| Objective:Chronic obstructive pulmonary disease(COPD)is a progressive and irreversible chronic airway inflammatory disease characterized by chronic inflammation of the airway and pulmonary parenchyma and incomplete reversible airflow limitation,which is often caused by smoking and exposure to a variety of harmful gases or particles.The high morbidity and mortality of COPD not only seriously affect the physical and mental health and quality of life of patients,but also bring serious burden to society and economy.Its potential pathogenesis is not completely clear.At present,it is recognized that there are inflammatory reaction,protease/antiprotease system imbalance,oxidative stress and so on,in which inflammatory reaction runs through the disease.Previous studies have considered that neutrophil inflammation and Th1/Th2 immune imbalance are the main inflammatory mechanisms.In recent years,it has been found that IL-17 and IL-22 secreted by Th17 cells,a new type of helper T lymphocytes independent of Th1 cells and Th2 cells,may also be involved in the occurrence and development of COPD.Through the detection of the concentration of IL-17 and IL-22 in the serum of patients with chronic obstructive pulmonary disease,the purpose of this study was to study the correlation between the expression level of IL-17 and IL-22 in serum and COPD and the effect on the progression of the disease,in order to explore the role of IL-17 and IL-22 in the pathogenesis of COPD and provide a possible new method for the prevention and treatment of COPD.Methods:Atotal of105patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)hospitalized in the Department of Respiratory and critical Care Medicine,Affiliated Hospital of North Sichuan Medical College from January to October 2021 were selected,including 63 males and 42 females,with an average age of(71.37±8.42)years.Patients with AECOPD were divided into mild,moderate and severe groups according to the severity of the disease.There were 35 patients with mild AECOPD,including 21 males and 14 females,with an average age of(71.89±8.25)years.There were3 5 patients with moderate AECOPD,including 20 males and 15 females,with an average age of(70.63±7.88)years.There were 35 patients with severe AECOPD,including 22 males and 13 females,with an average age of(71.60±9.27)years.40 patients with stable chronic obstructive pulmonary disease(COPD)from the Department of Respiratory and Critical Care Medicine of the Affiliated Hospital of North Sichuan Medical College were divided into stable COPD group(SCOPD),including 25 males and 15 females,with an average age of(68.55±7.02)years.38 healthy adults who were examined in the health management center of our hospital were selected as the healthy control group,including 23 males and 15 females,with an average age of(69.47±7.17)years.All theabove selected COPD patients were subjected to extremely detailed medical history collection and physical examination,and detailed clinical data were recorded.At the same time,the age and hemoglobin of healthy persons were collected.Fasting peripheral blood samples were collected from all the above-mentioned subjects,and the separated serum was transferred into EP tubes and stored in-80℃refrigerator.The plasma concentrations of IL-17 and IL-22 in each group weredetermined by double antibody sandwichenzyme-linked immunosorbent assay(ELISA).Result:(1)105 patients in AECOPD group were included in this study,including 63 males and 42 females,with an average age of(71.37±8.42)years and an average hemoglobin of(123.32±12.86)g/L;There were40 patients in the SCOPD group,including 25 males and 15 females,with an average age of(68.55±7.02)years and an average hemoglobin of(122.23±12.26)g/L.There were38 healthy subjects in the control group,including 23 males and 15 females,with an average age of(69.47±7.17)years and an average hemoglobin of(124.47±9.37)g/L.There was no significant difference in sex ratio among the three groups by chi-square test(χ2=0.076,P=0.963>0.05),and there was no significant difference in age among the three groups by F test(F=2.156,P=0.119>0.05).There was no statistical significance in the comparison of Hb indexes among the three groups by F test of variance(F=0.337,P=0.714>0.05).(2)The levels of serum IL-17 and IL-22 were(191.29±80.81)pg/ml and(227.47±81.48)pg/ml in AECOPD group,(151.55±32.83)pg/ml and(176.21±44.04)pg/ml in SCOPD group,(124.36±34.26)pg/ml and(109.80±21.08)pg/ml in Jiankang control group.The levels of serum IL-17 and IL-22 in AECOPD group were significantly higher than those in SCOPD group(P<0.05).The levels of IL-17 and IL-22 in SCOPD group were significantly higher than those in healthy control group(P<0.05).and the levels of IL-17 and IL-22 in serum in AECOPD group were significantly higher than those in healthy control group(P<0.05).(3)The levels of IL-17 and IL-22 were(140.07±25.24)pg/ml and(145.41±26.48)pg/ml in mild AECOPD group,(162.22±19.43)pg/ml and(211.32±28.86)pg/ml in moderate group,(271.58±93.57)pg/ml and(325.68±40.56)pg/ml in severe group.The serum levels of IL-17 and IL-22 in the severe AECOPD group were significantly higher than those in the moderate AECOPD group(P<0.05).The serum IL-17 and IL-22 levels in the severe AECOPD group were significantly higher than those in the mild AECOPD group(P<0.05).The serum IL-17 and IL-22 levels in the moderate AECOPD group were significantly higher than those in the mild AECOPD group(P<0.05).(4)The correlation analysis of serum IL-17 and IL-22 levels in AECOPD group showed a strong positive correlation,and the correlation was statistically significant(r=0.874,P<0.05).(5)The correlation analysis of serum IL-17 and IL-22 levels in SCOPD group showed a strong positive correlation,and the correlation was statistically significant(r=0.426,P<0.05).Conclusion:(1)Theexpression levels of serum IL-17 and IL-22 in acute exacerbation and stable stage were higher than those in healthy controls,suggesting that IL-17 and IL-22 may be involved in the pathogenesis of COPD,and COPD had persistent airway inflammation.(2)The levels of serum IL-17 and IL-22 were the highest in the severe AECOPD group,followed by the moderate group,and the lowest in the mild group,suggesting that IL-17 and IL-22 may be related to the severity of COPD.(3)The expression levels of serum IL-17 and IL-22 were positively correlated in both AECOPD group and SCOPD group,suggesting that IL-17 and IL-22 may play a synergistic role in the pathogenesis of COPD.(4)IL-17 and IL-22 are two important cytokines of Th17 type cells.The expression of IL-17 and IL-22 in serum of patients with AECOPD and SCOPD was increased,suggesting that Th17 type cells may be involved in the pathogenesis of COPD. |
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