Expression And Correlation Analysis Of MiR-146a/b In Serum Of Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective Chronic obstructive pulmonary disease（COPD）is a lung disease characterized by almost irreversible airflow obstruction and invasive disease progression.Although COPD is diagnosed by comprehensive analysis of pulmonary function tests and clinical symptoms,chronic obstructive pulmonary disease is often overtreated in the elderly.The purpose of this study was to study the expression of mi R-146a/b in serum of patients with chronic obstructive pulmonary disease（COPD）and its relationship with inflammatory index,GOLD stage and pulmonary function index,and to explore the diagnostic value of mi R-146a/b in COPD.Methods From January 2020 to November 2020,90 patients with acute exacerbation,90 patients with stable COPD and 90 healthy medical examiners whose age and sex were consistent with all COPD patients（AECOPD and stable COPD）were selected from Chaohu Hospital affiliated to Anhui Medical University.According to the standard GOLD guidelines for chronic obstructive pneumonia in 2020,acute recombination was divided into 6 cases of GOLD2,69 cases of GOLD3 and 15 cases of GOLD4.The stable stage group was divided into GOLD2 group（n = 21）,GOLD3 grade（n = 66）and GOLD4 grade（n = 3）.The venous blood was drawn into the test tube at fasting time in the early morning,and the expression of hypersensitive C-reactive protein（hs-CRP）was measured by immune scattering turbidimetry,procalcitonin（PCT）was measured by enzyme-linked immunosorbent assay（PCT）,hemoglobin sedimentation rate（ESR）was measured by Wechsler method,and pulmonary function was measured by expiratory volume within one second（FEV1）.Expiratory volume / forced vital capacity（FEV1/FVC）and peak inspiratory air flow（PEF）within one second.The expression level of mi R-146a/b in peripheral serum was measured by fluorescence quantitative PCR（q PCR）.All participants were approved in writing,and the study report was approved by the Ethics Committee of Anhui Medical University and Chaohu Hospital.Data analysis and comparison of inflammation indicators among the three groups（hs-CRP,PCT.The difference of relative expression of ESR）,pulmonary function（FEV1,FEV1/FVC,PEF）and mi R-146a/b,the relationship between the relative expression of mi R146a/b and GOLD grade in acute exacerbation and stable stage,and the correlation between the level of mi R-146a/b and inflammatory index and pulmonary function index.Results The relative expression of mi R-146a/b in serum of the acute exacerbation group was lower than that of the stable group and the control group,but there was no significant difference between the stable group and the control group,but the expression levels of PCT,CRP and ESR in the acute exacerbation group were higher than those in the stable stage and the control group,and those in the stable group were higher than those in the control group.The predicted values of FEV1,FEV1 and FEV1/FVC in the acute exacerbation group were lower than those in the stable stage and the control group,and those in the stable group were lower than those in the control group（P < 0.001）.There was significant difference in the relative expression of mi R-146a/b among different GOLD grades in the acute exacerbation group（P < 0.001）.In the acute exacerbation group,the relative expression of mi R-146 a in serum was negatively correlated with PCT,CRP and ESR（r = 0.324,-0.479,-0.326,P < 0.479）,and positively correlated with FEV1,FEV1 and FEV1/FVC（r = 0.471,0.410,0.435 P < 0.05）.In the acute exacerbation group,the relative expression of mi R-146 b was negatively correlated with PCT,CRP and ESR（r = 0.329,-0.486,-0.331,P < 0.05）,and positively correlated with the predicted values of FEV1,FEV1 and FEV1/FVC（r = 0.477,0.418,0.441）.In stable phase group,the relative expression of mi R-146 a was negatively correlated with PCT,CRP and ESR（r = 0.400,-0.412,-0.409,P < 0.05）,and positively correlated with FEV1,FEV1 and FEV1/FVC（r = 0.409,0.374,0.379,respectively）.In stable COPD group,the relative expression of mi R-146 b was negatively correlated with PCT,CRP and ESR（r = 0.405,-0.415,-0.412,P < 0.05）,and positively correlated with FEV1,FEV1 and FEV1/FVC（r = 0.413,0.380,0.377 P < 0.05）.Conclusion The low expression of mi R-146 a and mi R-146 b in serum of patients with acute exacerbation of chronic obstructive pulmonary disease showed a negative correlation with the level of inflammatory markers and GOLD stage,and a positive correlation with pulmonary function indexes,which may become important biomolecule markers for the diagnosis of AECOPD.