TY - JOUR
T1 - Airway inflammation contributes to health status in COPD
T2 - a cross-sectional study
AU - Snoeck-Stroband, Jiska B.
AU - Postma, Dirkje S.
AU - Lapperre, Therese S.
AU - Gosman, Margot M. E.
AU - Thiadens, Henk A.
AU - Kauffman, Henk F.
AU - Sont, Jacob K.
AU - Jansen, Desiree F.
AU - Sterk, Peter J.
PY - 2006/11/30
Y1 - 2006/11/30
N2 - Background: Chronic obstructive pulmonary disease ( COPD) is characterized by irreversible airflow limitation and airway inflammation, accompanied by decreased health status. It is still unknown which factors are responsible for the impaired health status in COPD. We postulated that airway inflammation negatively contributes to health status in COPD.Methods: In 114 COPD patients ( 99 male, age: 62 +/- 8 yr, 41 [ 31 - 55] pack-years, no inhaled or oral corticosteroids, postbronchodilator FEV1: 63 +/- 9% pred, FEV1/IVC: 48 +/- 9%) we obtained induced sputum and measured health status (St. George's respiratory questionnaire (SGRQ)), postbronchodilator FEV1, hyperinflation (RV/TLC), and airway hyperresponsiveness to methacholine (PC20). Sputum was induced by hypertonic saline and differential cell counts were obtained in 102 patients.Results: Univariate analysis showed that SGRQ total and symptom score were positively associated with % sputum macrophages ( r = 0.20, p = 0.05; and r = 0.20, p = 0.04, respectively). Multiple regression analysis confirmed these relationships, providing significant contributions of % sputum macrophages ( B = 0.25, p = 0.021) and RV/TLC ( B = 0.60, p = 0.002) to SGRQ total score. Furthermore, SGRQ symptom score was associated with % sputum macrophages ( B = 0.30, p = 0.03) and RV/TLC ( B = 0.48, p = 0.044), whilst SGRQ activity score was associated with % sputum macrophages ( B = 0.46, p = 0.002), RV/TLC ( B = 0.61, p = 0.015), and PC20 ( B = - 9.3, p = 0.024). Current smoking and FEV1 were not significantly associated with health status in the multiple regression analysis.Conclusion: We conclude that worse health status in COPD patients is associated with higher inflammatory cell counts in induced sputum. Our findings suggest that airway inflammation and hyperinflation independently contribute to impaired health status in COPD. This may provide a rationale for anti-inflammatory therapy in this disease.
AB - Background: Chronic obstructive pulmonary disease ( COPD) is characterized by irreversible airflow limitation and airway inflammation, accompanied by decreased health status. It is still unknown which factors are responsible for the impaired health status in COPD. We postulated that airway inflammation negatively contributes to health status in COPD.Methods: In 114 COPD patients ( 99 male, age: 62 +/- 8 yr, 41 [ 31 - 55] pack-years, no inhaled or oral corticosteroids, postbronchodilator FEV1: 63 +/- 9% pred, FEV1/IVC: 48 +/- 9%) we obtained induced sputum and measured health status (St. George's respiratory questionnaire (SGRQ)), postbronchodilator FEV1, hyperinflation (RV/TLC), and airway hyperresponsiveness to methacholine (PC20). Sputum was induced by hypertonic saline and differential cell counts were obtained in 102 patients.Results: Univariate analysis showed that SGRQ total and symptom score were positively associated with % sputum macrophages ( r = 0.20, p = 0.05; and r = 0.20, p = 0.04, respectively). Multiple regression analysis confirmed these relationships, providing significant contributions of % sputum macrophages ( B = 0.25, p = 0.021) and RV/TLC ( B = 0.60, p = 0.002) to SGRQ total score. Furthermore, SGRQ symptom score was associated with % sputum macrophages ( B = 0.30, p = 0.03) and RV/TLC ( B = 0.48, p = 0.044), whilst SGRQ activity score was associated with % sputum macrophages ( B = 0.46, p = 0.002), RV/TLC ( B = 0.61, p = 0.015), and PC20 ( B = - 9.3, p = 0.024). Current smoking and FEV1 were not significantly associated with health status in the multiple regression analysis.Conclusion: We conclude that worse health status in COPD patients is associated with higher inflammatory cell counts in induced sputum. Our findings suggest that airway inflammation and hyperinflation independently contribute to impaired health status in COPD. This may provide a rationale for anti-inflammatory therapy in this disease.
KW - OBSTRUCTIVE PULMONARY-DISEASE
KW - QUALITY-OF-LIFE
KW - GEORGES RESPIRATORY QUESTIONNAIRE
KW - WORKING PARTY STANDARDIZATION
KW - TESTS EUROPEAN-COMMUNITY
KW - SYSTEMIC INFLAMMATION
KW - OFFICIAL STATEMENT
KW - FLOW LIMITATION
KW - INDUCED SPUTUM
KW - LUNG
U2 - 10.1186/1465-9921-7-140
DO - 10.1186/1465-9921-7-140
M3 - Article
C2 - 17137518
SN - 1465-9921
VL - 7
JO - Respiratory Research
JF - Respiratory Research
M1 - 140
ER -