慢性阻塞性肺疾病急性加重患者血清和呼出气冷凝液中肺表面活性蛋白D与趋化因子配体18的表达及其临床意义_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

刘海平 ,  黄平 , 杜秀芳

广东医学院附属南山人民医院呼吸内科(广东深圳 518052);

Corresponding author：

黄平, Email: sznshp@263.net

Keywords：

慢性阻塞性肺疾病; 肺表面活性蛋白D; 趋化因子配体18; 呼出气冷凝液

DOI：

10.7507/1671-6205.2015052

Video：

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目的探索肺表面活性蛋白D (SP-D)、趋化因子配体18(CCL18)表达在慢性阻塞性肺疾病(简称慢阻肺)急性加重患者病情监测中的意义。方法选取2012年4月至2013年4月慢阻肺急性加重患者22例(慢阻肺急性加重组),健康吸烟者22例(对照组)。记录研究对象的年龄、烟龄、体重指数(BMI)、肺功能检查结果。收集慢阻肺急性加重组治疗前、后及对照组的血清和呼出气冷凝液(EBC),采用酶联免疫吸附试验(ELISA)检测各研究对象血清和EBC中SP-D、CCL18表达。分析SP-D、CCL18表达与年龄、烟龄、BMI及肺功能的相关性。结果与对照组比较,慢阻肺急性加重组患者治疗前血清及EBC中SP-D表达明显升高[(353.1±221.7) ng/mL比(207.3±171.6) ng/mL,(2.6±1.1) ng/mL比(1.9±1.1) ng/mL,P<0.05],而治疗后血清及EBC中SP-D表达比较,差异无统计学意义(P>0.05)。慢阻肺急性加重组治疗前后血清和EBC中SP-D表达比较,差异无统计学意义(P>0.05)。与对照组比较,慢阻肺急性加重组治疗前EBC中CCL18表达显著降低[(14.2±5.2) pg/mL比(19.1±5.6) pg/mL,P<0.05)],而治疗后EBC中CCL18表达差异无统计学意义(P>0.05);慢阻肺急性加重组治疗前EBC中CCL18表达低于治疗后[(14.2±5.2) pg/mL比(19.4±7.0) pg/mL,P<0.05]。各组研究对象血清中CCL18表达比较,差异均无统计学意义(P>0.05)。相关性分析结果表明:血清中SP-D表达与烟龄正相关(r=0.34,P<0.05);与第1秒用力呼气容积(FEV₁)、FEV₁占预计值百分比(FEV₁% pred)、用力肺活量(FVC)、FEV₁与FVC比值(FEV₁／FVC)负相关(r分别为-0.35、-0.34、-0.31、-0.36,P<0.05);与年龄、BMI均不相关(P>0.05)。EBC中SP-D表达与烟龄正相关(r=0.11,P<0.05);与FEV₁／FVC负相关(r=-0.37,P<0.05);与年龄、BMI、FEV₁、FEV₁% pred、FVC均不相关(P>0.05)。血清和EBC中CCL18表达和年龄、烟龄、BMI、FEV₁、FEV₁% pred、FVC及FEV₁／FVC均不相关(P>0.05)。结论 EBC和血清中SP-D、CCL18表达变化在慢阻肺急性加重病情监测中具有一定价值,而且EBC中SP-D、CCL18表达变化在慢阻肺急性加重患者病情监测中更具独特的优势。

Citation： 刘海平, 黄平, 杜秀芳. 慢性阻塞性肺疾病急性加重患者血清和呼出气冷凝液中肺表面活性蛋白D与趋化因子配体18的表达及其临床意义. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(2): 204-207. doi: 10.7507/1671-6205.2015052 Copy

1.	Vestbo J, Hurd SS, Agustí AG, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease:GOLD executive summary. Am J Respir Crit Care Med,2013,187:347-365.
2.	Restrepo MI, Anzueto A. Macrolide antibiotics for prevention of chronic obstructive pulmonary disease exacerbations:are we there yet? Am J Respir Crit Care Med,2014,190:1-2.
3.	Crouch E, Wright JR. Surfactant proteins A and D and pulmonary host defense. Annu Rev Physiol,2001,63:521-554.
4.	Moreno D, Garcia A, Lema D, et al. Surfactant protein D in chornic obstructive pulmonary disease (COPD). Recent Pat Endocr Metab Immune Drug Discov,2014,8:42-47.
5.	Miyagaki T, Sugaya M, Suga H, et al. Increased CCL18 expression in patients with cutaneous T-cell lymphoma:association with disease severity and prognosis. J Eur Acad Dermatol Venereol,2013,27:e60-67.
6.	蔡柏蔷.慢性阻塞性肺疾病急性加重(慢阻肺急性加重)诊治中国专家共识(草案).中华哮喘杂志(电子版),2013,7:1-13.
7.	Sin DD, Miller BE, Duvoix A, et al. Serum PARC/CCL-18 concentrations and health outcomes in chronic obstructive pulmonary disease. Am J Respir Crit Care Med,2011,183:1187-1192.
8.	Sin DD, Pahlavan PS, Man SF. Surfactant protein D:a lung specific biomarker in COPD? Ther Adv Respir Dis,2008,2:65-74.
9.	Mazur W, Toljamo T, Ohlmeier S, et al. Elevation of surfactant protein A in plasma and sputum in cigarette smokers. Eur Respir J,2011,38:277-284.
10.	Johansson SL, Tan Q, Holst R, et al. Surfactant protein D is a candidate biomarker for subclinical tobacco smoke-induced lung damage. Am J Physiol Lung Cell Mol Physiol,2014,306:L887-L895.
11.	Fujita M, Shannon JM, Ouchi H, et al. Serum surfactant protein D is increased in acute and chronic inflammation in mice. Cytokine,2005,31:25-33.
12.	Hirama N, Shibata Y, Otake K, et al. Increased surfactant protein-D and foamy macrophages in smoking-induced mouse emphysema. Respirology,2007,12:191-201.
13.	Sims MW, Tal-Singer RM, Kierstein S, et al. Chronic obstructive pulmonary disease and inhaled steroids alter surfactant protein D (SP-D) levels:a cross-sectional study. Respir Res,2008,9:13.
14.	Schutyser E, Richmond A, Van Damme J. Involvement of CC chemokine ligand 18 (CCL18) in normal and pathological processes. J Leukoc Biol,2005,78:14-26.
15.	Kim HO, Cho SI, Chung BY, et al. Expression of CCL1 and CCL18 in atopic dermatitis and psoriasis. Clin Exp Dermatol,2012,37:521-526.
16.	Kollert F, Probst C, Müller-Quernheim J, et al.CCL18 production is decreased in alveolar macrophages from cigarette smokers. Inflammation,2009,32:163-168.
17.	Horváth I, Hunt J, Barnes PJ, et al. Exhaled breath condensate:methodological recommendations and unresolved questions. Eur Respir J,2005,26:523-548.
18.	Davis MD, Montpetit A, Hunt J. Exhaled breath condensate:an overview. Immunol Allergy Clin North Am,2012,32:363-375.
19.	Muller WG, Morini F, Eaton S, et al. Safety and feasibility of exhaled breath condensate collection in ventilated infants and children. Eur Respir J,2006,28:479-485.
20.	Kubáň P, Foret F. Exhaled breath condensate:determination of non-volatile compounds and their potential for clinical diagnosis and monitoring. Anal Chim Acta,2013,805:1-18.

