Inflammatory markers of oropharynx in the stable phase of chronic obstructive pulmonary disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

JIANG Sumei ^1,2 , MA Yuan ¹ , WANG Zhengxia ¹ ,  HUANG Mao ¹

1. Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P. R. China;
2. Emergency Department of Taizhou Hospital of Traditional Chinese Medicine, Taizhou, Jiangsu 225300, P. R. China;

Corresponding author：

HUANG Mao, Email: hm6114@163.com

Keywords：

Chronic obstructive pulmonary disease; inflammatory markers; inflammatory factors; smoking index; oropharynx

DOI：

10.7507/1671-6205.202204066

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective This study aims to investigate the changes of inflammatory markers of oropharynx and its correlation with prognosis in the stable phase of chronic obstructive pulmonary disease (COPD). Methods Sixty-two patients with COPD in stable stage were divided into smoking and non-smoking groups, and 31 healthy persons were selected as controls. The pharyngeal swabs were collected to determine tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), collagen type Ⅳ (COL-4), and fibronectin (FN) by an enzyme-linked immunosorbent assay. Meanwhile, eosinophil count and C-reactive protein (CRP) in peripheral blood were measured. The correlations between the above metrics and COPD and the prognosis of the patients were analyzed. Results TNF-α, IL-8, COL-4, FN and CRP levels in patients with COPD were significantly higher compared with control groups (P<0.05), and there were significant differences between smoking and non-smoking groups in inflammatory markers such as TNF-α, IL-8, FN, CRP (P<0.05). The forced expiratory volume in one second (FEV₁) and FEV₁%pred of patients with COPD were significantly lower than the control group (P<0.05). The smoking index of patients with COPD in smoking group was significantly higher than that in smoking control group (P<0.05). TNF- α and IL-8 were positively associated with blood CRP in patients with COPD. Conclusion The inflammatory markers of oropharynx in patients with COPD are different from those in healthy persons and smoking may promote the increase of inflammatory markers of oropharynx in patients with COPD; the non-invasive detection of paired pharyngeal inflammatory markers may be helpful in determining acute onset and prognosis.

Citation： JIANG Sumei, MA Yuan, WANG Zhengxia, HUANG Mao. Inflammatory markers of oropharynx in the stable phase of chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(7): 459-464. doi: 10.7507/1671-6205.202204066 Copy

1.	中华医学会呼吸病学分会慢性阻塞性肺疾病学组, 中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会. 慢性阻塞性肺疾病诊治指南(2021年修订版). 中华结核和呼吸杂志, 2021, 44(3): 170-205.
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4.	Yoshida M, Minagawa S, Araya J, et al. Involvement of cigarette smoke-induced epithelial cell ferroptosis in COPD pathogenesis. Nat Commun, 2019, 10(1): 3145.
5.	Golpe R, Martín-Robles I, Sanjuán-López P, et al. Differences in systemic inflammation between cigarette and biomass smoke-induced COPD. Int J Chron Obstruct Pulmon Dis, 2017, 12: 2639-2646.
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7.	Barnes PJ. Cellular and molecular mechanisms of chronic obstructive pulmonary disease. Clin Chest Med, 2014, 35(1): 71-86.
8.	Moutsopoulos NM, Konkel JE. Tissue-specific immunity at the oral mucosal barrier. Trends Immunol, 2018, 39(4): 276-287.
9.	Gallo O, Locatello LG, Mazzoni A, et al. The central role of the nasal microenvironment in the transmission, modulation, and clinical progression of SARS-CoV-2 infection. Mucosal Immunol, 2021, 14(2): 305-316.
10.	Yao Y, Zhou J, Diao X, et al. Association between tumor necrosis factor-α and chronic obstructive pulmonary disease: a systematic review and meta-analysis. Ther Adv Respir Dis, 2019, 13: 1753466619866096.
11.	Bradford E, Jacobson S, Varasteh J, et al. The value of blood cytokines and chemokines in assessing COPD. Respir Res, 2017, 18(1): 180.
12.	Kranenburg AR, Willems-Widyastuti A, Moori WJ, et al. Enhanced bronchial expression of extracellular matrix proteins in chronic obstructive pulmonary disease. Am J Clin Pathol, 2006, 126(5): 725-735.
13.	Muñoz-Esquerre M, Huertas D, Escobar I, et al. Gene and protein expression of fibronectin and tenascin-C in lung samples from COPD patients. Lung, 2015, 193(3): 335-343.
14.	Gan WQ, Man SFP, Senthilselvan A, et al. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax, 2004, 59(7): 574-580.
15.	Thomsen M, Ingebrigtsen TS, Marott JL, et al. Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease. JAMA, 2013, 309(22): 2353-2361.
16.	Dahl M, Vestbo J, Lange P, et al. C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2007, 175(3): 250-255.
17.	Benson VS, Hartl S, Barnes N, et al. Blood eosinophil counts in the general population and airways disease: a comprehensive review and meta-analysis. Eur Respir J, 2022, 59(1): 2004590.
18.	Lin XF, Fan YC, Wang XD, et al. Correlation between tumor necrosis factor-α and interleukin-1β in exhaled breath condensate and pulmonary function. Am J Med Sci, 2017, 354(4): 388-394.
19.	Câmara J, Jarai G. Epithelial-mesenchymal transition in primary human bronchial epithelial cells is Smad-dependent and enhanced by fibronectin and TNF-α. Fibrogenesis Tissue Repair, 2010, 3(1): 2.
20.	Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary. Am J Respir Crit Care Med, 2017, 195(5): 557-582.
21.	Allinson JP, Hardy R, Donaldson GC, et al. Combined impact of smoking and early-life exposures on adult lung function trajectories. Am J Respir Crit Care Med, 2017, 196(8): 1021-1030.
22.	Pezzuto A, Carico E. Effectiveness of smoking cessation in smokers with COPD and nocturnal oxygen desaturation: functional analysis. Clin Respir J, 2020, 14(1): 29-34.
23.	Ellerbeck EF, Nollen N, Hutcheson TD, et al. Effect of long-term nicotine replacement therapy vs standard smoking cessation for smokers with chronic lung disease: a randomized clinical trial. JAMA Netw Open, 2018, 1(5): e181843.
24.	Fukuhara A, Saito J, Sato S, et al. The association between risk of airflow limitation and serum uric acid measured at medical health check-ups. Int J Chron Obstruct Pulmon Dis, 2017, 12: 1213-1219.
25.	Fan YL, Xu WJ, Wang YY, et al. Association of occupational dust exposure with combined chronic obstructive pulmonary disease and pneumoconiosis: a cross-sectional study in China. BMJ Open, 2020, 10(9): e038874.

1. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组, 中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会. 慢性阻塞性肺疾病诊治指南(2021年修订版). 中华结核和呼吸杂志, 2021, 44(3): 170-205.
2. WHO. Mortality and global health estimates [EB/OL]. 2020-11-21. Available from: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates.
3. Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease. Lancet, 2012, 379(9823): 1341-1351.
4. Yoshida M, Minagawa S, Araya J, et al. Involvement of cigarette smoke-induced epithelial cell ferroptosis in COPD pathogenesis. Nat Commun, 2019, 10(1): 3145.
5. Golpe R, Martín-Robles I, Sanjuán-López P, et al. Differences in systemic inflammation between cigarette and biomass smoke-induced COPD. Int J Chron Obstruct Pulmon Dis, 2017, 12: 2639-2646.
6. 贾心予, 吴桢珍, 吉宁飞, 等. 慢性阻塞性肺疾病急性加重期生物标志物的研究进展. 中国呼吸与危重监护杂志, 2020, 19(3): 299-303.
7. Barnes PJ. Cellular and molecular mechanisms of chronic obstructive pulmonary disease. Clin Chest Med, 2014, 35(1): 71-86.
8. Moutsopoulos NM, Konkel JE. Tissue-specific immunity at the oral mucosal barrier. Trends Immunol, 2018, 39(4): 276-287.
9. Gallo O, Locatello LG, Mazzoni A, et al. The central role of the nasal microenvironment in the transmission, modulation, and clinical progression of SARS-CoV-2 infection. Mucosal Immunol, 2021, 14(2): 305-316.
10. Yao Y, Zhou J, Diao X, et al. Association between tumor necrosis factor-α and chronic obstructive pulmonary disease: a systematic review and meta-analysis. Ther Adv Respir Dis, 2019, 13: 1753466619866096.
11. Bradford E, Jacobson S, Varasteh J, et al. The value of blood cytokines and chemokines in assessing COPD. Respir Res, 2017, 18(1): 180.
12. Kranenburg AR, Willems-Widyastuti A, Moori WJ, et al. Enhanced bronchial expression of extracellular matrix proteins in chronic obstructive pulmonary disease. Am J Clin Pathol, 2006, 126(5): 725-735.
13. Muñoz-Esquerre M, Huertas D, Escobar I, et al. Gene and protein expression of fibronectin and tenascin-C in lung samples from COPD patients. Lung, 2015, 193(3): 335-343.
14. Gan WQ, Man SFP, Senthilselvan A, et al. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax, 2004, 59(7): 574-580.
15. Thomsen M, Ingebrigtsen TS, Marott JL, et al. Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease. JAMA, 2013, 309(22): 2353-2361.
16. Dahl M, Vestbo J, Lange P, et al. C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2007, 175(3): 250-255.
17. Benson VS, Hartl S, Barnes N, et al. Blood eosinophil counts in the general population and airways disease: a comprehensive review and meta-analysis. Eur Respir J, 2022, 59(1): 2004590.
18. Lin XF, Fan YC, Wang XD, et al. Correlation between tumor necrosis factor-α and interleukin-1β in exhaled breath condensate and pulmonary function. Am J Med Sci, 2017, 354(4): 388-394.
19. Câmara J, Jarai G. Epithelial-mesenchymal transition in primary human bronchial epithelial cells is Smad-dependent and enhanced by fibronectin and TNF-α. Fibrogenesis Tissue Repair, 2010, 3(1): 2.
20. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary. Am J Respir Crit Care Med, 2017, 195(5): 557-582.
21. Allinson JP, Hardy R, Donaldson GC, et al. Combined impact of smoking and early-life exposures on adult lung function trajectories. Am J Respir Crit Care Med, 2017, 196(8): 1021-1030.
22. Pezzuto A, Carico E. Effectiveness of smoking cessation in smokers with COPD and nocturnal oxygen desaturation: functional analysis. Clin Respir J, 2020, 14(1): 29-34.
23. Ellerbeck EF, Nollen N, Hutcheson TD, et al. Effect of long-term nicotine replacement therapy vs standard smoking cessation for smokers with chronic lung disease: a randomized clinical trial. JAMA Netw Open, 2018, 1(5): e181843.
24. Fukuhara A, Saito J, Sato S, et al. The association between risk of airflow limitation and serum uric acid measured at medical health check-ups. Int J Chron Obstruct Pulmon Dis, 2017, 12: 1213-1219.
25. Fan YL, Xu WJ, Wang YY, et al. Association of occupational dust exposure with combined chronic obstructive pulmonary disease and pneumoconiosis: a cross-sectional study in China. BMJ Open, 2020, 10(9): e038874.

Chinese Journal of Respiratory and Critical Care Medicine

Inflammatory markers of oropharynx in the stable phase of chronic obstructive pulmonary disease

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