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10 September 2019 : Clinical Research  

Clinical Features of Patients with Bronchiectasis with Comorbid Chronic Obstructive Pulmonary Disease in China

Chenli Xie1AEG*, Yongtao Wen1BDF, Yiju Zhao1AF, Sufen Zeng1BE, Qingling Guo1CD, Qiuting Liang1AD, Lichong Chen1BF, Yuanbin Liu1AE, Fuman Qiu2BD, Lei Yang2CF, Jiachun Lu2CE

DOI: 10.12659/MSM.917034

Med Sci Monit 2019; 25:6805-6811

Abstract

BACKGROUND: The prevalence of bronchiectasis with comorbid chronic obstructive pulmonary disease (COPD) is rising, which causes extremely high risk of exacerbation and mortality. We aimed to evaluate the differences in clinicopathological manifestations, immune function, and inflammation in bronchiectasis patients with comorbid COPD vs. patients who only have COPD.

MATERIAL AND METHODS: Clinicopathological characteristics, including common potentially pathogenic microorganisms, lung function, immune function, and inflammation were assessed in bronchiectasis patients with comorbid COPD and in patients who only had COPD.

RESULTS: Compared to patients who only had COPD, patients with bronchiectasis with comorbid COPD had a higher positive rate of sputum bacteria (45.27% vs. 28.03%, P<0.01). Among them, Pseudomonas aeruginosa (P. aeruginosa) accounted for 25.19% in COPD (4.37%) (P<0.01). Likewise, patients with bronchiectasis with comorbid COPD had worse lung function, worse COPD assessment test scores, and worse Modified Medical Research Council scores. Moreover, compared with COPD only cases, patients with bronchiectasis with comorbid COPD had higher levels of white blood cells (WBC), neutrophils, C-reactive protein (CRP), and procalcitonin (PCT) (all P<0.05). Interestingly, the expression levels of Treg in patients with bronchiectasis with comorbid COPD were lower than in patients with COPD only (P<0.05). Th17 and Th17/Treg levels were higher (P<0.05). Furthermore, remarkable increased level of IL17 and IL-6 and decreased level of IL-10 and TGF-β were observed in the bronchiectasis combined COPD than in pure COPD (All P<0.05).

CONCLUSIONS: Our findings suggest that P. aeruginosa is the main pathogen of bacterial infection in bronchiectasis patients with comorbid COPD. These patients have more serious clinical manifestations and immune imbalance, which should be considered when providing clinical treatment.

Keywords: Bronchiectasis, Lung Diseases, Obstructive, Pseudomonas aeruginosa, biomarkers, China, Comorbidity, Disease Progression, Middle Aged, Pulmonary Disease, Chronic Obstructive, Respiratory Function Tests, Sputum

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750