1. Vestbo J, Hurd SS, Agustí AG, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease:GOLD executive summary. Am J Respir Crit Care Med,2013,187:347-365.
2. Restrepo MI, Anzueto A. Macrolide antibiotics for prevention of chronic obstructive pulmonary disease exacerbations:are we there yet? Am J Respir Crit Care Med,2014,190:1-2.
3. Crouch E, Wright JR. Surfactant proteins A and D and pulmonary host defense. Annu Rev Physiol,2001,63:521-554.
4. Moreno D, Garcia A, Lema D, et al. Surfactant protein D in chornic obstructive pulmonary disease (COPD). Recent Pat Endocr Metab Immune Drug Discov,2014,8:42-47.
5. Miyagaki T, Sugaya M, Suga H, et al. Increased CCL18 expression in patients with cutaneous T-cell lymphoma:association with disease severity and prognosis. J Eur Acad Dermatol Venereol,2013,27:e60-67.
6. 蔡柏蔷.慢性阻塞性肺疾病急性加重(慢阻肺急性加重)诊治中国专家共识(草案).中华哮喘杂志(电子版),2013,7:1-13.
7. Sin DD, Miller BE, Duvoix A, et al. Serum PARC/CCL-18 concentrations and health outcomes in chronic obstructive pulmonary disease. Am J Respir Crit Care Med,2011,183:1187-1192.
8. Sin DD, Pahlavan PS, Man SF. Surfactant protein D:a lung specific biomarker in COPD? Ther Adv Respir Dis,2008,2:65-74.
9. Mazur W, Toljamo T, Ohlmeier S, et al. Elevation of surfactant protein A in plasma and sputum in cigarette smokers. Eur Respir J,2011,38:277-284.
10. Johansson SL, Tan Q, Holst R, et al. Surfactant protein D is a candidate biomarker for subclinical tobacco smoke-induced lung damage. Am J Physiol Lung Cell Mol Physiol,2014,306:L887-L895.
11. Fujita M, Shannon JM, Ouchi H, et al. Serum surfactant protein D is increased in acute and chronic inflammation in mice. Cytokine,2005,31:25-33.
12. Hirama N, Shibata Y, Otake K, et al. Increased surfactant protein-D and foamy macrophages in smoking-induced mouse emphysema. Respirology,2007,12:191-201.
13. Sims MW, Tal-Singer RM, Kierstein S, et al. Chronic obstructive pulmonary disease and inhaled steroids alter surfactant protein D (SP-D) levels:a cross-sectional study. Respir Res,2008,9:13.
14. Schutyser E, Richmond A, Van Damme J. Involvement of CC chemokine ligand 18 (CCL18) in normal and pathological processes. J Leukoc Biol,2005,78:14-26.
15. Kim HO, Cho SI, Chung BY, et al. Expression of CCL1 and CCL18 in atopic dermatitis and psoriasis. Clin Exp Dermatol,2012,37:521-526.
16. Kollert F, Probst C, Müller-Quernheim J, et al.CCL18 production is decreased in alveolar macrophages from cigarette smokers. Inflammation,2009,32:163-168.
17. Horváth I, Hunt J, Barnes PJ, et al. Exhaled breath condensate:methodological recommendations and unresolved questions. Eur Respir J,2005,26:523-548.
18. Davis MD, Montpetit A, Hunt J. Exhaled breath condensate:an overview. Immunol Allergy Clin North Am,2012,32:363-375.
19. Muller WG, Morini F, Eaton S, et al. Safety and feasibility of exhaled breath condensate collection in ventilated infants and children. Eur Respir J,2006,28:479-485.
20. Kubáň P, Foret F. Exhaled breath condensate:determination of non-volatile compounds and their potential for clinical diagnosis and monitoring. Anal Chim Acta,2013,805:1-18.

Chinese Journal of Respiratory and Critical Care Medicine

慢性阻塞性肺疾病急性加重患者血清和呼出气冷凝液中肺表面活性蛋白D与趋化因子配体18的表达及其临床意义

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