Chest
Volume 112, Issue 2, August 1997, Pages 505-510
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Airway Inflammation in COPD Assessed by Sputum Levels of lnterleukin-8*

https://doi.org/10.1378/chest.112.2.505Get rights and content

Study objective

To assess the characteristics of airway inflammation in patients with COPD.

Methods

We measured the sputum concentration of interleukin-8 (IL-8), a chemokine involved in the migration and activation of neutrophils and eosinophils. We also measured myeloperoxidase (MPO) as a parameter of neutrophil activity and eosinophil cationic protein (ECP) as a parameter of eosinophil activity. Spontaneous sputum samples were obtained from 33 patients with stable COPD and 30 patients with asthma. Induced sputum samples were obtained from 12 normal control subjects.

Results

The sputum concentration of IL-8 was significantly higher in the patients with COPD than in the patients with asthma or in the control subjects (p<0.0001). Concentrations of MPO and ECP were significantly higher in the patients with COPD than in the control subjects but did not differ significantly between the patients with COPD and those with asthma. In the patients with COPD, the sputum concentration of IL-8 was significantly correlated with the concentration of MPO (r=0.55, p<0.001) and of ECP (r=0.53, p<0.01). The sputum concentration of IL-8 was negatively correlated with FEV1/FVC (r=—0.78, p<0.0001) in the COPD group.

Conclusions

Results suggest the activation of both neutrophils and eosinophils in the airways of patients with COPD. It appears that IL-8 plays a primary role in this activation. The sputum concentration of IL-8 appeared to be closely associated with the degree of airflow obstruction in patients with COPD and may serve as a marker in evaluating the severity of airway inflammation, which is a risk factor for COPD.

Section snippets

Subjects

The subjects consisted of 33 patients with COPD and 30 with asthma seen at the outpatient clinic of Nara Medical University Hospital, and 12 normal volunteers. Their characteristics are listed in Table 1. Informed consent was obtained from all subjects, and the study was approved by the ethics committee of our university. The criteria for diagnosis of COPD or asthma were based on the standards of the American Thoracic Society.10 In the patients with COPD, their FEV1 was <80% of predicted

Concentration of IL-8 in Sputum Supernatant

The sputum concentration of IL-8 was significantly higher in the group with COPD than in the group with asthma or in the normal control group. The group with asthma had a significantly higher IL-8 concentration in sputum than the normal control group (COPD: 21.0±1.8 ng/mL [range, 2.8 to 35.2 ng/mL; median, 21.4 ng/mL]; asthma: 8.7±1.4 ng/mL [range, 0.8 to 27.8 ng/mL; median, 5.7 ng/mL]; control: 3.3±0.7 ng/mL [range, 0.8 to 7.2 ng/mL; median, 2.4 ng/mL]; Fig 1).

Concentration of MPO in Sputum Supernatant

The sputum concentration of MPO

Discussion

Airway inflammation, a cardinal pathophysiologic feature in patients with asthma and also COPD,14 is usually evaluated using specimens obtained by bronchial lavage or bronchial biopsy. However, these methods are invasive and difficult to perform repeatedly or to use in patients with severe conditions. More recently, studies have been performed using sputum induced by the inhalation of hypertonic saline solution.15, 16 Although this method appears to be useful, it is not physiologic and its

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