Study On The Sputum And Serum IL-19,IL-20 Levels In Patients With Chronic Obstructive Pulmonary Disease

Objective The aim of the study was to investigate IL-19,IL-20 levels in the sputum and serum of patients with chronic obstructive pulmonary disease (COPD) , to explore the role of these mediators in the development of airway inflammation and association to parameters of lung function.Methods 30 patients with COPD , and 20 normal controls were enrolled in the study. The study was performed after informed consent was obtained from the participants. The participants` lung functions were measured by spirometry. peripheral blood samples were taken at both attack and stable stage of the disease, and serum was separated . Sputum induction was carried out according to the method reported by Pin[1] . The concentrations of sputum IL-19,IL-20 and serum IL-19,IL-20 were measured according to manufacture's instruction by ELISA ki. The concentrations of serum CRP were measured by transmissive heterometric titration.Result(1) The IL-8 level in serum of COPD group(including attack and stable stage)were higher than that of the control group(P=0.034; P=0.041). The IL-8 level in exacerbation stage of COPD (AECOPD) was significantly higher than in the stable stage(P=0.032). In induced sputum , the level of IL-8 of COPD group were also significantly higher than that of the control(sP=0.00; P=0.00),and the IL-8 level of AECOPD was higher than of the stable stage (P=0.025). The IL-8 level in induced sputum was significantly higher than that in the serum for COPD group( P<0.01). The level of IL-8 in induced sputum and serum of AECOPD were positively correlated with that of NE (r=0.627, r=0.68; respectively P<0.01). The IL-8 in induced sputum and serum were inversely correlated with FEV1.0%Pred,FEV1.0/FVC in AECOPD( P<0.01).(2) The IL-10 in serum of COPD group were higher than in the control group(P=0.021; P=0.046), but there was no significant difference of the IL-10 between the stable stage and the control group (P>0.05); IL-10 levels in induced sputum of COPD group was higher than that in the control group(P=0.038; P=0.046). There was no significant difference of the IL-10 between the stable stage and the control group (P>0.05). The level of IL-10 in induced sputum of AECOPD was higher than the level of IL-10 in serum(P<0.05). IL-10 levels was positively correlated to TNF-Αlevels in serum of AECOPD (r=0.471, P=0.009). The level of IL-10 both in sputum and serum of AECOPD were positively correlated with FEV1.0%Pred,FEV1.0/FVC in AECOPD(r=0.55, r=0.50, two side P<0.01;r=0.63, r=0.68, two side P<0.01).(3) The level of TNF-αin induced sputum and serum of AECOPD were higher than in the stable stage (P=0.024, P=0.041)and the control group (P=0.001; P=0.034). There were no significant difference of the level of TNF-αin induced sputum and serum between stable stage and the control group (both P>0.05). The TNF-αin serum of COPD group were significantly higher than that of TNF-αin induced sputum of COPD group (both P<0.05). The TNF-αin serum of AECOPD were positively correlated with IL-10,IL-20 in AECOPD (r=0.471, P=0.009;r=0.41, P=0.03). The TNF-αin serum of AECOPD were inversely correlated with FEV1.0%Pred,FEV1.0/FVC in AECOPD(r=-0.53, r=-0.71, respectively P<0.01).(4) The NE level in serum of AECOPD were higher than that of the stable stage (P=0.003)and the control group (P=0.034). The NE level in sputum of AECOPD was higher than that of the stable stage (P=0.000)and the control group (P=0.000).There were no significant difference of the NE in serum between the stable stage and the control group (P=0.053). The level of NE in sputum of stable stage were significantly higher than that in controls(P=0.000)and lower than that of NE in serum(P=0.000). The NE level in sputum of AECOPD was inversely correlated with FEV1.0%Pred,FEV1.0/FVC(r=-0.428, P<0.01;r=-0.582, P<0.01). The NE level in sputum of the stable stage was inversely correlated with FEV1.0%Pred,FEV1.0/FVC(r=-0.466, P=0.009; r=-0.548, P=0.002). The NE level in serum of AECOPD was inversely correlated with FEV1.0%Pred,FEV1.0/FVC (r=-0.673,P=0.000;r=-0.652 ,P=0.000). The NE level in serum of the stable stage was inversely correlated with FEV1.0%Pred,FEV1.0/FVC(r=-0.466,P<0.01; P=0.009 ;r=-0.548, P=0.002). The level of NE in serum of AECOPD group was inversely correlated with IL-8,TNF-α,IL-19,IL-20(r=0.425, P<0.01; r=0.761; P<0.01; r= 0.78, P<0.01; r=0.65, P<0.01).(5) The level of IL-19 in serum of COPD group were higher than in the control group(P=0.000; P=0.001). There was no significant difference between AECOPD and the stable stage (P>0.05). The IL-19 level of sputum in AECOPD was higher than that in stable stage and the control group(P=0.044; P=0.032).There was no significant difference between the stable stage and the control group (P>0.05). The IL-19 level in serum was significantly higher than that sputum for COPD group( P<0.01). The serum IL-19 was positively correlated with that of CRP in AECOPD (r= 0.527, P=0.003). The serum IL-19 was positively correlated with that of TNF-αin stable stage (r=0.486, P=0.007). The level of IL-19 in serum of AECOPD was inversely correlated with FEV1.0%Pred,FEV1.0/FVC (r=-0.544, P=0.003; r=-0.839, P=0.001). The level of IL-19 in serum of the stable stage was inversely correlated with FEV1.0%Pred,FEV1.0/FVC (r=-0.445, P=0.014; r=-0.432, P=0.017). The level of IL-19 in sputum of AECOPD was inversely correlated with FEV1.0%pred(r=-0.698, P=0.000).(6) The level of IL-20 in serum of COPD group were higher than that of the control group(P=0.016; P=0.037), IL-20 in serum of stable stage was higher than that of IL-20 in the control group( P<0.05). There were no significant difference of IL-20 in AECOPD group , stable stage, and the control group (P>0.05). The level of IL-20 in serum of COPD group were positively correlated with that of TNF-αin COPD group (r=0.41, P=0.03; r=0.696, P=0.00). It was positively correlated with CRP in AECOPD (r=0.758, P=0.00), and were inversely correlated with FEV1.0%Pred,FEV1.0/FVC (r=-0.588, P=0.01; r=-0.416, P=0.028). The level of IL-20 in serum of stable stage were inversely correlated with FEV1.0%Pred,FEV1.0/FVC (r=-0.705, P=0.000; r=-0.662, P=0.000).Conclusions1. IL-8,IL-10,TNF-α,NE and IL-19 contribute to the formation of airway inflammation , IL-8,TNF-α,NE and IL-19 were associated to airway limitation in patients with AECOPD. IL-8,NE contribute to the process of chronic airway inflammation. IL-20 probably do not contribute to the process of airway inflammation.2. IL-19 and IL-20 may play a role in the systemic inflammation process of COPD, and contribute to the poor quality of life of COPD patients.