The relationship between comorbidities and systemic inflammation in patient with COPD

Objectives: In recent years the effects of the comorbidities related with COPD on morbidity and mortality of the disease is well understood. However, the debate over the role and exact mechanisms on systemic inflammation is stil going on the development of comorbidities. In this study, it is aimed to evaluate the relationship between the systemic inflammation and comorbidities in COPD patients and and thus to gain more comprehensive information about the nature of systemic inflammation in such diseases.Materials and Methods: In this study, comorbidities, systemic and local inflammation markers were analyzed on patients who admitted to the Chest Diseases out-patient clinic in Cukurova Unıversity Balcalı Medical Faculty Hospital between February 2010 and July 2010, clinically suspected diagnosis of COPD and were diagnosed COPD by lung function tests according to GOLD 2009, over 40 years who still smoke or stopped smoking 50 stable patients and 42 healthy adults with similar age and sex. Venous blood sample was examined for markers of systemic inflammation (CRP, fibrinogen, AAT, TNF-?, sTNF-R,IL-1, IL-6,IL-8, neutrophils, lymphocytes, eosinophils), induced sputum sample was examined for local inflammation markers (TNF-?, IL-6, neutrophils, lymphocytes, eosinophils).Results: With the mentioned examinations, at least one comorbidity was determined in 80 % of patients with COPD and 47.6 % in the control group . The depression, cachexia, pulmonary hypertension and prevalence of coronary artery disease from these comorbidities in patients with COPD were shown to be significantly higher than the control group. The patients with COPD exclusive of the average serum IL-6 levels and average percentage of eosinophils on the peripheral smear, all peripheral blood serum and sputum inflammatory markers were statistically significantly found higher than the control group . In addition, the mean serum TNF- ? and IL-8 levels were found to be associated with presence of comorbidity in patients with COPD. The determined comorbidities which are anxiety, depression, anemia, heart rate, osteoporosis and metabolic syndrome were found to be associated with one or more systemic inflammatory markers.Conclusion: We found that, the observed comorbidities in COPD, is closely related to systemic inflammation .It is suggest that there is a close relationship between the local inflammation and systemic inflammation, however these do not support the thesis of local and systemic inflammation were devoloped on different mechanisms or local inflammation devoloped earlier than systemic inflammation.Key words: COPD, comorbidity, systemic inflammation