Markers of Systemic Inflammation in Smoker and Non-Smoker Chronic Obstructive Pulmonary Diseases: Systemic Inflammation in Smokers and Non-Smokers

Snehanshu Debabrata Malla; Amit Kumar Verma; Shiva Narang; Mohit Mehndiratta; Edelbert Anthonio Almeida

doi:10.54393/pjhs.v5i11.1957

Authors

Snehanshu Debabrata Malla Department of Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
Amit Kumar Verma Department of Respiratory Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
Shiva Narang Department of Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
Mohit Mehndiratta Department of Biochemistry, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
Edelbert Anthonio Almeida Department of Biochemistry, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India

DOI:

https://doi.org/10.54393/pjhs.v5i11.1957

Keywords:

Obstructive Pulmonary Disease, Inflammatory Markers, Erythrocyte Sedimentation Rate, C-Reactive Protein, Fibrinogen, Interleukin

Abstract

Non-smoker and tobacco smoker also have different inflammatory and proteolytic effects in the lung in experimental studies. Objectives: To compare the clinical, investigational profile and inflammatory markers e.g. ESR, CRP, Fibrinogen, IL-5 and IL-6 between smoker and non-smoker COPD patients.2. To compare the CAT score, mMRC score and various spirometry parameters between smoker and non-smoker COPD patients3. To calculate the diagnostic performance, sensitivity and specificity of inflammatory markers e.g. ESR, CRP, Fibrinogen, IL-5 and IL-6 between smoker and non-smoker COPD patients. Methods: In this cross-sectional study 80 subjects between age group of 40 to 65 years participated. This study included category A, B and C patients of COPD included and category D of COPD patients were excluded and those who were exposed to occupational exposure to smoke. Serum levels of inflammatory markers including ESR, CRP, IL-5, IL-6, and Fibrinogen measured. Results: This study showed that there was statistically significant difference in ESR, CRP and fibrinogen levels between smoker and non-smoker COPD. There was also significant statistical difference between smoker and non-smoker COPD with respect to gender, old TB, haemoglobin, and the spirometry parameters. Conclusions: Therefore, this phenotypical categorization of patients with COPD may result in better understanding of the varied pathophysiology and help as screening tool for diagnosis of non-smoker COPD patients. ESR, CRP and fibrinogen may be used as a screening tool between smoker and non-smoker COPD patients, for a focused approach to treatment.

References

Agusti A and Vogelmeier CF. GOLD 2024: a brief overview of key changes. Jornal Brasileiro de Pneumologia. 2023 Dec; 49(6): e20230369. doi: 10.36416/1806-3756/e20230369.

KF R. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. GOLD executive summary. American Journal of Respiratory and Critical Care Medicine. 2007 Sep; 176: 532-55. doi: 10.1164/rccm.200703-456SO.

Celli B, Fabbri L, Criner G, Martinez FJ, Mannino D, Vogelmeier C et al. Definition and nomenclature of chronic obstructive pulmonary disease: time for its revision. American Journal of Respiratory and Critical Care Medicine. 2022 Dec; 206(11): 1317-25. doi: 10.1164/rccm.202204-0671PP.

Halpin DM, Celli BR, Criner GJ, Frith P, Varela MV, Salvi S et al. It is time for the world to take COPD seriously: a statement from the GOLD board of directors. European Respiratory Journal. 2019 Jul; 54(1). doi: 10.1183/13993003.00914-2019.

Agustí A, Celli BR, Criner GJ, Halpin D, Anzueto A, Barnes P et al. Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary. American Journal of Respiratory and Critical Care Medicine. 2023 Apr; 207(7): 819-37. doi: 10.1164/rccm.202301-0106PP.

Sandhaus RA, Turino G, Brantly ML, Campos M, Cross CE, Goodman K et al. The diagnosis and management of alpha-1 antitrypsin deficiency in the adult. Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation. 2016 Jun; 3(3): 668. doi: 10.15326/jcopdf.3.3.2015.0182.

