Systemic anti-inflammatory mediators in COPD: increase in soluble interleukin 1 receptor II during treatment of exacerbations

• Published in: Thorax Vol. 56; no. 9; pp. 721 - 726
• Main Authors: Dentener, M A, Creutzberg, E C, Schols, A M W J, Mantovani, A, van‘t Veer, C, Buurman, W A, Wouters, E F M
• Format: Journal Article
• Language: English
• Published: London BMJ 01.09.2001; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adult; Aged; Aged, 80 and over; Antibiotics; Antigens, CD - analysis; Bacterial infections; Biological and medical sciences; Carrier Proteins; Chronic Disease; Chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease, asthma; Cyclic AMP Receptor Protein - analysis; Cytokines; Disease; DNA-Binding Proteins - analysis; Drug therapy; Female; Forced Expiratory Volume - physiology; Hospitals; Humans; Infections; Inflammation; Lung diseases; Lung diseases, Obstructive; Lung Diseases, Obstructive - metabolism; Lung Diseases, Obstructive - physiopathology; Male; Medical sciences; Middle Aged; Original; Pneumology; Proteins; Receptors, Interleukin-1 - metabolism; Receptors, Interleukin-1 Type II; Receptors, Tumor Necrosis Factor - analysis; Receptors, Tumor Necrosis Factor, Type I; Receptors, Tumor Necrosis Factor, Type II; Signal Transduction; Transcription Factors; Tumor necrosis factor-TNF; Vital Capacity - physiology; Germany; Human; Lung disease; Pathophysiology; Respiratory disease; Cytokine; Exploration; Receiver; Inflammation; Crisis; Chronic; Lung function; Treatment; Interleukin 1; Bronchus disease; Obstructive pulmonary disease
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax.56.9.721

BACKGROUND The aim of this study was to test the hypothesis that the chronic inflammatory process present in chronic obstructive pulmonary disease (COPD) is due to a defective endogenous anti-inflammatory mechanism. METHODS Systemic levels of the anti-inflammatory mediators soluble interleukin 1 receptor II (sIL-1RII), soluble tumour necrosis factor receptor p55 (sTNF-R55) and sTNF-R75, and of C reactive protein (CRP) and lipopolysaccharide binding protein (LBP) were analysed in 55 patients with stable COPD (median forced expiratory volume in one second (FEV1) 34% predicted (range 15–78)) and compared with levels in 23 control subjects. In addition, changes in these mediators were studied in 13 patients with COPD (median FEV1 34% predicted (range 19–51)) during the first 7 days in hospital with an exacerbation of the disease. RESULTS Patients with stable COPD were characterised by a systemic inflammatory process indicated by an increased leucocyte count (7.2 (4.7–16.4)v 4.8 (3.5–8.3) × 109/l), raised levels of CRP (11.8 (1.1–75.0) v 4.1 (0.6–75.0) μg/ml) and LBP (45.6 (8.1–200.0)v 27.9 (14.1–71.5) μg/ml), and moderate increases in both sTNF-Rs. In contrast, the sIL-1RII level did not differ between patients and controls (4.53 (2.09–7.60)v 4.63 (3.80–5.93) ng/ml). During treatment of disease exacerbations, systemic levels of both CRP (at day 3) and LBP (at day 7) were significantly reduced compared with day 1, whereas sIL-1RII levels increased. CONCLUSIONS These data suggest an imbalance in systemic levels of pro- and anti-inflammatory mediators in patients with stable COPD. The increase in the anti-inflammatory mediator sIL-1RII during treatment of exacerbations may contribute to the clinical improvement.