The processes of inflammation and fibrosis in patients with chronic obstructive pulmonary disease

Abstract

The aim of the study was to determine the categories of COPD patients with a predominance of fibrotic or inflammatory processes. The study included 37 stable COPD patients (men – 33 (89.2%), women – 4 (10.8%), mean age – 63.5±1.18 years, the level of forced expiratory volume for the first second after the test with bronchodilators (FEV_1post) – 46.7±5.81% of the proper value). To determine the categories of COPD patients with a predominance of inflammation or fibrosis, a cluster analysis was performed. For this purpose the most important indicators from a clinical point of view were selected: the number of exacerbations over the past year, dyspnea severity according to the mMRC scale, the level of FEV₁ post and reversibility level in absolute values, systemic inflammation markers levels (CAA, C-RP) and profibrotic cytokine TGF-β₁. Thus, according to the results of cluster analysis, two categories of patients were identified. The first category – COPD patients with a predominance of the inflammatory process with low dyspnea severity, high functional indicators (FEV₁ >50% of the proper value), high airway reversibility level, low level of profibrotic cytokine TGF-β₁, high levels of systematic inflammation markers (C-RP and CAA). The second category – COPD patients with a predominance of the fibrosis process, with a high dyspnea severity, low functional indicators (FEV₁ ≤50% of the proper value), low airway reversibility level, low levels of systematic inflammation markers (C-RP and CAA), and high profibrotic cytokine TGF-β₁ levels. The prevalence of inflammatory processes was observed mainly in COPD patients, who belong to clinical group C; the prevalence of fibrotic processes – mainly in patients of clinical group B.