Serum ECP and MPO are increased during exacerbations of chronic bronchitis with airway obstruction

doi:10.1016/S0753-3322(00)80071-2

Biomedicine & Pharmacotherapy

Volume 54, Issue 5, June 2000, Pages 274-278

https://doi.org/10.1016/S0753-3322(00)80071-2 Get rights and content

Summary

Many studies have demonstrated that, in asthma, serum levels of eosinophil cationic protein (ECP) are related to the activity and severity of the disease and can be used to evaluate the response to steroid treatment. During exacerbations of chronic bronchitis, airway inflammation shows some features of asthmatic inflammatory processes, with recruitment of eosinophils and recovery of significant amounts of ECP in bronchial lavage fluid (BAL). Involvement of neutrophils, with high levels of myeloperoxidase (MPO), is, on the contrary, typical of this latter disease, and not shared with asthma. In spite of the information collected with BAL and bronchial biopsy studies, few data still exist on serum levels of these proteins in chronic bronchitis. The objective of this study was to assess if serum levels of ECP and MPO are specifically increased in exacerbations of chronic bronchitis, as compared to other non-asthmatic acute respiratory disturbances. Serum ECP, MPO and immunoglobulin E (IgE) levels were measured in 17 non-atopic patients with exacerbation of chronic bronchitis with airway obstruction (COPD) and in 11 control subjects seeking emergency medical treatment for unrelated acute respiratory problems. Spirometry was performed in patients able to give the necessary collaboration. All the subjects of this study were recruited from the emergency department. Both ECP and MPO were significantly increased in serum from patients with exacerbated COPD (22.2 ± 4.1 vs 9.5 ± 1.4 mcg/L and 853 ± 168 vs 375 ± 41 mcg/L) and a strong correlation existed between these two variables (r = 0.782). A further control group was made of 11 patients with stable COPD. These subjects had levels of both ECP (13.1 ± 2.7 mcg/L) and MPO (469 ± 71) significantly lower than patients with exacerbated disease and higher than those without COPD. We conclude that serum ECP and MPO are increased during the exacerbations of COPD. These observations can give a basis for further studies aimed to evaluate the utility of these two proteins as markers of activity and severity of COPD.

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Citation Excerpt :
However, the failure of finding eosinophils may be due to the high levels of neutrophil elastase which causes degranulation of eosinophils through which these cells are no longer recognizable under microscope (Keatings and Barnes, 1997; Liu et al., 1999). Broncho-alveolar lavage fluid from patients with COPD do contain increased levels of eosinophilic cationic proteins (Fiorini et al., 2000). Also, the levels of eotaxin, a chemoattractant for eosinophils produced by epithelial cells, are higher in sputum of patients with COPD than in healthy control (Balzano et al., 1999).
Chronic obstructive pulmonary disease (COPD) is a global health problem. Being a progressive disease characterized by inflammation, it deteriorates pulmonary functioning. Research has focused on airway inflammation, oxidative stress, and remodelling of the airways. Macrophages, neutrophils and T cells are thought to be important key players. A number of new research topics received special attention in the last years. The combined use of inhaled corticosteroids and long-acting β₂-adrenoceptor agonists produces better control of symptoms and lung function than that of the use of either compound alone. Furthermore, collagen breakdown products might be involved in the recruitment and activation of inflammatory cells by which the process of airway remodelling becomes self-sustaining. Also, TLR (Toll-like receptor)-based signalling pathways seem to be involved in the pathogenesis of COPD. These new findings may lead to new therapeutic strategies to stop the process of inflammation and self-destruction in the airways of COPD patients.

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Original articleSerum ECP and MPO are increased during exacerbations of chronic bronchitis with airway obstruction

Summary

Rev Fr Allergol

Rev Fr Allergol

J Allergy Clin Immunol

Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease

Am J Respir Crit Care Med

Airway structure to function relationships in asthma and COPD

Monaldi Arch Chest Dis

Upregulation of adhesion molecules in the bronchial mucosa of subjects with chronic obstructive bronchitis

Am J Respir Crit Care Med

Quantitation of mast cells and eosinophils in the bronchial mucosa of symptomatic atopic asthmatics and healthy control subjects using immunohistochemistry

Am Rev Respir Dis

Asthma versus chronic obstructive pulmonary disease — exploring why ‘reversibility versus irreversibility’ is no longer an appropriate approach

Clin Exp Allergy

The natural history of chronic bronchitis and emphysema. An eight year study of early COPD in working men in London

Induced sputum eosinophil cationic protein (ECP) measurement in asthma and chronic obstructive airway disease (COAD)

Clin Exp Allergy

Concentrations of ECP are increased in COPD but these are not modified, by treatment with inhaled corticosteroids [abstract]

Thorax

Effects of inhaled and oral glucocorticoids on inflammatory indices in asthma and COPD

Am J Respir Crit Care Med

Airway inflammation in smokers with nonobstructive and obstructive chronic bronchitis

Am Rev Respir Dis

Original article
Serum ECP and MPO are increased during exacerbations of chronic bronchitis with airway obstruction