0
Correspondence |

Response FREE TO VIEW

Ramsey Sabit, MD; Paul Thomas, HTec; Dennis J. Shale, MD, FCCP; Peter Collins, MD; Seamus J. Linnane, MB, BCh
Author and Funding Information

From the Department of Respiratory Medicine (Drs Sabit, Shale, and Linnane), Academic Department, and Department of Lung Function (Mr Thomas), University Hospital Llandough; Department of Haematology and Coagulation (Dr Collins), University Hospital of Wales; and The Blackrock Clinic (Dr Linnane).

Correspondence to: Ramsey Sabit, MD, Department of Respiratory Medicine, University Hospital Llandough, Penarth, Vale of Glamorgan, CF64 2XX, Wales; e-mail: ramsey.sabit@gmail.com


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(1):230. doi:10.1378/chest.10-2099
Text Size: A A A
Published online

To the Editor:

We thank Drs Su and Chou for their interest in our recent article in CHEST (July 2010),1 and submit our response to the comments made. We would like to clarify that although our study did demonstrate a rise in markers of coagulation and serum IL-6 in response to hypoxic challenge, such an association does not necessarily imply a causal relationship. We accept that the origin for the rise in serum IL-6 in response to hypoxia is not clear and, moreover, may not necessarily reflect a rise in IL-6 at the tissue level. We agree with the authors that respiratory muscles may be a possible source for increased IL-6 release as a consequence of hypoxia stimulating ventilation. Indeed, our department has demonstrated a rise in serum IL-6 in response to exercise in patients with cystic fibrosis.2 However, given the modest rise in respiratory rate in the patients undergoing hypoxic challenge, it would seem unlikely that the increased load on respiratory muscles could solely account for the rise in serum IL-6. A number of other studies have similarly demonstrated a rise in serum IL-6 and other inflammatory markers in response to hypoxia,3,4 although the exact mechanism for this association is yet to be elucidated.

Of possible greater interest is whether this rise in serum IL-6, regardless of its origin, contributes to the rise in markers of coagulation, as is postulated in other disease states associated with chronic systemic inflammation. Such a question only can be answered by future studies examining the relationship among hypoxia, systemic inflammation, and coagulation in patients with systemic inflammation and healthy control subjects.

Sabit R, Thomas P, Shale DJ, Collins P, Linnane SJ. The effects of hypoxia on markers of coagulation and systemic inflammation in patients with COPD. Chest. 2010;1381:47-51. [CrossRef] [PubMed]
 
Ionescu AA, Mickleborough TD, Bolton CE, et al. The systemic inflammatory response to exercise in adults with cystic fibrosis. J Cyst Fibros. 2006;52:105-112. [CrossRef] [PubMed]
 
Ertel W, Morrison MH, Ayala A, Chaudry IH. Hypoxemia in the absence of blood loss or significant hypotension causes inflammatory cytokine release. Am J Physiol. 1995;2691 Pt 2:R160-R166. [PubMed]
 
Klausen T, Olsen NV, Poulsen TD, Richalet JP, Pedersen BK. Hypoxemia increases serum interleukin-6 in humans. Eur J Appl Physiol Occup Physiol. 1997;765:480-482. [CrossRef] [PubMed]
 

Figures

Tables

References

Sabit R, Thomas P, Shale DJ, Collins P, Linnane SJ. The effects of hypoxia on markers of coagulation and systemic inflammation in patients with COPD. Chest. 2010;1381:47-51. [CrossRef] [PubMed]
 
Ionescu AA, Mickleborough TD, Bolton CE, et al. The systemic inflammatory response to exercise in adults with cystic fibrosis. J Cyst Fibros. 2006;52:105-112. [CrossRef] [PubMed]
 
Ertel W, Morrison MH, Ayala A, Chaudry IH. Hypoxemia in the absence of blood loss or significant hypotension causes inflammatory cytokine release. Am J Physiol. 1995;2691 Pt 2:R160-R166. [PubMed]
 
Klausen T, Olsen NV, Poulsen TD, Richalet JP, Pedersen BK. Hypoxemia increases serum interleukin-6 in humans. Eur J Appl Physiol Occup Physiol. 1997;765:480-482. [CrossRef] [PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543