Antunes MA, Lopes-Pacheco M, Rocco PR. Oxidative Stress‐Derived Mitochondrial Dysfunction in Chronic Obstructive Pulmonary Disease: A Concise Review. Oxidative Medicine and Cellular Longevity. 2021 Mar; 2021(1): 6644002. doi: 10.1155/2021/6644002.

Porto BN and Stein RT. Neutrophil extracellular traps in pulmonary diseases: too much of a good thing?. Frontiers in Immunology. 2016 Aug; 7: 311. doi: 10.3389/fimmu.2016.00311.

Block H, Zarbock A. A fragile balance: does neutrophil extracellular trap formation drive pulmonary disease progression?. Cells. 2021 Jul; 10(8): 1932. doi: 10.3390/cells10081932.

Rincon M and Irvin CG. Role of IL-6 in asthma and other inflammatory pulmonary diseases. International Journal of Biological Sciences. 2012 Oct; 8(9): 1281. doi: 10.7150/ijbs.4874.

Golpe R, Martín-Robles I, Sanjuán-López P, Pérez-de-Llano L, González-Juanatey C, López-Campos JL et al. Differences in systemic inflammation between cigarette and biomass smoke-induced COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2017 Sep: 2639-46. doi: 10.2147/COPD.S141068.

Hlapčić I, Belamarić D, Bosnar M, Kifer D, Vukić Dugac A, Rumora L. Combination of systemic inflammatory biomarkers in assessment of chronic obstructive pulmonary disease: Diagnostic performance and identification of networks and clusters. Diagnostics. 2020 Nov; 10(12): 1029. doi: 10.3390/diagnostics10121029.

Yun JH, Lamb A, Chase R, Singh D, Parker MM, Saferali A et al. Blood eosinophil count thresholds and exacerbations in patients with chronic obstructive pulmonary disease. Journal of Allergy and Clinical Immunology. 2018 Jun; 141(6): 2037-47. doi: 10.1016/j.jaci.2018.04.010.

Hussein FG, Mohammed RS, Khattab RA, Al-Sharawy LA. Serum interleukin-6 in chronic obstructive pulmonary disease patients and its relation to severity and acute exacerbation. The Egyptian Journal of Bronchology. 2022 Dec; 16(1): 10. doi: 10.1186/s43168-022-00115-z.

Garth J, Barnes JW, Krick S. Targeting cytokines as evolving treatment strategies in chronic inflammatory airway diseases. International Journal of Molecular Sciences. 2018 Oct; 19(11): 3402. doi: 10.3390/ijms19113402.

Pandey AK, Verma AK, Singh A, Kant S, Chaudhary SC, Bajpai J et al. The severity of non-smoking chronic obstructive pulmonary disease is correlated with biomass fuel exposure and COPD assessment test score. Lung India. 2024 Jul; 41(4): 251-8. doi: 10.4103/lungindia.lungindia_304_23.

Yazici O, Gulen ST, Yenisey C, Eryilmaz U, Abas BI, Polatli M. Comparison of inflammation biomarkers among chronic obstructive pulmonary disease groups: a cross sectional study. Nigerian Journal of Clinical Practice. 2020 Jun; 23(6): 817-24. doi: 10.4103/njcp.njcp_222_19.

Salvi SS, Brashier BB, Londhe J, Pyasi K, Vincent V, Kajale SS et al. Phenotypic comparison between smoking and non-smoking chronic obstructive pulmonary disease. Respiratory Research. 2020 Dec; 21: 1-2. doi: 10.1186/s12931-020-1310-9.

Wei J, Xiong XF, Lin YH, Zheng BX, Cheng DY. Association between serum interleukin-6 concentrations and chronic obstructive pulmonary disease: a systematic review and meta-analysis. PeerJ. 2015 Aug; 3: e1199. doi: 10.7717/peerj.1199.

Narendra DK and Hanania NA. Targeting IL-5 in COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2019 May: 1045-51. doi: 10.2147/COPD.S155306.