Dynamic pulmonary hyperinflation and low grade systemic inflammation in stable COPD patients

D. Gatta, G. Aliprandi*, L. Pini, A. Zanardini*, M. Fredi*, C. Tantucci

Unit of Respiratory Medicine, Department of Medical and Surgical Sciences, University of Brescia, Brescia (Italy) *Unit of Pulmonary Rehabilitation, Hospital “Domus Salutis” Brescia (Italy)

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• Respiratory Medicine

Background and Objectives: It is increasingly recognized that a low grade of systemic inflammation occurs in patients with advanced chronic obstructive pulmonary disease (COPD). C-reactive protein (CRP), a marker of systemic chronic inflammatory response, has been related with decreased survival in large cohorts of COPD patients.
The aim of the study was to assess if resting dynamic pulmonary hyperinflation (DH) is linked to the presence of systemic inflammation in COPD.

Materials and Methods: In a 12-month retrospective study involving 55 out-patients with COPD (FEV1 59±23% pred.) examined in stable conditions, inspiratory capacity (IC) was measured at rest and considered as index of DH when lower than 80% predicted. Simultaneously, CRP (by immuno-turbidometry) and white blood cells (WBC), uric acid and alpha-1 globulins were measured in the venous blood in the morning before eating.

Results: CRP was significantly increased in the COPD patients with IC 80% pred. (n=20; IC = 97+13% pred.), amounting to 0.70±0.59 vs 0.29±0.28 mg/dl, respectively (p < 0.01). CRP was inversely related to IC (% pred.) (r=0.45, p < 0.01). WBC, serum uric acid (an endogenous danger signal), and albumin and alfa-1 globulins were not different between the two groups.

Discussion: These results show that the IC reduction is associated with higher serum levels of CRP in stable COPD patients, suggesting a potential role of dynamic pulmonary hyperinflation on development and maintenance of low grade systemic inflammation in COPD.

Corresponding Author: Claudio Tantucci, MD; e-mail: tantucci@med.unibs.it

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