Markers of eosinophilic and neutrophilic inflammation of respiratory tract in patients with non-allergic bronchial asthma and chronic obstructive pulmonary disease
E.Yu. Trushina, E.M. Kostina
Penza Institute for Advanced Medical Education – Branch Campus of the Russian Medical Academy of Continuous Professional Education, Penza, Russia, Penza, Russia
Background. Bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) are heterogeneous diseases with different underlying pathogenetic mechanisms due to different types of respiratory tract inflammation, and therefore, different responses to therapy. The evaluation of the types of respiratory tract inflammation, the isolation of markers of eosinophilic and neutrophilic inflammation will provide a differentiated approach to the diagnosis and treatment of these pathologies.
Objective. Determination of the markers of types of respiratory tract inflammation in patients with non-allergic bronchial asthma (NABA) and COPD.
Methods. 99 patients were examined. They were divided into 2 groups: group 1 (n=49) – patients with NABA, group 2 (n=50) – patients with COPD. The cellular composition of induced sputum (IS) and blood, blood eosinophilic cationic protein (ECP), and neutrophil elastase (NE) levels were determined. Parameters are presented as median (Me) and quartiles (Q25; Q75%). Multivariate analysis to identify significant factors and ROC analysis were used. The results were considered statistically significant at p value <0.05.
Results. A significantly high neutrophil level in IS was determined in patients with NABA (73%) and COPD (78%) in comparison with healthy individuals (p<0.05). A high eosinophil level in IS (more than 3%) was detected only in 12 (24.48%) patients with NABA and in 5 (10%) patients with COPD. A significantly increased blood neutrophil level, both in percentage and in absolute count, was revealed in patients with NABA (67% and 5.30×109/L, respectively) and with COPD (72% and 7.30×109/L, respectively) compared with the control group (p<0.05). A high blood eosinophil level the (more than 3%) was observed in 10 (20.40%) patients with NABA and in 8 (16%) patients with COPD. High ECP values were found in 14 (28.57%) patients with NABA and in 6 (12%) patients with COPD. A high level of NE was found in 34 (69.38%) patients with NABA and in 41 (82%) patients with COPD. Significantly high NE level was observed in patients with NABA (150 ng/ml) and COPD (175 ng/ml) compared with the control group (80 ng/ml) (p<0.05). Threshold value for ECP was 19.92 ng/ml and higher, for eosinophils in IS – 3.50% and higher, for NE – 135 ng/ml and higher, for the absolute neutrophil count – 5.38×109/L and higher.
Conclusion. Markers of eosinophilic inflammation in patients with NABA and COPD were ECP and eosinophils in IS, markers of neutrophilic inflammation in patients with NABA and COPD - NE and the absolute neutrophil count.
About the Autors
Corresponding author: Elena Yu. Trushina, Cand. Sci. (Med.), Teaching Assistant at the Department of Pulmonology and Phthisiology, Penza Institute for Advanced Medical Education – Branch Campus of the RMACPE, Penza, Russia; email@example.com
Address: 8A Stasova St., Penza 440060, Russian Federation