Markers of inflammation and oxidative stress during lower respiratory tract infections in COPD patients.
BACKGROUND
Lower respiratory tract infections (LRTI) occur frequently in patients with Chronic Obstructive Pulmonary Disease (COPD), and are a major cause of morbidity, mortality and health care utilization. The aim of this study was to investigate if non- or less invasive markers of inflammation and oxidative stress can predict the course of the infections.


METHODS
Twenty-five COPD patients who were admitted to hospital with a LRTI were included. Within 24 hours after admittance, spirometry (FEV1, FVC, MEF50), measurement of hydrogen peroxide (H2O2) in exhaled breath condensate (EBC), symptom scores and analyses of ESR, CRP, ECP, and MPO in serum were performed. All patients were treated with intravenous dexamethasone, nebulised salbutamol/ipratropium and, if needed, antibiotics. The tests were repeated at day 2, 3, 7 and 30.


RESULTS
Complete data of the first four visits were collected in 19 patients. The H2O2 concentration and spirometry parameters did not change significantly during the study period. CRP, ESR and MPO levels decreased significantly during treatment, while the other serum inflammatory parameters did not change. There were no significant correlations between H2O2 concentration, spirometry and serum inflammatory parameters.


CONCLUSIONS
In conclusion, this study showed no significant changes in H2O2 concentration in EBC, or spirometry during treatment of a LRTI in COPD patients. In contrast, several serum inflammatory markers did decrease during hospitalization, thus providing a simple tool to monitor exacerbations.
van Beurden
W J
WJ
Department of Pulmonology, Catharina Hospital, Eindhoven, The Netherlands. wendy.beurdenvan@wanadoo.nl
Smeenk
F W
FW
Harff
G A
GA
Dekhuijzen
P N
PN
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001774:Blood Chemical Analysis; D018450:Disease Progression; D005260:Female; D006760:Hospitalization; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D011014:Pneumonia / Q000150:complications / Q000175:diagnosis*; D011336:Probability; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013147:Spirometry; D018709:Statistics, Nonparametric
D000305:Adrenal Cortex Hormones; D018836:Inflammation Mediators