Allergy Asthma Immunol Res.  2014 Jul;6(4):316-324. 10.4168/aair.2014.6.4.316.

Systemic Inflammation in Older Adults With Asthma-COPD Overlap Syndrome

• Fu JJ
• McDonald V
• Gibson PG
• Simpson JL

• KMID: 2260212
• DOI: http://doi.org/10.4168/aair.2014.6.4.316

Abstract

PURPOSE
The role of systemic inflammation on asthma-COPD overlap syndrome is unknown. This study aimed to examine systemic inflammation in asthma-COPD overlap syndrome, and to identify associations between clinical characteristics and inflammatory mediators in asthma-COPD overlap syndrome.
METHODS
In 108 adults older than 55 years comprising healthy controls (n=29), asthma (n=16), COPD (n=21) and asthma-COPD overlap syndrome (n=42), serum high sensitivity C-reactive protein and Interleukin 6 (IL-6) were assayed. Spirometry, induced sputum, quality of life, comorbidities and medications were assessed, and their associations with asthma-COPD overlap syndrome were analyzed using logistic regression. Associations between systemic inflammatory mediators and clinical characteristics were tested in multivariate linear regression models.
RESULTS
Patients with asthma-COPD overlap syndrome had significantly elevated IL-6 levels compared with healthy controls and asthmatics. Age, comorbidity index and IL-6 level were independently associated with asthma-COPD overlap syndrome. FEV1% predicted was inversely associated with IL-6 level, and cardiovascular disease was associated with an increased IL-6 level. Systemic markers were not associated with airway inflammation.
CONCLUSIONS
Systemic inflammation is commonly present in asthma-COPD overlap syndrome, and asthma-COPD overlap syndrome resembled COPD in terms of systemic inflammation. IL-6 is a pivotal inflammatory mediator that may be involved in airflow obstruction and cardiovascular disease and may be an independent treatment target.

Keyword

Ageing; C-reactive protein; interleukin-6; asthma; obstructive airway disease; comorbidity

MeSH Terms

Adult*
Asthma
C-Reactive Protein
Cardiovascular Diseases
Comorbidity
Humans
Inflammation*
Interleukin-6
Linear Models
Logistic Models
Pulmonary Disease, Chronic Obstructive
Quality of Life
Spirometry
Sputum
C-Reactive Protein
Interleukin-6

Figure

• 

  Fig. 1 Participant recruitment flow chart.

• 

  Fig. 2 Systemic inflammatory mediators in different groups. *With statistical significance.

• 

  Fig. 3 (A) Correlation between FEV1% predicted with IL-6, (B) Levels of IL-6 in patients with CVD vs non-CVD.

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