Correlation Analysis Between Serum Desmosine,Inflammatory Indices And Clinical Phenotype In Patients With Bronchiectasis

Objective Bronchiectasis is a general term for a class of heterogeneous diseases.Different patients have great differences in clinical manifestations,pathophysiology,imaging and therapeutic effects.Many scholars divided patients with bronchiectasis into different clinical phenotypes through etiology,complications,cluster analysis and other methods,hoping to achieve better disease management by dividing clinical phenotypes.Increased protease activity is an important cause of the progression of bronchiectasis,and desmosine is the product of neutrophil elastase degradation of elastin.Desmosines allow us to assess the activity of neutrophil elastase on the one hand and lung damage on the other.So desmosine is an important biomarker for bronchiectasis.Infection and inflammation are another important cause to promote the occurrence and development of bronchiectasis.PCT,hs-CRP and IL-6 are commonly used clinically as inflammatory markers.In this study,the expression levels of serum desmosine,PCT,hs-CRP,and IL-6 in patients with bronchiectasis were studied to explore their value in diagnosis,treatment,and prognosis,as well as their correlation with some clinical phenotypes.Methods A total of 128 patients with bronchiectasis admitted to the Department of Respiratory and Critical Care Medicine,Chaohu Hospital Affiliated to Anhui Medical University from January 2021 to March 2022 were selected.According to the severity index of bronchiectasis（BSI）,whether patients with chronic obstructive pulmonary disease were complicated,and whether pseudomonas aeruginosa were detected,the patients were divided into a mild group of 30 cases,a moderate group of 30 cases,a severe group of 30 cases,a group with chronic obstructive pulmonary disease of 20cases,and a pseudomonas aeruginosa group of 18 cases.Thirty healthy subjects who underwent physical examination in our hospital during the same period were selected as control group.All patients with bronchiectasis met the definition and diagnostic criteria in the Expert Consensus on the Diagnosis and Treatment of Adult bronchiectasis in China.Sputum samples were collected for pathogen analysis.Serum samples were collected for detection of serum concentrations of DES,PCT,hs-CRP and IL-6.BSI score,CAT score and lung function test were performed independently.All subjects had written approval,and this study was approved by the Ethics Committee of Chaohu Hospital Affiliated to Anhui Medical University.Results Desmosine and inflammatory markers were highly expressed in patients（P<0.05）.The concentration of desmosine in serum was positively correlated with BSI score and CAT score,and negatively correlated with FEV₁/FVC.Serum desmosine concentration and CAT score in COPD group were higher than those in severe COPD group[（26.11±4.05ng/ml）and（23.85±3.36）],respectively[（17.91±4.19ng/ml）and（19.33±2.71）].FEV₁/FVC（53.23±5.15）%was lower than that in severe group（63.25±5.21）%,and the difference was statistically significant（P<0.05）.Serum desmosine,hs-CRP,PCT and CAT scores in P.aeruginosa group[（25.15±3.44）ng/ml,（76.33±13.97）mg/L,（3.75±0.23）ng/ml,（25.44±3.76）]were higher than those in severe group[（17.91±4.19）ng/m l,（67.53±9.20）mg/L,（1.94±0.16）ng/ml,（19.33±2.71）],and FEV₁/FVC（59.47±3.61）%was lower than that in severe group（63.25±5.21）%,the difference was statistically significant（P<0.05）.Conclusion Serum desmosine expression level increased in patients with bronchiectasis,and was positively correlated with BSI score and CAT score,and negatively correlated with FEV₁/FVC,which could be used as an indicator to judge the disease and prognosis.Serum inflammatory indicators hs-CRP,PCT and IL-6 were elevated in patients with bronchiectasis,which could be used to judge the severity of the disease.Patients with chronic obstructive pulmonary disease and Pseudomonas aeruginosa colonization had high serum expression of desmosine,suggesting that neutrophil elastase activity was higher in these patients.