avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2023-13-3-213-223PKZRCJavk-1616Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLEАНАЛИЗ БИОМАРКЕРОВ ВОСПАЛЕНИЯ В КОНДЕНСАТЕ ВЫДЫХАЕМОГО ВОЗДУХА У ПАЦИЕНТОВ С ХОБЛ В СОЧЕТАНИИ С ОБЛИТЕРИРУЮЩИМ АТЕРОСКЛЕРОЗОМ АРТЕРИЙ НИЖНИХ КОНЕЧНОСТЕЙAnalysis of Inflammation Biomarkers in Exhaled Breath Condensate in Patients with COPD Combined with Peripheral Arterial DiseaseКотляровС. Н.KotlyarovS. N.

Рязань

Ryazan 

СучковИ. А.SuchkovI. A.

Рязань

Ryazan 

УрясьевО. М.UryasevO. M.

Рязань

Ryazan 

КотляроваА. А.KotlyarovaA. A.

Рязань

Ryazan 

Рязанский государственный медицинский университет им. акад. И.П. ПавловаРоссияRyazan State Medical UniversityRussian Federation202307062023133213223Copyright © Котляров С.Н., Сучков И.А., Урясьев О.М., Котлярова А.А., 20232023Котляров С.Н., Сучков И.А., Урясьев О.М., Котлярова А.А.Kotlyarov S.N., Suchkov I.A., Uryasev O.M., Kotlyarova A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1616

Актуальность. Хроническая обструктивная болезнь легких (ХОБЛ) является одной из наиболее значимых респираторных патологий, что связано с ее высокой распространенностью и влиянием на прогноз. Частота обострений и коморбидность — важные факторы, влияющие на течение ХОБЛ. Считается, что локальное и системное воспаление могут лежать в основе гетерогенного течения ХОБЛ. В этой связи оценка активности локального воспаления в дыхательных путях может быть полезна для оценки течения ХОБЛ. Цель. Изучить молекулярные механизмы ХОБЛ и оценить биомаркеры воспаления в конденсате выдыхаемого воздуха у пациентов с ХОБЛ с частыми обострениями в сочетании с периферическим атеросклерозом. Материалы и методы. Проведен биоинформационный анализ данных из Gene Expression Omnibus (GEO) с целью изучения генной онтологии дифференциально экспрессируемых генов при ХОБЛ. Далее проведено исследование провоспалительных цитокинов интерлейкина — 1 бета (interleukin (IL)-1β) и фактора некроза опухоли альфа (tumor necrosis factor alpha (TNFα)) в конденсате выдыхаемого воздуха (КВВ) у пациентов с ХОБЛ с частыми обострениями без сопутствующих атеросклеротических сердечно-сосудистых заболеваний (АССЗ) и у пациентов с ХОБЛ с частыми обострениями и облитерирующим атеросклерозом артерий нижних конечностей (ОААНК) в сравнении со здоровым контролем. Результаты. Дифференциально экспрессируемые гены вовлечены в биологические процессы и сигнальные пути по Киотской энциклопедии генов и геномов (Kyoto Encyclopedia of Genes and Genomes, KEGG пути), связанные с иммунным ответом, которые могут связывать развитие и прогрессирование ХОБЛ и атеросклероза. У пациентов с ХОБЛ в сочетании с атеросклерозом наблюдались более высокие значения IL-1β и TNFα в КВВ, по сравнению с контролем (p <0,001). У пациентов с ХОБЛ с частыми обострениями и ОААНК были обнаружены наиболее высокие уровни IL-1β и TNFα в КВВ в сравнении с пациентами без АССЗ (р=0,0038 и p=0,0005 соответственно). Вывод. У пациентов с ХОБЛ с частыми обострениями и ОААНК повышены уровни TNFα и IL1β в КВВ, что может свидетельствовать о наличии локального воспаления в дыхательных путях, выраженность которого связана с клиническим течением ХОБЛ. 

Background. Chronic obstructive pulmonary disease (COPD) is one of the most significant diseases due to its high prevalence and impact on prog- nosis. The frequency of exacerbations and comorbidity are important factors influencing the course of COPD. It is believed that local and systemic inflammation may underlie this heterogeneous course of COPD. In this regard, assessment of local inflammation activity in the respiratory tract may be useful to assess the course of COPD. Aim. To study molecular mechanisms of COPD and assess inflammation biomarkers in the exhaled breath condensate (EBC) in patients with COPD with the phenotype of frequent exacerbations combined with peripheral atherosclerosis. Materials and Methods. Bioinformatic analysis of data from Gene Expression Omnibus (GEO) was performed to examine gene ontology of differentially expressed genes in COPD. Proinflammatory cytokines interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNFα) in EBC in COPD patients without concomitant atherosclerotic cardiovascular disease (ASCVD) in the stable course phase, in patients with COPD with the phenotype of frequent ex- acerbations and peripheral artery disease (PAD) compared with healthy controls were examined. Results. Differentially expressed genes are involved in biological processes and signaling pathways according to the Kyoto Encyclopedia of Genes and Genomes (KEGG pathway) associated with the immune response that may link the development and progression of COPD and atherosclerosis. Patients with COPD combined with atherosclerosis had higher values of IL-1β and TNFα in EBC compared with controls (p <0.001). COPD patients with frequent exacerbations and PAD had the highest levels of IL-1β and TNFα in EBC compared with patients without ASCVD (p=0.0038 and p=0.0005, respectively). Conclusion. TNFα and IL1-β levels in EBC are elevated in COPD patients with frequent exacerbations and PAD, which may indicate the presence of local inflammation in the airways, the severity of which is associated with the clinical course of COPD.

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The authors declare that there are no conflicts of interest present.