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Systemic inflammation associated with frequent asthma, COPD exacerbations

Increases in systemic inflammation predict more frequent exacerbations in patients with asthma as well as airway Interluekin-1β in patients with COPD, according to study results.

“Importantly, we identified a potential causal pathway that shows how airway innate immune activation through Interluekin-1β (IL-1β) results in systemic inflammation and exacerbations in COPD,” Juan-Juan Fu, MD, PhD, department of Integrated Traditional Chinese and West Medicine, West China Hospital, and colleagues wrote. “This pathway could contribute to a vicious cycle between previous and future exacerbations and may identify potential molecular treatment targets that could reduce exacerbations in COPD.”

Fu and colleagues conducted a prospective cohort study on 152 participants with asthma (n = 63) and COPD (n = 89) to investigate airway innate immune activation and systemic inflammation as predictors of exacerbations in patients with asthma and COPD.

Participants attended a baseline visit to assess demographics including smoking status, medical history and medication use.

The researchers also collected data regarding respiratory hospitalizations, ER visits and unscheduled primary care doctor visits.

Participants had sputum gene expression measured using a quantitative real-time polymerase chain reaction.

Baseline sputum IL-1β gene expression and protein level predicted the frequent exacerbation phenotype and the number of exacerbations in patients with COPD (OR = 1.26; 95% CI, 1.06-1.51).

Systemic inflammation, categorized by the level of IL-6, was also an independent predictor of exacerbation frequency 12 months after follow-up in both asthma (IRR = 1.1; 95% CI, 1.02-1.17) and COPD (IRR = 1.01; 95% CI, 1-1.02).

Fu and colleagues noted the importance of continued research and the strengths of the results in helping to prevent future exacerbations.

“Anti-inflammatory therapies targeting the airway IL-1β-systemic inflammatory pathway, which break the vicious cycle of inflammation leading to exacerbations, show promise as a strategy for preventing exacerbations,” Fu and colleagues wrote. “In addition, further studies investigating the role of IL-1β including its relationship to the inflammasome activation and bacterial colonization are [warranted].”

Disclosure: Fu reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.