Objective This study aims to investigate the changes of inflammatory markers of oropharynx and its correlation with prognosis in the stable phase of chronic obstructive pulmonary disease (COPD). Methods Sixty-two patients with COPD in stable stage were divided into smoking and non-smoking groups, and 31 healthy persons were selected as controls. The pharyngeal swabs were collected to determine tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), collagen type Ⅳ (COL-4), and fibronectin (FN) by an enzyme-linked immunosorbent assay. Meanwhile, eosinophil count and C-reactive protein (CRP) in peripheral blood were measured. The correlations between the above metrics and COPD and the prognosis of the patients were analyzed. Results TNF-α, IL-8, COL-4, FN and CRP levels in patients with COPD were significantly higher compared with control groups (P<0.05), and there were significant differences between smoking and non-smoking groups in inflammatory markers such as TNF-α, IL-8, FN, CRP (P<0.05). The forced expiratory volume in one second (FEV1) and FEV1%pred of patients with COPD were significantly lower than the control group (P<0.05). The smoking index of patients with COPD in smoking group was significantly higher than that in smoking control group (P<0.05). TNF- α and IL-8 were positively associated with blood CRP in patients with COPD. Conclusion The inflammatory markers of oropharynx in patients with COPD are different from those in healthy persons and smoking may promote the increase of inflammatory markers of oropharynx in patients with COPD; the non-invasive detection of paired pharyngeal inflammatory markers may be helpful in determining acute onset and prognosis.
Objective To explore the clinical and inflammatory characteristics and risk factors of severe asthma to improve clinicians' awareness of the disease. Methods The general information of patients with asthma who visited the Department of Respiratory Medicine, the First Hospital of Shanxi Medical University from May 2018 to May 2021, as well as the diagnosis and treatment of asthma, personal history, comorbidities, auxiliary examination, asthma control test (ACT) score were collected. A total of 127 patients were included, including 40 in the severe asthma group and 87 in the mild-to-moderate asthma group. Chi-square test, independent sample t test and logistic regression were used to analyze the clinical characteristics, inflammatory markers and risk factors of severe asthma. Results Compared with the patients with mild to moderate asthma, the patients with severe asthma were more older (51.0±12.0 years vs 40.7±12.8 years, P<0.05), had more smokers (32.5% vs. 14.9%, P<0.05), and more males (67.5% vs. 40.2%, P<0.05). The patients with severe asthma got poor FEV1%pred [(56.1±23.8)% vs. (93.2±18.0)%, P<0.05] and FEV1/FVC [(56.7±13.2)% vs. (75.8±9.0)%, P<0.05)], and more exacerbations in the previous year (2.7±3.1 vs. 0.1±0.4, P<0.05), lower ACT score (14.4±3.7 vs. 18.0±5.0, P<0.05), and higher blood and induced sputum eosinophil counts [(0.54±0.44)×109/L vs. (0.27±0.32)×109/L, P<0.05; (25.9±24.2)% vs. (9.8±17.5)%, P<0.05]. There was no significant difference in the proportion of neutrophils in the induced sputum or FeNO between the two groups (P>0.05). Analysis of related risk factors showed that smoking (OR=2.740, 95%CI 1.053 - 7.130), combined with allergic rhinitis (OR=14.388, 95%CI 1.486 - 139.296) and gastroesophageal reflux (OR=2.514, 95%CI 1.105 - 5.724) were risk factors for severe asthma. Conclusions Compared with patients with mild to moderate asthma, patients with severe asthma are characterized by poor lung function, more exacerbations, and a dominant eosinophil inflammatory phenotype, which is still poorly controlled even with higher level of treatment. Risk factors include smoking, allergic rhinitis, and gastroesophageal reflux, etc.