Although the complex role of cytokines has not been fully established, it seems that the profile of cytokine expression in COPD differs from that in asthma. The aim of our study was to determine the cytokines’ levels in Bronchoalveolar Lavage (BAL) in COPD patients with and without reversibility during an exacerbation, in order to see if cytokines usually detected in asthma, are expressed in higher levels in COPD patients with asthmatic component.
18 COPD patients ( 16 males and 2 females), admitted to our hospital because of an exacerbation, were included. Appropriate treatment for at least five days was provided, until stabilization was achieved. Bronchoscopy and assessment of cytokine levels (IL-1β, IL-4, IL-8, IL-13, TNF±) using immunohistochemistry techniques, was performed in all patients. FEV1 reversibility test was performed according to ATS criteria, before bronchoscopy and after a 2-week course of oral steroids (20mg prednizolone). The patients were separated in two groups, Group A and Group B, with post-bronchodilator FEV1 reversibility ≥12% or < 12%, respectively.
11 patiens were included in Group A and 7 patients in Group B, according to the reversibility test. In Group A, all patients expressed high levels of IL-4 and IL-8, 8 of IL-13, 6 of IL-1β and 9 of TNFα. In Group B, all patients expressed high levels of IL-4 and IL-8, 5 of IL-13 and 6 of IL-1β and TNFα.
Several studies have shown that IL-4 and IL-13 are increased in BAL of asthmatics, while IL-1β, IL-8 and TNFα are increased in BAL of COPD patients. According to our results, the cytokine profile seen in patients with COPD, with or without FEV1 reversibility, was not different. IL-4 and IL-8 were elevated in both groups. Whether these inflammatory markers will be able to distinguish COPD patients with better response to treatment remains to be investigated in future clinical trials.
Cytokine profile in BAL in COPD exacerbation, cannot predict reversibility, but may be related with the benefit from treatment.
V. Polychronopoulos, None.