IL-23 and IL-27 in the pathogenesis of COPD and provide a new way for the prevention and treatment of COPD.Methods:A total of 45 patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)hospitalized in the Department of Respiratory and Critical Care Medicine of the Affiliated Hospital of North Sichuan Medical College from January 2020 to January 2021 were selected as the acute exacerbation group,including 36 males and 9 females,with an average age of(72.69±8.77)years.And according to the severity of AECOPD patients were divided into mild,medium,heavy three groups,including mild group of 17 cases(male 12 cases,women in 5 cases,mean age(77.29±4.37)years),moderate group of 16 cases(15 males and 1 female,average age(73.88±8.19)years),severe group of 12 cases(male 9 cases,3 cases of women,average age(64.58±9.06)years.A total of 34 patients with COPD at stable stage were assigned to the stable stage group,including 24 males and 10 females,with an average age of(72.88±8.00)years.Thirty-eight people without other respiratory diseases were selected as the control group,including 24 males and 14 females,with an average age of(69.37±5.23)years.Twenty-seven patients with AECOPD were treated with anti-infection,antispasmolysis and antiasthmatic treatment,anticough and expectorant treatment,and oxygen inhalation for 1-2 weeks before and after treatment.Among them,there were 24 males and 3 females,with an average age of(69.59±9.67)years.The blood samples of the above subjects were collected,separated and transferred into EP tubes and stored in a refrigerator at-80℃.Serum levels of IL-23 and IL-27 in each group were measured by double-antibody sandwich enzyme linked immunosorbent assay(ELISA),and the correlation between IL-23 and IL-27 and inflammatory indexes such as WBC,NEU%and hs-CRP was analyzed.Result:(1)A total of 45 patients in the acute exacerbation group were enrolled in this study,including 36 males(80%)and 9 females.The average age was(72.69±8.77)years.In the stable phase group,there were 34 patients,including 24 males(70.6%)and 10 females(29.4%),with an average age of(72.88±8.00)years.In the control group,there were 38 patients,including 24 males(63.2%)and 14 females(36.8%),with an average age of(69.37±5.23)years.There was no significant difference in age and sex among all groups(P>0.05).(2)Serum IL-23 levels in acute exacerbation group,stable phase group and control group(1047.13±251.25pg/ml,758.42±117.87pg/ml,600.71 ±53.80pg/ml);IL-27 levels(67.69 ± 14.57pg/ml,47.82±5.74pg/ml,27.63 ±8.75pg/ml);hs-CRP levels were 12.75(3.22,24.67)mg/L,2.34(1.01,6.59)mg/L,2.17(1.11,3.15)mg/L;WBC level 6.70(4.88,11.09)×109/L,5.41(4.55,6.17)×109/L,6.35(4.91,8.15)×109/L;NEU%levels were(75.09±12.24)%,(67.52±7.91)%,(56.14±4.79)%.The levels of serum IL-23,IL-27,WBC,NEU%and hs-CRP in acute exacerbation group were higher than those in stable phase group,with statistical significance(P<0.05).The levels of serum IL-23,IL-27,NEU%and hs-CRP in acute exacerbation group were higher than those in control group,with statistical significance(P<0.05).There was no significant difference in WBC level between acute exacerbation group and control group(P>0.05).The levels of serum IL-23,IL-27 and NEU%in stable phase group were higher than those in control group,and the difference was statistically significant(P<0.05).There were no significant differences in serum hs-CRP and WBC levels between the stable phase group and the control group(P>0.05).(3)The levels of IL-23,IL-27,WBC,NEU%and hs-CRP in AECOPD mild group were 876.86±64.22pg/ml,52.91± 3.97pg/ml,(7.51±3.43)×109/L,(79.89 ± 7.50)%,18.26(11.66,33.50)mg/L;IL-23,IL-27,WBC,NEU%and hs-CRP levels in the moderate group were 1029.74±234.63pg/ml,72.92±6.92pg/ml,(9.05±4.26)×109/L,(71.59±17.06)%,4.61(2.84,22.66)mg/L.The levels of IL-23,IL-27,WBC,NEU%and hs-CRP in the severe group were 1311.55±223.41pg/ml,81.67 ± 13.05pg/ml,(8.19±4.14)×109/L,(72.98 ± 7.94)%,6.83(2.37,14.25)mg/L.Serum IL-23 and IL-27 levels in severe AECOPD group were higher than those in moderate group,and the difference was statistically significant(P<0.05).There were no significant differences in WBC,NEU%and hs-CRP levels between severe AECOPD group and moderate AECOPD group(P>0.05).Serum IL-23 and IL-27 in severe AECOPD group were higher than those in mild group,and the difference was statistically significant(P<0.05).NEU%and hs-CRP levels in severe AECOPD group were significantly different from those in mild AECOPD group(P<0.05).There was no significant difference in WBC level between severe AECOPD group and mild AECOPD group(P>0.05).Serum IL-23 and IL-27 levels in moderate AECOPD group were higher than those in mild AECOPD group,and the difference was statistically significant(P<0.05).The level of hs-CRP in moderate AECOPD group was significantly different from that in mild AECOPD group(P<0.05).There was no significant difference in WBC and NEU%between moderate AECOPD group and mild AECOPD group(P>0.05).(4)The levels of serum IL-23,IL-27,WBC,NEU%and hs-CRP in AECOPD group before treatment were 1165.96±258.62pg/ml,77.31±10.39pg/ml,(8.73±4.22)×109/L,(71.91±13.89)%,4.78(2.50,16.33)mg/L;After treatment,the levels of serum IL-23,IL-27,WBC,NEU%and hs-CRP were 832.54±82.68pg/ml,56.19±10.25pg/ml,(7.16±1.85)×109/L,(65.52±6.08)%and 2.61(0.84,3.79)mg/L.The levels of serum IL-23,IL-27,hs-CRP and NEU%in the group before AECOPD treatment were higher than those in the group after treatment,and the difference was statistically significant(P<0.05).The level of WBC in the group before AECOPD treatment was higher than that in the group after treatment,but the difference was not statistically significant(P>0.05).(5)There was a positive correlation between serum IL-23 and IL-27 levels in acute exacerbation group(r=0.548,P<0.05).There was no significant correlation between serum IL-23,IL-27 levels and hs-CRP,WBC and NEU%in acute exacerbation group(P>0.05).There was no significant correlation between serum IL-23 and IL-27 levels in stable phase group(P>0.05).There was no significant correlation between serum IL-23 and IL-27 levels and WBC,NEU%and hs-CRP in stable phase group(P>0.05).Conclusion:(1)Serum IL-23 and IL-27 levels were the highest in the acute exacerbation group,followed by the stable phase group and the lowest in the control group,suggesting that IL-23 and IL-27 may be involved in the process of COPD airway inflammation,and COPD airway inflammation continues to exist.(2)Serum IL-23 and IL-27 levels decreased after treatment,suggesting that IL-23 and IL-27 can be used as biomarkers to evaluate the clinical efficacy of COPD.(3)Serum IL-23 and IL-27 levels were the highest in the severe AECOPD group,followed by the moderate group and the lowest in the mild group,suggesting that IL-23 and IL-27 may be related to the severity of COPD.(4)Serum IL-23 and IL-27 levels were positively correlated in the AECOPD group,suggesting that IL-23 and IL-27 may jointly promote the occurrence of inflammation in COPD,providing a direction for the early diagnosis of AECOPD. |
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