The Examination Of T Lymphocytes And Cytokines In Patients With Chronic Obstructive Pulmonary Disease And Their Significance

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease. It characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles and gases. No obvious patho-physiological changes in early stage for patients existed. As the disease evolved, the slowly progressive development of airflow limitation and obstruction occurred. The enlargement of airspaces and destruction of alveolar walls reduced severely alveolar capillary, resulting in no blood flows and air changes for alveolar walls. The regression of lung function induced hypoxia, carbon dioxide retention. The hypoxemia and hypercapnia followed, affecting living quality of COPD patients, many of whom died of respiratory failure and chronic cor pulmonale. As a commonest disease, with high death rate, enormous burden of disease and escalating healthcare costs, COPD is becoming an important public health problem.It was shown after the further research that their lung inflammation would still exist even if the COPD patients stopped smoking. So, it is possibly the composite factor including inflammation that finally determines the progress of COPD. In addition to several cytokines, neutrophils, macrophages and T lymphocytes were involved in the inflammatory progress of COPD. Some doctors assume that COPD is an autoimmune disease.In the first part of this report, T lymphocytes and their subsets in peripheral blood of COPD patients were examined by using double immunofluorescence labeling and flow cytometry. The results showed that: compared with normal control subjects, (1) CD3+T lymphocytes and CD4~+T subsets in acute exacerbating COPD patients were decrease,CD8~+ T subsets was increase,with the ratio of CD4~+/ CD8~+ being decreased and inverted;(2) CD4~+CD45RA~+ subsets and CD4~+CD45RA~+/CD4~+CD45RO~+ were decrease, CD4~+CD45RO~+ subsets was increase; (3) CD8~+CD45RA~+ subsets, CD8~+CD45RO~+ subsets and CD8~+CD45RA~+/CD8~+CD45RO~+ were increase;(4) the autoimmune disease related CD4~+CD28~+ subsets was decrease. These results suggested that the dysfunction of cellular immunity existed in COPD patients.In the second part of this report, the inflammation related factors in peripheral blood of COPD patients were determined by using ELISA. The results showed that: (1) the concentration of IL-1β, IL-6, IL-8, IL-10, TNF-αand hs-CRP in acute exacerbating COPD patients was greatly increased compared with those paracmasis COPD patients and normal control subjects. The difference is of significance in statistics (P<0.05); (2) the concentration of anti- inflammatory cytokines IL-10 in acute exacerbating COPD patients was lower than not only the normal control subjects (P<0.05), but also the paracmasis COPD patients, suggesting that these inflammation associated factors were involved in the inflammatory progress of COPD.