title: Systemic signs of neutrophil mobilization during clinically stable periods and during exacerbations in smokers with obstructive pulmonary disease.
abstract: BACKGROUND
  It is still unclear whether signs of neutrophil mobilization in the blood of patients with chronic obstructive pulmonary disease represent true systemic events and how these relate to bacterial colonization in the airways. In this study, we evaluated these issues during clinically stable periods and during exacerbations in smokers with obstructive pulmonary disease and chronic bronchitis (OPD-CB).
  
  
  METHODS
  Over a period of 60 weeks for each subject, blood samples were repeatedly collected from 60 smokers with OPD-CB during clinically stable periods, as well as during and after exacerbations. Myeloperoxidase (MPO) and neutrophil elastase (NE) protein and mRNA, growth of bacteria in sputum, and clinical parameters were analyzed. Ten asymptomatic smokers and ten never-smokers were included as controls.
  
  
  RESULTS
  We found that, during clinically stable periods, neutrophil and NE protein concentrations were increased in smokers with OPD-CB and in the asymptomatic smokers when compared with never-smokers. During exacerbations, neutrophil and MPO protein concentrations were further increased in smokers with OPD-CB, without a detectable increase in the corresponding mRNA during exacerbations. However, MPO and NE protein and mRNA displayed positive correlations. During exacerbations, only increased neutrophil concentrations were associated with growth of bacteria in sputum. Among patients with low transcutaneous oxygen saturation during exacerbations, PaO2 (partial oxygen pressure) correlated with concentrations of MPO and NE protein and neutrophils in a negative manner.
  
  
  CONCLUSIONS
  There are signs of systemic neutrophil mobilization during clinically stable periods and even more so during exacerbations in chronic obstructive pulmonary disease. In this condition, MPO and NE may share a cellular origin, but its location remains uncertain. Factors other than local bacteria, including hypoxemia, may be important for driving systemic signs of neutrophil mobilization.
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Andelid
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Andersson
authors.affiliation: Department of Pediatrics, Dokkyo Medical University, Japan.
authors.forename: Shigemi
authors.initials: S
authors.lastname: Yoshihara
authors.affiliation: Department of Bacteriology, Institute of Laboratory Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Åhrén
authors.affiliation: Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Pernilla
authors.initials: P
authors.lastname: Jirholt
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Ann
authors.initials: A
authors.lastname: Ekberg-Jansson
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden ; Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Lindén
mesh_terms: D029481:Bronchitis, Chronic / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D019272:Leukocyte Elastase / Q000097:blood / Q000235:genetics; D008137:Longitudinal Studies; D008168:Lung / Q000276:immunology* / Q000382:microbiology / Q000503:physiopathology; D008297:Male; D018375:Neutrophil Activation; D009504:Neutrophils / Q000276:immunology* / Q000378:metabolism; D009195:Peroxidase / Q000097:blood; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology / Q000503:physiopathology; D012333:RNA, Messenger / Q000097:blood; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000097:blood / Q000276:immunology; D013183:Sputum / Q000382:microbiology; D013997:Time Factors
chemical_list: D012333:RNA, Messenger; D009195:Peroxidase; D019272:Leukocyte Elastase
keywords: C-reactive protein; COPD; elastase; infection; myeloperoxidase; oxygen