title: Viral infection is associated with an increased proinflammatory response in chronic obstructive pulmonary disease.
abstract: The development of new diagnostic methods based on molecular biology has led to evidence of the important role of respiratory viruses in chronic obstructive pulmonary disease (COPD) exacerbations. Cytokines and chemokines are recognized as key actors in the pathogenesis of COPD. The objective of this study was to evaluate the association between viral infection and host cytokine responses in 57 COPD patients hospitalized with an acute exacerbation. Seventeen cytokines were profiled using a Luminex-Biorad multiplex assay in plasma samples collected in the first 24 h following hospital admission. Stepwise linear regression analysis was performed, taking into account the influence of seven potential confounding factors in the results. Twenty-four out of 57 showed radiological signs of community-acquired pneumonia (CAP) at hospital admission, 25 patients required admission to the intensive care unit (ICU), 20 had a bacterial infection, and 20 showed a detectable respiratory virus in pharyngeal swabs. Regression analysis showed that viral infection correlated with higher levels of interleukin-6 (IL-6) (log value of the coefficient of regression B, p=0.47, 0.044), and monocyte chemoattractant protein-1 (MCP-1) (p=0.43, 0.019), and increased admission to the ICU. Viral infection also correlated with higher levels of interferon-γ (IFN-γ) (p=0.70, 0.026), which, in turn, was inversely associated with the severity of illness. Finally, viral infection was independently associated with higher levels of tumor necrosis factor-α (TNF-α) (p=0.40, 0.002). Thus our study demonstrates that in patients with COPD exacerbations, viral infection is directly associated with higher systemic levels of cytokines central to the development of the antiviral response, which are also known to contribute to inflammation-mediated tissue damage. These results reveal a potential specific role of viral infection in the pathogenesis of COPD exacerbations.
authors: Infection and Immunity Medical Investigation Unit, Hospital Clínico Universitario de Valladolid-IECSCYL, Valladolid, Spain.
authors: Raquel
authors: R
authors: Almansa
authors: Lorenzo
authors: L
authors: Socias
authors: David
authors: D
authors: Andaluz-Ojeda
authors: Ignacio
authors: I
authors: Martín-Loeches
authors: Felipe
authors: F
authors: Bobillo
authors: Jesús
authors: J
authors: Blanco
authors: Lucia
authors: L
authors: Rico
authors: Jose Ángel
authors: JÁ
authors: Berezo
authors: Ángel
authors: Á
authors: Estella
authors: Monica
authors: M
authors: Sanchez-Garcia
authors: Alicia
authors: A
authors: San José
authors: Agueda
authors: A
authors: Herrero
authors: Mar
authors: M
authors: Justel
authors: Vicente
authors: V
authors: Roig
authors: Milagros
authors: M
authors: Del Olmo
authors: Sara
authors: S
authors: Rosich
authors: Irene
authors: I
authors: Rodriguez
authors: Carlos
authors: C
authors: Disdier
authors: Jose María
authors: JM
authors: Eiros
authors: Raúl
authors: R
authors: Ortiz De Lejarazu
authors: Jesus F
authors: JF
authors: Bermejo-Martin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000150:complications; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D014777:Virus Diseases / Q000150:complications* / Q000276:immunology*
chemical_list: D016207:Cytokines