Systemic signs of neutrophil mobilization during clinically stable periods and during exacerbations in smokers with obstructive pulmonary disease

Figures & data

Figure 1 Blood concentrations of (A) neutrophils, (B) MPO protein, (C) NE protein, and (D) CRP in smokers with OPD-CB, AS, and NS during a clinically stable period at the time of inclusion.

Notes: The data are presented both as individual (dots) and median (bold lines) values (*P<0.05, Kruskal–Wallis test followed by the Mann–Whitney U-test, n=10 [never-smokers and asymptomatic smokers], n=60 [OPD-CB]).

Abbreviations: AS, asymptomatic smokers; CRP, C-reactive protein; MPO, myeloperoxidase; NE, neutrophil elastase; NS, never-smokers; OPD-CB, obstructive pulmonary disease and chronic bronchitis.

Figure 2 Correlations between (A) blood concentrations of MPO protein and neutrophils (ρ=0.38, P<0.05, Spearman rank correlation) and (B) blood concentrations of NE protein and neutrophils (ρ=0.38, P<0.05, Spearman rank correlation) of smokers with obstructive pulmonary disease and chronic bronchitis (n=34) during a clinically stable period at the time of inclusion.

Abbreviations: MPO, myeloperoxidase; NE, neutrophil elastase.

Figure 3 Correlations between (A) blood concentrations of MPO and NE protein (ρ=0.72, P<0.001, Spearman rank correlation) and (B) levels of mRNA for MPO and NE in blood leukocytes (r=0.85, P<0.001, Spearman rank correlation) in smokers with obstructive pulmonary disease and chronic bronchitis (n=34) during a clinically stable period at the time of inclusion.

Abbreviations: MPO, myeloperoxidase; NE, neutrophil elastase; OPD-CB, obstructive pulmonary disease and chronic bronchitis.

Table 1 Circulating markers of inflammation in smokers with OPD-CB

Marker	Inclusion (n=60)	Exacerbation (n=38)	P-value
MPO (µg/mL)	27 (15–62)	38 (16–570)	<0.01
NE (µg/mL)	44 (131–102)	53 (23–212)	>0.05
CRP (mg/L)	2.3 (2.0–19.0)	6.5 (0.3–300)	<0.001
Leukocytes (×10^9/L)	7.1 (4.5–13.5)	8.3 (5.4–16.0)	<0.01
Neutrophils (×10^9/L)	4.1 (2.3–9.6)	5.5 (3.1–13.0)	<0.01

Abbreviations: CRP, C-reactive protein; MPO, myeloperoxidase; NE, neutrophil elastase; OPD-CB, obstructive pulmonary disease and chronic bronchitis.

Table 2 Characteristics of smokers with OPD-CB and low transcutaneous oxygen during exacerbations

Severity of OPD-CB	Inclusion (n=18)			Exacerbation (n= 18)
	Transcutaneous oxygen saturation (%)	Inhaled glucocorticoids (yes/no)	Respiration rate (per minute)	PaO2 (kPa)	Respiration rate (per minute)	Hospitalization (yes/no)
Mild (n=10)	95 (94–98)	6/4	18 (15–22)	8.9 (7.2–10.4)	21 (18–22)	2/8
Severe (n=8)	93 (92–95)	6/2	20 (16–24)	7.8 (7.3–9.8)	20 (16–26)	1/7

Notes: All individuals in the table had transcutaneous oxygen saturation <94% but none required mechanical ventilation during exacerbations; mild, OPD-CB corresponding to GOLD stage I and II; severe, OPD-CB corresponding to GOLD stage III–IV; the data are presented as the median and range (n=8–10).

Abbreviations: OPD-CB, obstructive pulmonary disease and chronic bronchitis; PaO₂, partial oxygen pressure; GOLD Global Initiative for Chronic Obstructive Lung Disease.

Figure 4 Blood concentrations of MPO protein before, during, and after exacerbations in smokers with obstructive pulmonary disease and chronic bronchitis (n=38).

Notes: The data are presented as individual (circles) and median (bold lines) values (*) P<0.05; Mann Whitney U-test).

Abbreviations: EXA, exacerbation; MPO, myeloperoxidase.

Figure 5 Correlations between (A) blood concentrations of MPO and NE protein (ρ=0.4, P<0.05, Spearman rank correlation) and (B) levels of MPO and NE mRNA in blood leukocytes (ρ=0.89, P<0.001, Spearman rank correlation) from smokers with obstructive pulmonary disease and chronic bronchitis (n=34) during exacerbations. The data are presented as individual values.

Abbreviations: MPO, myeloperoxidase; NE, neutrophil elastase.

Figure 6 Correlations between oxygen saturation and signs of systemic inflammation in smokers with obstructive pulmonary disease and chronic bronchitis (n=18) who displayed transcutaneous hypoxia during exacerbations.

Notes: (A) PaO₂ and blood neutrophil concentrations (ρ=0.63, P<0.01, Spearman rank correlation). (B) PaO₂ and blood concentrations of NE protein (ρ=0.56, P<0.05, Spearman rank correlation). (C) PaO₂ and blood concentrations of MPO protein (ρ=0.5, P<0.05, Spearman rank correlation).
Abbreviations: MPO, myeloperoxidase; NE, neutrophil elastase; PaO₂, partial oxygen pressure.