Immunodeficiency in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Xie, Sheling; Wang, Kaifei; Zhang, Wei; Xiao, Kun; Peng, Yan; Li, Yanqin; He, Wanxue; Zhang, Yuhan; Xie, Lixin

doi:10.1007/s10753-018-0830-7

Cited by 6 publications

(4 citation statements)

References 81 publications

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“…Several studies have found 25,26 that the increased number of T cells in the lungs and airways of patients with COPD correlated with disease severity, and the proportion of T cells in sputum was significantly increased during AECOPD compared to that in the stable phase. 27,28 Serum sIL-2R expression is increased with T-cell activation. Our study showed that the AECOPD patients with adverse outcomes who still smoked had a significantly higher serum concentration of sIL-2R than those patients with good outcomes, suggesting that cigarette smoke may promote the occurrence and development of COPD by activating T cells.…”

Section: Discussionmentioning

confidence: 99%

Increased Serum Soluble Interleukin-2 Receptor Associated with Severity of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Zhang¹,

Ren²,

Sun³

et al. 2021

COPD

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Background: This study aimed to reveal the correlation between serum soluble interleukin-2 receptor (sIL-2R) and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A total of 315 patients diagnosed with AECOPD between December 2017 and June 2020 were enrolled. The patients were divided into the good and adverse groups based on the outcomes. An adverse outcome in COPD exacerbation was defined by the presence of at least one of the following: (1) death from a respiratory cause during hospitalisation or within 1 month of follow-up; (2) intensive care unit admission; (3) invasive or non-invasive mechanical ventilation; and (4) COPD-related emergency visit or readmission within 1 month of follow-up. A good outcome was considered as the absence of all the aforementioned issues. The patients underwent lung function (spirometry) assessment, and clinical and inflammatory profiles were collected. Univariate and multivariate analyses were performed to identify the correlation between serum sIL-2R concentration and other variables related to adverse outcomes of AECOPD. The receiver operating characteristic curve was used to show the predictive ability of sIL-2R for adverse outcomes of AECOPD. Results: We enrolled 315 patients, of whom 161 and 154 had good and adverse outcomes, respectively. We demonstrated that patients with adverse outcomes of AECOPD had a higher concentration of serum sIL-2R than patients with good outcomes (p < 0.001). The increased serum sIL-2R was positively associated with mMRC scores (p < 0.001), GLOD grades (p < 0.001), frequent exacerbation (p < 0.001), and smoking (p < 0.001) in patients with AECOPD and negatively correlated with pulmonary function (p < 0.001). An elevated sIL-2R level was a predictor for the risk of adverse outcomes in AECOPD with a cut-off value of 860 U/mL. Conclusion: Increased serum sIL-2R concentration correlated with the risk of the adverse outcomes in AECOPD, indicating that it can be a predictive factor contributing to the diagnosis and assessment of adverse outcomes in patients with AECOPD.

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Section: Discussionmentioning

confidence: 99%

Increased Serum Soluble Interleukin-2 Receptor Associated with Severity of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Zhang¹,

Ren²,

Sun³

et al. 2021

COPD

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“…Increased severity and frequency of ECOPD could also be due to a relative immune dysfunction, as indicated by an increased number of functionally suppressive circulating cells and effector T-cell dysfunction [87]. Indeed, peripheral lymphocytes obtained from patients with ECOPD exhibit impaired responsiveness to bacterial antigens compared to those with stable COPD and healthy controls [88].…”

Section: Severe Exacerbations Of Copdmentioning

confidence: 99%

COPD, Pulmonary Fibrosis and ILAs in Aging Smokers: The Paradox of Striking Different Responses to the Major Risk Factors

Beghè

Cerri

Fabbri

et al. 2021

IJMS

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Aging and smoking are associated with the progressive development of three main pulmonary diseases: chronic obstructive pulmonary disease (COPD), interstitial lung abnormalities (ILAs), and idiopathic pulmonary fibrosis (IPF). All three manifest mainly after the age of 60 years, but with different natural histories and prevalence: COPD prevalence increases with age to >40%, ILA prevalence is 8%, and IPF, a rare disease, is 0.0005–0.002%. While COPD and ILAs may be associated with gradual progression and mortality, the natural history of IPF remains obscure, with a worse prognosis and life expectancy of 2–5 years from diagnosis. Acute exacerbations are significant events in both COPD and IPF, with a much worse prognosis in IPF. This perspective discusses the paradox of the striking pathological and pathophysiologic responses on the background of the same main risk factors, aging and smoking, suggesting two distinct pathophysiologic processes for COPD and ILAs on one side and IPF on the other side. Pathologically, COPD is characterized by small airways fibrosis and remodeling, with the destruction of the lung parenchyma. By contrast, IPF almost exclusively affects the lung parenchyma and interstitium. ILAs are a heterogenous group of diseases, a minority of which present with the alveolar and interstitial abnormalities of interstitial lung disease.

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“…Chronic obstructive pulmonary disease (COPD), a chronic airway inflammation, is characterized by a progressive and irreversible decline in lung function, and recurrent episodes of respiratory infection. Suppressed innate and adaptive immune responses to the respiratory pathogen are strongly associated with the acute exacerbation of COPD (AECOPD) and disease pathogenesis (18)(19)(20). Hence, we hypothesize that the presence of TTV might be related to the progression of COPD, and the TTV load may indicate the immune status of COPD patients.…”

Section: Introductionmentioning

confidence: 99%

Associations Between Sputum Torque Teno Virus Load and Lung Function and Disease Severity in Patients With Chronic Obstructive Pulmonary Disease

et al. 2021

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Purpose: Viral load of Torque Teno virus (TTV) is elevated in immunosuppressed patients. The weakened immune response is typical in chronic obstructive pulmonary disease (COPD) patients. However, the relationship between TTV and COPD is still unknown.Patients and Methods: We enrolled 91 patients admitted to hospitals with acute exacerbation of COPD (AECOPD) between January 2017 and August 2017 (ClinicalTrials.gov ID, NCT03236480). Sputum samples were gathered during hospitalization and the 120-day follow-up. TTV distribution and genogroups were assessed, and the associations between viral loads and clinical parameters were analyzed.Results: TTV DNA was detected in 95.6% of COPD patients, and the viral load was nearly invariable at the stable and exacerbation states. Most TTV DNA-positive patients carried four distinct genotypes. Sputum load of TTV was positively associated with RV/TLC (r = 0.378, p = 0.030), and negatively correlated with FEV1/pre and FEV1/FVC (r = −0.484, −0.432, p = 0.011, 0.024, respectively). Neutral correlation between the TTV DNA load and COPD assessment test (CAT) scores (r = 0.258, p = 0.018) was observed.Conclusion: Sputum loads of TTV DNA could be a novel indicator for lung function and disease severity assessment in COPD patients.

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Immunodeficiency in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Cited by 6 publications

References 81 publications

Increased Serum Soluble Interleukin-2 Receptor Associated with Severity of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Increased Serum Soluble Interleukin-2 Receptor Associated with Severity of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

COPD, Pulmonary Fibrosis and ILAs in Aging Smokers: The Paradox of Striking Different Responses to the Major Risk Factors

Associations Between Sputum Torque Teno Virus Load and Lung Function and Disease Severity in Patients With Chronic Obstructive Pulmonary Disease

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