Öz
Amaç: Kronik
obstrüktif akciğer hastalığı (KOAH)'nda hava yolu inflamasyonu, biyobelirteçler
kullanılarak ölçülebilir. Bu çalışma, sistemik inflamasyonun biyobelirteçlerini
kullanarak KOAH'ın heterojenliğini araştırmak için yapılmıştır.
Gereç ve Yöntem: 19
KOAH'lı hastanın toraks bilgisayar tomografisi amfizem baskın ve kronik bronşit
baskın olmasına göre değerlendirildi ve kan biyobelirteçleriyle
karşılaştırıldı.
Bulgular: Çalışma
grubunun yaş ortalaması 72,1±8,0 yıldı. KOAH fenotipiyle kan biyobelirteçleri
arasında bir fark saptanmazken, amfizem baskın ile kronik bronşit arasında, toraks
anteroposterior (AP) ve transvers çap açısından istatistiksel olarak anlamlı
fark saptanmıştır. AP çap/transvers çap oranı ile TNF-alfa arasında pozitif
yönlü güçlü istatistiksel olarak anlamlı korelasyon saptandı.
Sonuç: Yaygın kronik
bronşitli hastalar ile yaygın pulmoner amfizemi olan hastalar arasında inflamatuar
biyobelirteçler açısından anlamlı fark bulunmaması, bu iki klinik ve
fonksiyonel fenotipin benzer inflamatuar bir paterne sahip olabileceğini
düşündürmüştür. Sonuç olarak, KOAH'ın fenotipik ayrımı ya da tedaviye yanıtın
değerlendirilmesi için biyobelirteçlerin kullanımına büyük bir ilgi vardır.
Sonuçlarımızın, daha büyük klinik çalışmaların planlanmasında fayda
sağlayacağını düşünüyoruz.
Anahtar Kelimeler
Kaynakça
- Referans 1) Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS, Mannino DM. Global burden ofCOPD: systematic review and meta-analysis.Eur Respir J 2006; 28: 523–532.
- Referans 2) American Thoracic Society. Standards for the diagnosis and care of patients withchronic obstructive pulmonary disease. Am J Respir Crit Care Med 1995; 152:s77–s121.
- Referans 3 )Chung KF, Adcock IM. Multifaceted mechanisms in COPD: inflammation, immunity,and tissue repair and destruction. Eur Respir J 2008; 31: 1334–1356.
- Referans 4) Burrows B, Fletcher CM, Heard BE, Jones NL, Wootliff JS. The emphysematous and bronchial types of chronic airways obstruction. A clinicopathological study of patients in Londonand Chicago. Lancet 1966;1:830e5.
- Referans 5) Snoeck-Stroband JB, Lapperre TS, Gosman MM, Boezen HM,Timens W, ten Hacken NH, et al Corticosteroids in Obstructive Lung Disease (GLUCOLD) Study Group. Chronic bronchitis sub-phenotype within COPD: inflammation in sputum and biopsies.Eur Respir J 2008;31:70e7.
- Referans 6) Rogers DF. The role of airway secretions in COPD: pathophysiology,epidemiology and pharmacotherapeutic options. COPD 2005;2:341e53.
- Referans 7) Miravitlles M. Cough and sputum production as risk factors for poor outcomes in patients with COPD. Respir Med 2011;105:1118e28.
- Referans 8) Kim V, Han MK, Vance GB, Make BJ, Newell JD, Hokanson JE. The chronic bronchitic phenotype of COPD: an analysis of the COPDGene study. Chest 2011;140:626e33.
- Referans 9) Agusti A, Calverley PM, Celli B, Coxson HO, Edwards LD, Lomas DA, et alEvaluation of COPD longitudinally to identify predictive surrogate endpoints (ECLIPSE) investigators. Characterisationof COPD heterogeneity in the ECLIPSE cohort. Respir Res 2010;10(11):122.
- Referans 10) Boschetto P, Miniati M, Miotto D, Braccioni F, De Rosa E, Bononi I, Papi A, Saetta M, FabbriLM, Mapp CE. Predominant emphysema phenotype in chronic obstructive pulmonarydisease patients. Eur Respir J 2003; 21: 450–454.
- Referans 11) Boschetto P, Quintavalle S, Zeni E, Leprotti S, Potena A, Ballerin L, Papi A, Palladini G,Luisetti M, Annovazzi L, Iadarola P, De RosaE, Fabbri LM, Mapp CE. Association betweenmarkers of emphysema and more severe chronic obstructive pulmonary disease.Thorax 2006; 61: 1037–1042.
- Referans 12) Balbi B, Majori M, Bertacco S.Inhaled corticosteroids in stable COPD patients. Do they have effects on cells and molecular mediators of airway inflammation? Chest 2000;117:1633–7.Referans 13) Llewellyn-Jones CG, Harris TA, Stockley RA. Effects of fluticasone propionate on sputum of patients with chronic bronchitis and emphysema. Am J Crit Care Med 1996;153:616–21.
- Referans 14) Miniati M, Filippi E, Falaschi F, Carrozzi L, Milne EN, Sostman HD, Pistolesi M. Radiologicevaluation of emphysema in patients with chronic obstructive pulmonary disease.Chest radiography versus high-resolution computed tomography. Am J Respir CritCare Med 1995; 151: 1359–1367.
- Referans 15) Milne ENC, Pistolesi M. Detecting and quantifying chronic bronchitis and emphysema;in Milne ENC, Pistolesi M (eds).Reading the Chest Radiograph. A Physiologic Approach.St Louis, Mosby, 1993, pp 267–310.
