TNF-? And IL-1? In Exhaled Breath Condensate Correlate With Pulmonary Function And Complications

Purpose:Exhaled breath condensate(EBC)is very popular in recent years,with little trauma,operation simple and convenient,and it also has many other advantages in respiratory system disease detection.EBC contains a large number of medium factors,now we think that molecular weight which is less than 65 k? is permitted to enter in the EBC.These substances include interleukin and small molecular substances,such as interferon.Chronic obstructive pulmonary disease(COPD)is a common chronic respiratory system disease.In the clinical work,for the thoracic surgery patients with COPD,we usually only use lung function testing to assess the patient's lung pathological physiology indexes,and we just rely on the results may cause certain deviation.what more,this may affect physician's judgment of the surgery.In the clinical work,we often encounter this situation that the patients with poor lung function,but the results is good,they recovery well with no complications.Surprisingly,a lot of patients with good lung function results,but appeared a lot of complications.This requires that we should pay more attention to the patient's lung pathological physiology.If we find the method,it may provide more powerful guarantee to the healthy of all the patients.How to accurate the evaluation of patients with preoperative pulmonary function,and to find a true measure of patients with lung pathological physiology,we launched the following research,this research mainly solve the following questions:1.Can we detect the TNF-? and IL-1? in EBC.2.Can the content of TNF-? and IL-1? in EBC reflect the content of TNF-? and IL-1?in lung tissue.3.Can the content of TNF-? and IL-1? in EBC reflect the content of TNF-? and IL-1?in lung tissue reflect the level of lung function.4.After the lung protection treatment,will the the content of TNF-? and IL-1? in EBC be changed.Methods:This study selected 60 patients who will be performed pulmonary lobectomy resection because of lung cancer in Tianjin Chest Hospital from January2015 to June 2015,Test lung function check at the beginning,according to the results of pulmonary function are divided into three groups,named the COPD treatment group and COPD control group and no COPD group,each group has 20 cases.Give the COPD treatment group 1 week lung protection treatment to improve lung function,the other two groups cannot be accepted any lung protection treatment.To collect EBC and arterial blood gas of No COPD group and COPD control group before the surgery,COPD treatment group collect EBC and arterial blood gas on the seventh day and the first day before the surgery.All the three groups collect EBC and arterial blood gas on the first day and the seventh day after the surgery.Collect lung tissue samples during the surgery.Store the EBC in the refrigerator of-80?,and then apply ELISA method to test the content of TNF-? and IL-1?,Select three pieces of 1cm3 normal lung tissue which be 5 cm away from the lung cancer,respectively for Immunofluorescence detection and using ELISA method to detect lung tissue TNF-?and IL-1? content and transmission electron microscopy observation.Fix the specimen of pulmonary tissue for Immunofluorescence with 10% formalin,and perform paraffin embedding to make into sections of 5 micrometer thickness.The specimen used for ELISA should be stored in a refrigerator of-80?in 30 minutes.Used for TEM observation of immediate placement specimens were fixed in lung tissue,under the condition of low temperature 0 to 4 ? to electron microscope room.Results:1.The average content of TNF-? in the EBC of COPD treatment group on the seventh day before surgery,on the first day before surgery,the first day after surgery and the seventh day after surgery respectively was 0.838pg/?l,0.4638pg/?l,0.6643pg/?l,0.2507pg/?l;and the average content of IL-1? respectively was 3.7162pg/?l,1.4129pg/?l,2.2569pg/?l,0.8489pg/?l.The average content of TNF-? in the EBC of COPD control group on the first day before surgery,the first day after surgery and the seventh day after surgery respectively was 0.7282pg/?l,0.8353pg/?l,0.3979pg/?l;and the average content of IL-1? respectively was 2.9012pg/?l,3.3221pg/?l,1.3832pg/?l;The average content of TNF-? in the EBC of no COPD group on the first day before surgery,the first day after surgery and the seventh day after surgery respectively was 0.4513 pg/?l,0.5025 pg/?l,0.2746 pg/?l;and the average content of IL-1? respectively was 1.3317 pg/?l,1.7316 pg/?l,0.6362 pg/?l.2.The average content of TNF-? in the lung tissue in COPD treatment group,COPD control group and no COPD group respectively was 0.0291pg/?l,0.0417pg/?l,0.0323pg/?l;the average content of IL-1? respectively was 0.0297pg/?l,0.0640pg/?l,0.0257pg/?l?3.Immunofluorescence results:the Mean density for the distribution of IL-1? in COPD treatment group,COPD control group and no COPD group respectively was3.60�10-4,3.69�10-4,3.40�10-4;the Mean density for the distribution of TNF-? in COPD treatment group,COPD control group and no COPD group respectively was10.15�10-4,11.81�10-4,8.89�10-4.Conclusion: 1.The content of IL-1? and TNF-? in EBC can reflect the content of IL-1? in the lung tissue,and with a positive correlation.2.The content of IL-1? and TNF-? in EBC and lung tissue can reflect the state of lung function.3.The content of TNF-? and IL-1? in EBC of COPD group is significantly higher than no COPD group;In COPD treatment group,after the lung protection treatment,the content of TNF-?and IL-1? dropped significantly,and after the surgery,the content of TNF-? and IL-1?was obvious rise,after the lung protection treatment,the content of TNF-? and IL-1?significantly lower again,to explain that our lung protection treatment had a significant effect in the inflammatory reaction and stress changes of COPD patients.4.The content of IL-1? and TNF-? in lung tissue of COPD group was significantly higher than that of the no COPD group.5.The content of TNF-? and IL-1? in EBC had no significant correlation with complications.6.Immunofluorescence results show: The distribution of IL-1? and TNF-? of COPD group was wider than that in no COPD group.The Mean density of IL-1? and TNF-? of COPD treatment group was significantly lower than COPD control group.