Detection of respiratory viruses and expression of inflammatory cytokines in patients with acute exacerbation chronic obstructive pulmonary disease in Mongolia China

Abstract

Chronic obstructive pulmonary disease (COPD) was estimated to be the third cause of global mortality by 2020. Acute exacerbation COPD (AECOPD) is a sudden worsening of COPD symptoms and could be due to virus/bacterial infections and air pollution. Increased expression of inflammatory markers in patients with AECOPD is associated with viral infection. This study aimed to detect different viruses and analyze the expression of various inflammatory markers associated with AECOPD patients. Three hundred and forty-seven patients diagnosed with COPD according to GOLD criteria were included in this study. Swab samples and blood were collected for the detection of viruses by RT-PCR and expression of inflammatory markers, respectively. Of the swab samples, 113 (32.6%) of samples were positive for virus detection. Of these, HRV (39.8%) was the predominant virus detected followed by FluB (27.4%) and FluA (22.1%). The presence of HRV was significantly higher (p=0.044) among the other detected viruses. When compared to healthy controls the expression levels of TNF-α, IL-6 and IL-8 were significantly higher (p<0.05) in virus-positive patients. The IL-6 and IL-8 were the next predominantly expressed in markers among the samples. The higher expression rate of IL-8 was significantly (p<0.05) associated with patients having COPD GOLD III severity level and smoking history. Although HRV was the predominant virus detected the combined prevalence of Influenza A and B surpassing the rate of HRV. The high-level expression of well known inflammatory markers of AECOPD, TNF-α, IL-6 and IL-8 indicates a chronic severe illness. These markers play an important role and could be used as a marker for determining the severity of AECOPD.

Anti-inflammatory effects of medications used for viral infection-induced respiratory diseases

“…1 ). Furthermore, sputum and serum levels of IL-8 and TNF-α and serum IL-6 levels were elevated during an influenza virus infection-induced COPD exacerbation [ 66 , 67 ].…”

“…RV infection-induced cytokines, such as IL-5, IL-13, IL-25, and IL-33, were associated with persistent and severe asthma [ 78 ], and the serum levels of eosinophil cationic protein (ECP), IL-5, IL-6, and IP-10 were elevated in RV-infected children with wheezing [ 79 , 80 ]. Furthermore, sputum IL-1β, IL-5, IL-13, IL-25, and IL-33 levels, serum IL-6, IL-8, TNF-α, and IP-10 levels, plasma fibrinogen levels and the number of peripheral blood eosinophils were elevated in patients with RV infection-exacerbated COPD [ 19 , 20 , 67 , 81 ].…”