- Referans 16) Reid MB, Li YP. Tumor necrosis factor-alpha and muscle wasting:a cellular perspective. Respir Res 2001, 2(5):269-72.
Öz
Purpose: Airway inflammation in chronic obstructive pulmonary disease (COPD) can
be measured using biomarkers. This study was conducted to investigate the
heterogeneity of COPD using biomarkers of systemic inflammation.
Materials and Methods: Thirty-six patients with COPD had thoracic computer
tomography assessed as predominantly emphysematous and chronic bronchitis
predominance and compared with blood biomarkers.
Results: The mean age of the study group was 72,1±8,0 years. There was a
statistically significant difference between AP and transverse diameter between
emphysema predominant and chronic bronchitis. There was a positive
statistically significant correlation between thorax anteroposterior (AP)
diameter and transverse diameter ratio and TNF-alpha, while no difference was
found between COPD phenotype and blood biomarkers.
Conclusion: The absence of a significant difference in
inflammatory biomarkers between patients with diffuse chronic bronchitis and those
with diffuse pulmonary emphysema suggests that these two clinical and
functional phenotypes may have a similar inflammatory pattern. In conclusion,
there is great interest in the use of biomarkers for assessing phenotypic
discrimination or response to COPD. We think that our results will be
beneficial in planning larger clinical trials.
Anahtar Kelimeler
Kaynakça
- Referans 1) Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS, Mannino DM. Global burden ofCOPD: systematic review and meta-analysis.Eur Respir J 2006; 28: 523–532.
- Referans 2) American Thoracic Society. Standards for the diagnosis and care of patients withchronic obstructive pulmonary disease. Am J Respir Crit Care Med 1995; 152:s77–s121.
- Referans 3 )Chung KF, Adcock IM. Multifaceted mechanisms in COPD: inflammation, immunity,and tissue repair and destruction. Eur Respir J 2008; 31: 1334–1356.
- Referans 4) Burrows B, Fletcher CM, Heard BE, Jones NL, Wootliff JS. The emphysematous and bronchial types of chronic airways obstruction. A clinicopathological study of patients in Londonand Chicago. Lancet 1966;1:830e5.
- Referans 5) Snoeck-Stroband JB, Lapperre TS, Gosman MM, Boezen HM,Timens W, ten Hacken NH, et al Corticosteroids in Obstructive Lung Disease (GLUCOLD) Study Group. Chronic bronchitis sub-phenotype within COPD: inflammation in sputum and biopsies.Eur Respir J 2008;31:70e7.
- Referans 6) Rogers DF. The role of airway secretions in COPD: pathophysiology,epidemiology and pharmacotherapeutic options. COPD 2005;2:341e53.
- Referans 7) Miravitlles M. Cough and sputum production as risk factors for poor outcomes in patients with COPD. Respir Med 2011;105:1118e28.
- Referans 8) Kim V, Han MK, Vance GB, Make BJ, Newell JD, Hokanson JE. The chronic bronchitic phenotype of COPD: an analysis of the COPDGene study. Chest 2011;140:626e33.
- Referans 9) Agusti A, Calverley PM, Celli B, Coxson HO, Edwards LD, Lomas DA, et alEvaluation of COPD longitudinally to identify predictive surrogate endpoints (ECLIPSE) investigators. Characterisationof COPD heterogeneity in the ECLIPSE cohort. Respir Res 2010;10(11):122.
- Referans 10) Boschetto P, Miniati M, Miotto D, Braccioni F, De Rosa E, Bononi I, Papi A, Saetta M, FabbriLM, Mapp CE. Predominant emphysema phenotype in chronic obstructive pulmonarydisease patients. Eur Respir J 2003; 21: 450–454.
- Referans 11) Boschetto P, Quintavalle S, Zeni E, Leprotti S, Potena A, Ballerin L, Papi A, Palladini G,Luisetti M, Annovazzi L, Iadarola P, De RosaE, Fabbri LM, Mapp CE. Association betweenmarkers of emphysema and more severe chronic obstructive pulmonary disease.Thorax 2006; 61: 1037–1042.
- Referans 12) Balbi B, Majori M, Bertacco S.Inhaled corticosteroids in stable COPD patients. Do they have effects on cells and molecular mediators of airway inflammation? Chest 2000;117:1633–7.Referans 13) Llewellyn-Jones CG, Harris TA, Stockley RA. Effects of fluticasone propionate on sputum of patients with chronic bronchitis and emphysema. Am J Crit Care Med 1996;153:616–21.
- Referans 14) Miniati M, Filippi E, Falaschi F, Carrozzi L, Milne EN, Sostman HD, Pistolesi M. Radiologicevaluation of emphysema in patients with chronic obstructive pulmonary disease.Chest radiography versus high-resolution computed tomography. Am J Respir CritCare Med 1995; 151: 1359–1367.
- Referans 15) Milne ENC, Pistolesi M. Detecting and quantifying chronic bronchitis and emphysema;in Milne ENC, Pistolesi M (eds).Reading the Chest Radiograph. A Physiologic Approach.St Louis, Mosby, 1993, pp 267–310.
- Referans 16) Reid MB, Li YP. Tumor necrosis factor-alpha and muscle wasting:a cellular perspective. Respir Res 2001, 2(5):269-72.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | İç Hastalıkları |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 4 Mayıs 2020 |
| Gönderilme Tarihi | 8 Ekim 2018 |
| Yayımlandığı Sayı | Yıl 2020 |