| PrefaceChronic obstructive pulmonary disease ( COPD ) is a very common respiratory disease. It is a chronic inflammatory disease characterized by progressive, irreversible obstruction in the air way and usually develops into pulmonary heart disease in the late stage. The etiology and the pathogenesis of COPD are not completely clear by now, but a lot of studies have shown that endotoxin and some cytokines play a very important role in the development and progression of COPD. During the acute episode of COPD, the level of endotoxin, interleukin- 6 (IL - 6) , interleukin - 8 (IL - 8 ) and tumor necrosis factor alpha (TNF - ) in patients' plasma is markedly increased, but there is few report on the correlation of endotoxin with IL - 6, IL - 8 and TNF- a . Our study , by detecting the plasmatic level of endotoxin, IL -6, IL - 8 and TNF - , was to investigate the correlation of endotoxin with IL - 6, IL - 8 and TNF - in the plasma of COPD patients during acute episode and their role in the pathogenesis of COPD, and furthermore to provide suitable methods for treatment.Materials and Methods1. MaterialsAll the study objects were divided into two groups: COPD group and control group. COPD group consisted of 32 patients in acute episode who had been diagnosed definitely according to the criteria formulated by Chinese Medicine Association, and their average age is 58.9 11. 1. The control group was composed of 20 healthy volunteers who had no history of smoking and their average age is 53. 4 ?11.3.2. Methods(1) Collection of specimen; 5ml venous blood was aspirated in the morning when the patients were in fast. 3ml of the blood was placed in ordinary tubes. After centrifuged, the specimen was conserved under - 30 for later detection of IL - 6, IL - 8 and TNF -a. Another 2ml was placed in a heparin - anticoagulated sterilized tubes. After homogenized and centrifuged, the plasma was put into another sterilized tubes, being conserved under - 201 for later detection of endotoxin.(2) Detection of the cytokines automatic chemical fluorescent enzyme immune analysis instrument. (1)detecting the level of IL - 6 with indirect method. (2)detecting the level of IL - 8 and TNF - a with direct method.(3) Detection of the level of endotoxin with kinetic turbimetric Assay method.3. Statistical analysis: t test was performed and correlation analysis was performed through Excel software.Results1. Comparison of the level of endotoxin, IL -6, IL -8 and TNF - between COPD group and control group(1)The level of endotoxin in COPD group was significantly higher than that of control group.(2)The level of IL - 6 in COPD group was significantly higher than that of control group.(3)The level of IL - 8 in COPD group was significantly higher than that of control group.(4)The level of TNF - a in COPD group was significantly higher than that of control group.2. correlation analysis of the level of endotoxin with IL - 6, IL -8 and TNF - a in patients of acute episode(1)The level of endotoxin in the plasma of COPD patients was of no correlation with that of IL - 6. ( P > 0.05 )(2)The level of endotoxin in the plasma of COPD patients was of positive correlation with that ofIL-8. (P<0.01)(3)The level of endotoxin in the plasma of COPD patients was of positive correlation with that of TNF -a (P<0.01)DiscussionEndotoxin is a kind of polysaccharide lying in the cell membrane of bacteria. It is a pathogenic material of strong toxicity and may cause a series of pathophysiological changes in both animals and human beings. Cytokines are polypeptides produced and secreted by body cells. They could transmit complex molecular massage by combining with the specific receptors on the surface of immune cells so as to control themovement, multiplication, differentiation and the reactivity of immune cells. Among all the cytokines, IL - 6, IL - 8 and TNF - a are the main important inflammatory mediators, and they all take part in the endotoxic injury to the lung.
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