Published ahead of print on December 13, 2007, doi:10.1164/rccm.200708-1234OC
© 2008 American Thoracic Society doi: 10.1164/rccm.200708-1234OC
Inflammatory Profile of New Bacterial Strain Exacerbations of Chronic Obstructive Pulmonary Disease1 Division of Pulmonary and Critical Care and Sleep Medicine, Department of Medicine, University at Buffalo, State University of New York; 2 Veterans Affairs Western New York Healthcare System, Buffalo, New York; and 3 Division of Infectious Diseases, Department of Microbiology, and 4 Department of Biostatistics, University at Buffalo, State University of New York Correspondence and requests for reprints should be addressed to Sanjay Sethi, M.D., VA WNY Healthcare System (151), 3495 Bailey Avenue, Buffalo, NY 14215. E-mail: ssethi{at}buffalo.edu Rationale: Whether the airway and systemic inflammatory profile in bacterial exacerbations of chronic obstructive pulmonary disease (COPD) is distinct from nonbacterial exacerbations is unclear. Previous studies have not used molecular typing of bacterial pathogens, which is required to accurately define bacterial infection in COPD. The relationship between clinical severity and course of exacerbation and inflammation is also not fully understood. Objectives: To determine if (1) systemic and airway inflammation is distinct in new bacterial strain exacerbations and (2) clinical severity and resolution of exacerbations is related to airway and systemic inflammation. Methods: In a prospective longitudinal cohort study in COPD, sputum and serum samples obtained before, at, and following exacerbations during a 2-year period were studied.
Measurements and Main Results: Clinical information, molecular typing of bacterial pathogens, sputum IL-8, tumor necrosis factor (TNF)- Conclusions: Neutrophilic airway inflammation and systemic inflammation are more intense with well-defined bacterial exacerbations than with nonbacterial exacerbations. Clinical course of exacerbation and inflammation are closely linked.
Key Words: chronic obstructive pulmonary disease exacerbation inflammation
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