Mixed Th2 and non-Th2 inflammatory pattern in the asthma-COPD overlap: a network approach
Por:
de Llano LP, Cosío BG, Iglesias A, de Las Cuevas N, Soler-Cataluña JJ, Izquierdo JL, López-Campos JL, Calero C, Plaza V, Miravitlles M, Torrego A, Martinez-Moragon E, Soriano JB, Viña AL and Bobolea I
Publicada:
1 ene 2018
Ahead of Print:
12 feb 2018
Resumen:
Introduction: The asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is a clinical condition that combines features of those two diseases, and that is difficult to define due to the lack of understanding of the underlying mechanisms. Determining systemic mediators may help clarify the nature of inflammation in patients with ACO.
Objectives: We aimed at investigating the role and interaction of common markers of systemic inflammation (IL-6, IL-8, and tumor necrosis factor-alpha), Th2-related markers (periostin, IL-5, and IL-13), and IL-17 in asthma, COPD, and ACO.
Methods: This is a cross-sectional study of patients aged >= 40 years with a post-bronchodilator forced expiratory volume in the first second/forced vital capacity < 0.70 recruited from out-patient clinics in tertiary hospitals with a clinical diagnosis of asthma, COPD, or ACO. ACO was defined by a history of smoking > 10 pack-years in a patient with a previous diagnosis of asthma or by the presence of eosinophilia in a patient with a previous diagnosis of COPD. Clinical, functional, and inflammatory parameters were compared between categories using discriminant and network analysis.
Results: In total, 109 ACO, 89 COPD, and 94 asthma patients were included. Serum levels (median [interquartile range]) of IL-5 were higher in asthma patients than in COPD patients (2.09 [0.61-3.57] vs 1.11 [0.12-2.42] pg/mL, respectively; p=0.03), and IL-8 levels (median [interquartile range]) were higher in COPD patients than in asthma patients (9.45 [6.61-13.12] vs 7.03 [4.69-10.44] pg/mL, respectively; p < 0.001). Their values in ACO were intermediate between those in asthma and in COPD. Principal component and network analysis showed a mixed inflammatory pattern in ACO in between asthma and COPD. IL-13 was the most connected node in the network, with different weights among the three conditions.
Conclusion: Asthma and COPD are two different inflammatory conditions that may overlap in some patients, leading to a mixed inflammatory pattern. IL-13 could be central to the regulation of inflammation in these conditions.
Filiaciones:
de Llano LP:
Department of Respiratory Medicine, Hospital Lucus Augusti, Lugo, Spain
Cosío BG:
Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Spain
CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
Iglesias A:
CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
de Las Cuevas N:
Department of Allergy, Hospital 12 de Octubre, Madrid, Spain
:
CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
Department of Respiratory Medicine, Hospital Arnau de Vilanova, Valencia, Spain
Izquierdo JL:
Department of Respiratory Medicine, Hospital Universitario de Guadalajara, Guadalajara, Spain
López-Campos JL:
CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
Department of Respiratory Medicine, Hospital Virgen del Rocío, Sevilla, Spain
Calero C:
Department of Respiratory Medicine, Hospital Virgen del Rocío, Sevilla, Spain
Plaza V:
CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
Department of Respiratory Medicine, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
Institut d'Investigació Biomédica Sant Pau, IIB Sant Pau, Barcelona, Spain
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
Miravitlles M:
CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
Department of Respiratory Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Torrego A:
Department of Respiratory Medicine, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
Institut d'Investigació Biomédica Sant Pau, IIB Sant Pau, Barcelona, Spain
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
:
Department of Respiratory Medicine, Hospital Dr Peset, Valencia, Spain
Soriano JB:
Instituto de Investigación Hospital de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
Viña AL:
Department of Respiratory Medicine, Hospital Puerta de Hierro, Madrid, Spain
Bobolea I:
Servei de Pneumologia i Alergia, Hospital Clinic, Barcelona, Spain
Green Submitted, Green Published, gold
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