1. Mixed Th2 and non-Th2 inflammatory pattern in the asthma–COPD overlap: a network approach
- Author
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Perez de Llano, Luis, Cosio, Borja G., Iglesias, Amanda, de las Cuevas, Natividad, Jose Soler-Cataluna, Juan, Luis Izquierdo, Jose, Luis Lopez-Campos, Jose, Calero, Carmen, Plaza, Vicente, Miravitlles, Marc, Torrego, Alfons, Martinez-Moragon, Eva, Soriano, Joan B., Lopez Vina, Antolin, Bobolea, Irina, and CHACOS Study Grp
- Subjects
redes neuronales (ordenador) ,Overlap ,Male ,Vital capacity ,inflammatory cytokines ,humanos ,Vital Capacity ,Systemic inflammation ,interleucina-8 ,volumen espiratorio forzado ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Interquartile range ,Forced Expiratory Volume ,interleucina-6 ,mediadores de la inflamación ,células TH2 ,interleucina-5 ,Eosinophilia ,moléculas de adhesión celular ,030212 general & internal medicine ,network analysis ,Lung ,mediana edad ,Original Research ,anciano ,COPD ,Interleukin-13 ,factor de necrosis tumoral alfa ,Interleukin-17 ,Discriminant Analysis ,General Medicine ,adulto ,Middle Aged ,interleucina-17 ,Inflammatory cytokines ,Prognosis ,asma ,pronóstico ,medicine.anatomical_structure ,IL-13 ,Network analysis ,Female ,Interleukin 17 ,medicine.symptom ,Inflammation Mediators ,Adult ,medicine.medical_specialty ,International Journal of Chronic Obstructive Pulmonary Disease ,03 medical and health sciences ,Th2 Cells ,Internal medicine ,medicine ,asthma mechanisms ,overlap ,Humans ,Asthma ,Aged ,Asthma mechanisms ,business.industry ,Interleukin-6 ,Tumor Necrosis Factor-alpha ,Interleukin-8 ,Neural Networks (Computer) ,medicine.disease ,respiratory tract diseases ,Cross-Sectional Studies ,pulmón ,030228 respiratory system ,Spain ,análisis discriminante ,Neural Networks, Computer ,capacidad vital ,Interleukin-5 ,business ,COPD mechanisms ,interleucina 13 ,Cell Adhesion Molecules ,Biomarkers ,estudios transversales - Abstract
Introduction: The asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is a clinical condition that combines features of those two diseases, and that is difficult to define due to the lack of understanding of the underlying mechanisms. Determining systemic mediators may help clarify the nature of inflammation in patients with ACO. Objectives: We aimed at investigating the role and interaction of common markers of systemic inflammation (IL-6, IL-8, and tumor necrosis factor-alpha), Th2-related markers (periostin, IL-5, and IL-13), and IL-17 in asthma, COPD, and ACO. Methods: This is a cross-sectional study of patients aged >= 40 years with a post-bronchodilator forced expiratory volume in the first second/forced vital capacity < 0.70 recruited from out-patient clinics in tertiary hospitals with a clinical diagnosis of asthma, COPD, or ACO. ACO was defined by a history of smoking > 10 pack-years in a patient with a previous diagnosis of asthma or by the presence of eosinophilia in a patient with a previous diagnosis of COPD. Clinical, functional, and inflammatory parameters were compared between categories using discriminant and network analysis. Results: In total, 109 ACO, 89 COPD, and 94 asthma patients were included. Serum levels (median [interquartile range]) of IL-5 were higher in asthma patients than in COPD patients (2.09 [0.61-3.57] vs 1.11 [0.12-2.42] pg/mL, respectively; p=0.03), and IL-8 levels (median [interquartile range]) were higher in COPD patients than in asthma patients (9.45 [6.61-13.12] vs 7.03 [4.69-10.44] pg/mL, respectively; p < 0.001). Their values in ACO were intermediate between those in asthma and in COPD. Principal component and network analysis showed a mixed inflammatory pattern in ACO in between asthma and COPD. IL-13 was the most connected node in the network, with different weights among the three conditions. Conclusion: Asthma and COPD are two different inflammatory conditions that may overlap in some patients, leading to a mixed inflammatory pattern. IL-13 could be central to the regulation of inflammation in these conditions., The authors are grateful to all the patients who participated in the study. A number of investigators contributed to the study logistics and they are listed in the Supplementary materials. The project was endorsed by the COPD and Asthma Research Board (PII de EPOC y asma) of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). The project was partially funded by the Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III, Ministerio de Economia y Competitividad (FIS 15/01263) through European Union FEDER funds and by unrestricted grant from Chiesi Espana S.A.U.
- Published
- 2018