Mixed Th2 and non-Th2 inflammatory pattern in the asthma-COPD overlap: a network approach

• Published in: International journal of chronic obstructive pulmonary disease 2018-01, Vol.13, p.591-601
• Main Authors: de Llano, Luis Pérez, Cosío, Borja G, Iglesias, Amanda, de Las Cuevas, Natividad, Soler-Cataluña, Juan Jose, Izquierdo, Jose Luis, López-Campos, Jose Luis, Calero, Carmen, Plaza, Vicente, Miravitlles, Marc, Torrego, Alfons, Martinez-Moragon, Eva, Soriano, Joan B, Viña, Antolin Lopez, Bobolea, Irina
• Format: Article
• Language: English
• Subjects: Adult; Aged; Airway management; Ambulatory care facilities; Analysis; Asthma; Asthma - blood; Asthma - diagnosis; Asthma - immunology; Asthma - physiopathology; asthma mechanisms; Biomarkers; Biomarkers - blood; Cell Adhesion Molecules - blood; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; COPD mechanisms; Cross-Sectional Studies; Discriminant Analysis; Eosinophilia; Female; Forced Expiratory Volume; Hospitals; Humans; Inflammation; Inflammation Mediators - blood; inflammatory cytokines; Inhalers; Interleukin-13 - blood; Interleukin-17 - blood; Interleukin-5 - blood; Interleukin-6 - blood; Interleukin-8 - blood; Lung - physiopathology; Lung diseases; Lung volume measurement; Male; Medical research; Middle Aged; Necrosis; Neural Networks (Computer); Original Research; Prognosis; Pulmonary Disease, Chronic Obstructive - blood; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - immunology; Pulmonary Disease, Chronic Obstructive - physiopathology; Spain; Th2 Cells - immunology; Th2 Cells - metabolism; Tumor necrosis factor; Tumor Necrosis Factor-alpha - blood; Tumor necrosis factor-TNF; Tumors; Variables; Vital Capacity
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/copd.s153694

The asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is a clinical condition that combines features of those two diseases, and that is difficult to define due to the lack of understanding of the underlying mechanisms. Determining systemic mediators may help clarify the nature of inflammation in patients with ACO. We aimed at investigating the role and interaction of common markers of systemic inflammation (IL-6, IL-8, and tumor necrosis factor-α), Th2-related markers (periostin, IL-5, and IL-13), and IL-17 in asthma, COPD, and ACO. This is a cross-sectional study of patients aged ≥40 years with a post-bronchodilator forced expiratory volume in the first second/forced vital capacity 10 pack-years in a patient with a previous diagnosis of asthma or by the presence of eosinophilia in a patient with a previous diagnosis of COPD. Clinical, functional, and inflammatory parameters were compared between categories using discriminant and network analysis. In total, 109 ACO, 89 COPD, and 94 asthma patients were included. Serum levels (median [interquartile range]) of IL-5 were higher in asthma patients than in COPD patients (2.09 [0.61-3.57] vs 1.11 [0.12-2.42] pg/mL, respectively; =0.03), and IL-8 levels (median [interquartile range]) were higher in COPD patients than in asthma patients (9.45 [6.61-13.12] vs 7.03 [4.69-10.44] pg/mL, respectively;