Mixed Th2 and non-Th2 inflammatory pattern in the asthma-COPD overlap : a network approach
Pérez de Llano, Luis (Hospital Universitario Lucus Augusti (Lugo))
Cosio, Borja G.. (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Iglesias, Amanda (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
de las Cuevas, Natividad (Hospital Universitario 12 de Octubre (Madrid))
Soler-Cataluña, Juan Jose (Hospital Arnau de Vilanova (Lleida, Catalunya))
Izquierdo, Jose Luis (Hospital Universitario de Guadalajara)
López-Campos, José Luis (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Calero, Carmen (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Plaza, Vicente (Universitat Autònoma de Barcelona. Departament de Medicina)
Miravitlles, Marc (Hospital Universitari Vall d'Hebron)
Torrego, Alfons (Universitat Autònoma de Barcelona. Departament de Medicina)
Martinez-Moragon, Eva (Hospital Universitari Doctor Peset (València))
Soriano, Joan B.. (Instituto de Investigación Hospital Universitario de la Princesa)
Viña, Antolin Lopez (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Bobolea, Irina (Hospital Clínic i Provincial de Barcelona)

Data:	2018
Resum:	The asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is a clinical condition that combines features of those two diseases, and that is difficult to define due to the lack of understanding of the underlying mechanisms. Determining systemic mediators may help clarify the nature of inflammation in patients with ACO. We aimed at investigating the role and interaction of common markers of systemic inflammation (IL-6, IL-8, and tumor necrosis factor-α), Th2-related markers (periostin, IL-5, and IL-13), and IL-17 in asthma, COPD, and ACO. This is a cross-sectional study of patients aged ≥40 years with a post-bronchodilator forced expiratory volume in the first second/forced vital capacity <0. 70 recruited from outpatient clinics in tertiary hospitals with a clinical diagnosis of asthma, COPD, or ACO. ACO was defined by a history of smoking >10 pack-years in a patient with a previous diagnosis of asthma or by the presence of eosinophilia in a patient with a previous diagnosis of COPD. Clinical, functional, and inflammatory parameters were compared between categories using discriminant and network analysis. In total, 109 ACO, 89 COPD, and 94 asthma patients were included. Serum levels (median [interquartile range]) of IL-5 were higher in asthma patients than in COPD patients (2. 09 [0. 61-3. 57] vs 1. 11 [0. 12-2. 42] pg/mL, respectively; p =0. 03), and IL-8 levels (median [interquartile range]) were higher in COPD patients than in asthma patients (9. 45 [6. 61-13. 12] vs 7. 03 [4. 69-10. 44] pg/mL, respectively; p <0. 001). Their values in ACO were intermediate between those in asthma and in COPD. Principal component and network analysis showed a mixed inflammatory pattern in ACO in between asthma and COPD. IL-13 was the most connected node in the network, with different weights among the three conditions. Asthma and COPD are two different inflammatory conditions that may overlap in some patients, leading to a mixed inflammatory pattern. IL-13 could be central to the regulation of inflammation in these conditions.
Ajuts:	Ministerio de Economía y Competitividad FIS/15/01263
Nota:	Altres ajuts: The authors are grateful to all the patients who participated in the study. A number of investigators contributed to the study logistics and they are listed in the Supplementary materials. The project was endorsed by the COPD and Asthma Research Board (PII de EPOC y asma) of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució i la comunicació pública de l'obra, sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Asthma mechanisms ; COPD mechanisms ; Inflammatory cytokines ; Overlap ; Network analysis ; IL-13
Publicat a:	International journal of COPD, Vol. 13 (february 2018) , p. 591-601, ISSN 1178-2005

DOI: 10.2147/COPD.S153694
PMID: 29483774

11 p, 1.3 MB

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