The Research On The Expression Of SP-D And IL-17in The Lungs Of Patients WithCOPD

PART Ⅰ SP-D expression and clinical significance in pulmonary of stable chronic obstructive pulmonary diseaseObjective Through observing SP-D expression in normal lung function smokers and chronic obstructive pulmonary disease patients,study the relationship between SP-D and smoking, limited airwayflow, diffusion function, quality of life and the nutritional imbalance.Methods The lung cancer patients needing surgical treatment were divided into normal lung function non-smoking group (NS group,16cases), normal lung function smoking group (S group,16cases),smoking with stable COPD group (COPD group,18cases).Select the normal lung tissues from the surgical specimens which is5cm over from the lung cancer resection,then observe the pathological changes of lung tissues after HE staining and detected the lung tissue SP-D level with immunohistochemistry.Result1.Lung tissues morphology (HE staining):The bronchial mucosa of NS group were complete,the inflammatory cells in walls and alveolar cavity were little,there were little obvious effusions in pipe cavity,alveolar sizes were consistent,alveolar walls were also complete;the bronchial mucosa and alveolar spaces of S group were complete,with more visible inflammatory cells infiltration,there were a small amount of the effusions in lumens, alveolar sizes were consistent,the proliferation of II type alveolar cells were abnormal;the bronchial epithelial cells of COPD group fell off,the smooth muscle and fibroblast in pipe walls proliferated,with a large number of inflammatory cells infiltration,the lumens and alveolar cavity had obvious secretion and inflammatory cells,a large number of alveolar walls fractured and fused, the proliferation of Ⅱ type alveolar cells were abnormal,but there were still a large number of cell necrosis,fell off.2.Immunohistochemistry display:SP-D was expressed in the airway and lung parenchyma. In the airway wall,SP-D+cells were mainly epithelial cells and macrophages; In the lung parenchyma SP-D+cells mainly were Ⅱ type alveolar cells and alveolar macrophage.The expression in SP-D+cells of COPD group and S group was stronger than NS group (p<0.05),which of S group was stronger than COPD group.3. Airway and alveolar SP-D express respectively with smoking,airflow limitation, diffusion function,the severity of symptoms and the nutritional imbalance:In the three groups,smoking index was respectively positive correlation with the expression of SP-D in airway and parenchyma(r=0.43,p=0.011; r=0.533,p=0.001);the expression of SP-D in the airway of COPD group was positively correlated with FEV1%expected value (r=0.697,p=0.001),negatively correlated with CAT score (r=-0.592,p=0.01), positively related with DLCO%(r=0.346,p=0.16) and BMI (r=0.553,p=0.017);In the lung parenchyma of COPD group,the expression of SP-D had positive correlation with FEV1%expected value (r=0.555,p=0.017) negative correlation with CAT score (r=-0.59,p=0.01),and positive related with DLCO%(r=0.541,p=0.02) and BMI (r=0.588,p=0.01)Conclusion The SP-D expression is enhanced in S group and COPD group,which in S group is stronger than in COPD group.SP-D expression is positively correlated with smoking index,smoking maybe the important incentive of increasing SP-D;the SP-D expression strength is respectively closely related to airflow limitation,the quality of life,and the BMI;SP-D expression in parenchyma is positively correlated with diffusion function. PART II IL-17expression and clinical significance in pulmonary of stable chronic obstructive pulmonary diseaseObjective Through observing SP-D expression in normal lung function smokers and chronic obstructive pulmonary disease patients,study the relationship between IL-17and smoking, limited airway flow, blood gas barrier, quality of life and the nutritional imbalance.Methods The lung cancer patients needing surgical treatment were divided into normal lung function non-smoking group (NS group,16cases), normal lung function smoking group (S group,16cases),smoking with stable COPD group (COPD group,18cases). Select the normal lung tissues from the surgical specimens which is5cm over from the lung cancer resection,then observe the pathological changes of lung tissues after HE staining and detected the lung tissue IL-17level with immunohistochemistry.Result l.Lung tissues morphology (HE staining):the result same to which of PART Ⅰ.2.Immunohistochemistry display:IL-17was both expressed in the lung airway and parenchyma.In the lung parenchyma, IL-17+cells mainly were lymphocyte,neutrophil and alveolar macrophage;In the airway wall,IL-17+cells were mainly epithelial cells, lymphocyte,neutrophil and macrophages,some smooth cells and fibroblast also expressed IL-17.The expression in IL-17+cells of COPD group and S group was stronger than NS group (p<0.05),which of COPD group was stranger than S group.3. Airway and alveolar IL-17express respectively with smoking,airflow limitation, diffusion function,the severity of symptom and BMI:In the three groups,smoking index was respectively positive correlation with the expression of IL-17in airway and parenchyma(r=0.453,p=0.007; r=0.573,p=0.000);the expression of IL-17in the airway of COPD group was negatively correlated with FEV1%expected value (r=-0.729,p=0.001),positively correlated with CAT score (r=0.73,p=0.001), negatively related with DLCO%(r=-0.493,p=0.038) and BMI (r=-0.653,p=0.003);In the lung parenchyma of COPD group,the expression of IL-17had negative correlation with FEV1%expected value (r=-0.489,p=0.039), positive correlation with CAT score (r=0.644,p=0.004), negatively related with DLCO%(r=-0.52,p=0.027)and BMI (r=-0.485,p=0.041).Conclusion The IL-17expression is enhanced in S group and COPD group, which in COPD group is stronger than S group.IL-17expression is positively correlated with smoking index,smoking maybe the important incentive of increasing IL-17;the IL-17expression strength is respectively closely related to airway limitation,the severity of symptom, diffusion function and the BMI. PARTⅢ The significance of imbalance of SP-D and IL-17in lung tissues of COPD patientsObjective Through observing the expression of SP-D and IL-17in lung tissues of stable COPD patients,to explore the relationship between SP-D and IL-17, and the significance of the imbalance between pro-inflammatory factor and anti-inflammatory factor in COPD.Methods It was same to PART I and PART Ⅱ.Result1.The relationship between SP-D and IL-17in airway and parenchyma, the expression of SP-D in airway was positively correlated with the expression of IL-17(r=0.636,p=0.008) in smoking group,in accord with the relation in parenchyma (r=0.517,p=0.04),while the expression of SP-D in airway was negatively correlated with the expression of IL-17(r=-0.884,p=0.000) in COPD group,in accord with the relation in parenchyma (r=-0.518,p=0.028)2. Airway and alveolar SP-D/IL-17express respectively with airflow limitation, diffusion function,CAT score and BMI:The expression of SP-D/IL-17in the airway of COPD group was positively correlated with FEV1%expected value (r=0.66,p=0.003), DLCO%(r=0.288,p=0.247) and BMI (r=0.455,p=0.058),negatively correlated with CAT score (r=-0.551,p=0.018);In the lung parenchyma of COPD group,SP-D/IL-17had positive correlation with FEV1%expected value (r=0.618,p=0.006), DLCO%(r=0.579,p=0.012)and BMI(r=0.582,p=0.011),negative correlation with CAT score (r=-0.71,p=0.001)Conclusion The correlations of SP-D and IL-17are inverse in lung tissues of smoking patients and COPD patients, the expressions of SP-D and IL-17are imbalance in COPD,the degree of imbalance of SP-D and IL-17is closely related with airway limitation,diffusion function,the severity of symptom,and BMI.