CORRELATION BETWEEN INDEXES AND CHANGES OF IMMUNE FUNCTION IN ACUTE EXACERBATION OF COPD

Qianbing Li^{1, *}, Dongping Li², Jun Chen¹, Jiafeng Su³, Peng Ye¹, Yan Yu¹, Yufeng Xu¹, Hejun Liu¹

¹Department of Respiratory Diseases, Anqing First People’s Hospital, Anqing 246052, Anhui Province, China - ²Department of Respiratory Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 246052, Guangdong Province, China - ³Department of Nursing, Anqing First People’s Hospital, Anqing 246052 Anhui Province, China¹Department of Respiratory Diseases, Anqing First People’s Hospital, Anqing 246052, Anhui Province, China - ²Department of Respiratory Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 246052, Guangdong Province, China - ³Department of Nursing, Anqing First People’s Hospital, Anqing 246052 Anhui Province, China

Objective: To evaluate the correlation between inflammatory factors, lung function and immune function in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). 

Methods: 96 patients with COPD treated in our hospital from January 2021 to January 2022 were included in this study. According to the course of the disease, they were divided into 40 cases in the stable stage group and 56 cases in the acute exacerbation stage group; In addition, 50 healthy subjects in the same period were selected as the reference group; The indexes of lung function, inflammation and immunology were measured. 

Results: the pulmonary function indexes FEV1 and FEV1 / FVC of the three groups were compared (P<0.05); Compared with the control group, the indexes of pulmonary function in patients with COPD decreased in stable stage or acute exacerbation stage (P<0.05); FEV1 / FVC and FEV1 in acute exacerbation group were significantly lower than those in stable phase group (P<0.05). The expression levels of inflammatory factors hs CRP, IL-37 and IL-6 in the three groups were compared (P<0.05); The levels of hs CRP, IL-37 and IL-6 in patients with acute exacerbation and stable COPD were higher than those in the control group (P<0.05); The levels of hs CRP, IL-37 and IL-6 in patients with acute exacerbation COPD were higher than those in patients with stable COPD (P<0.05). Comparison of immunological indexes among the three groups (P < 0.05); Compared with the control group, the indexes of CD8 +, Th17 increased and the indexes of CD3 +, CD4 +, Treg decreased in patients with acute exacerbation and stable COPD (P<0.05); The indexes of CD8 +, Th17 in patients with acute exacerbation COPD were higher than those in patients with stable COPD, while the indexes of CD3 +, CD4 +, Treg were lower than those in patients with stable COPD (P<0.05). Pearson correlation analysis showed that FEV1 and FEV1 / FVC indexes of pulmonary function were positively correlated with immune indexes CD3 +, CD4 +, Treg, etc., and moderately negatively correlated with Th17 (P < 0.05); The correlation between FEV1 and FEV1 / FVC and CD8 + was very weak (P>0.05). The inflammatory indexes hs CRP, IL-37 and IL-6 showed significant negative correlation with CD3 +, CD4 +, Treg (P<0.05), but significant positive correlation with CD8 +, Th17 (P<0.05). 

Conclusion: the level of pulmonary function in patients with acute exacerbation COPD decreased significantly, and the expression level of inflammatory factors increased significantly; The overexpression of inflammatory factors and the decline of pulmonary function are significantly correlated with the changes of immune function. Immunological indexes can be used as important indexes to predict and evaluate the pulmonary function and prognosis of patients with acute exacerbation COPD.