The Comparison Of Change And Influence Factors Of Neutrophil In Neutrophilic Asthma And COPD

Background:Bronchial asthma is a common heterogeneous respiratory disease,which is classifie d to different phenotypes according to leukoyte classification in induced sputum.NA(ne utrophilic asthma)is the phenotype that neutrophils are the main inflammatory cells.C OPD(chronic obstructive pulmonary disease)is another heterogeneous respiratory diseas e,in which neutrophils are the main inflammatory cells too.Similar inflammation exists in both these two diseases.And more,many NA patients have sever symptoms that we could not distinguish them from COPD.Ashma is one of the risk factors of COPD.We have realized that inner links may exist between these two diseases,followed by the r aising of Asthma-COPD Overlap Syndrome(ACOS).COPD is more serious than asthma in clinical features and prognosis respectively.Taking all together,we think there may be some differences in the amount and the influence factors of neutrophil between the two diseases.Objectives:1.Compare leukoyte classification in induced sputum between NA and COPD;2.Exploring the role of MPO/CP system in NA and COPD through compareing the levels of the MPO and CP in sputum supernatant and MPO/CP ratio of the two diseases;3.Exploring the possible reasons of the differences in clinic and pathophysiology between NA and COPD,through comparing the mentioned two protease/antiprotease systems of neutrophil in induced sputum.Methods:Asthma and COPD patients,healthy volunteers were collected from Outpatient Dep artment of Respiratory Diseases of Xinqiao Hospital between March 2015 and September 2015.The subjects who was in the period of exacerbations were excluded.Then w e obtained the induced sputum,leukocyte classification was made.NA was defined as t hat NEU%>65% & EOS%<2%,while EA was defined as that NEU%<65% & EOS%>2%.Myeloperoxidase(MPO),Ceruloplasmin(CP),neutrophilic elastase(NE),?1-antitrypsin(?1-AT),PMN Elasetase/alpha1-PI Complex,matrix metalloproteinase-9(MMP-9),tissue inhibit or of metalloproteinase-1(TIMP-1),MMP-9/TIMP-1 Complex in sputum supernatant wer e detected by ELISA.Result:1.WBC counts and neutrophil counts in NA and COPD are higher than Control(P<0.05).Neutrophils percentage in NA and COPD are tend to be higher than Control.There are no significant differences between NA and COPD(P>0.05).2.Here are 4 groups:NA(n=9),COPD(n=11),EA(n=9),Control(n=8).Datas are showe d as Median(Q1,Q3)in turn,MPO(ng/ml):80.46(64.41,96.06),78.03(66.19,125.60),68.96(64.73,86.79),8.58(16.07,34.58);NA and COPD are higher than Control(P<0.05),differences a mong the NA and COPD and EA have no statistical significance(P>0.05).CP(mg/ml):7.70(5.38,9.62),9.48(7.77,10.55),6.92(5.60,9.03),9.33(7.58,10.03);there are no significant d ifferences among the 4 groups(P>0.05).MPO/CP ratio:10.65(9.16,12.98),10.33(7.55,11.77),9.77(7.14,16.40),3.97(2.26,4.69);NA,COPD are higher than Control(P<0.05),differences a mong the NA and COPD and EA have no statistical significance(P>0.05).Here is signi ficant positive correlation between CP and MPO in NA and COPD respectively(r=0.767 and 0.645,P<0.05);Here is neither significant correlation between MPO/CP ratio and MPO,nor MPO/CP ratio and CP(r=-0.050 and-0.617,P>0.05)in NA;Here is significant positive correlation between MPO/CP ratio and MPO(r=0.845,P<0.05),no significant correlation between MPO/CP ratio and CP(r=0.300,P>0.05)in COPD.3.Here are 4 groups:NA(n=9),COPD(n=11),EA(n=9),Control(n=5,contained in abov e-mentioned part).Datas are showed as Median(Q1,Q3)in turn,NE(ng/ml):2.80(1.90,9.40),7.42(3.86,12.03),1.67(1.07,8.53),0.60(0.48,0.75).NA is higher than Control(P=0.020),COPD is higher than Control(P=0.000);?1-AT(mg/ml):31.46(7.54,37.32),21.00(12.40,43.57),10.77(7.80,27.10),4.43(4.14,10.26),NA tends to be higher than Control(P=0.070),COPD is higher than Control(P=0.017);PMN Elasetase/alpha1-PI Complex(ng/ml):86.13(52.60,145.06),87.19(74.28,155.97),95.73(70.56,162.78),47.34(45.03,67.93),difference betw een groups has no statistical significance(P=0.085),NA tends to be higher than Control,as well as COPD and EA;MMP-9(ng/ml):1208.88(873.99,1378.98),1458.18(1338.30,1629.00),936.00(757.17,1503.18),597.9(510.30,895.86),COPD is higher than Control(P=0.003),Both NA and EA tend to be higher than Control,COPD tends to be higher than NA and EA;TIMP-1(ng/ml):1404.83(790.52,2229.01),1618.96(1384.70,2907.42),874.33(650.02,2104.88),856.92(660.47,1029.27),difference between groups has no statistical significance(P=0.094),COPD tends to be higher than Control;MMP-9/TIMP-1 Complex(ng/ml):51.25(47.76,95.10),26.68(17.06,39.46),34.25(26.47,63.46),9.74(4.96,16.28),NA is higher than Control(P=0.000),EA is higher than Control(P=0.027),NA is higher than COPD(P=0.012),COPD tends to be higher than Control.Conclusions:1.There is similar neutrophil infiltration in NA and COPD.2.Similar degree of imbalance exists in MPO/CP system in NA and COPD,the imbalance may be one of the reasons of the imbalance in oxidation/antioxidation system in the two diseases.3.The imbalance is exist in proteases/antiproteases system in sputum supernatant of both NA and COPD,and is more obvious in COPD.This may explains the prominent differences in clinic and pathophysiology of these two common diseases to some extent.