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Objective To explore the predictive value of serum chemokine interleukin (IL)-8 for acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A total of 112 COPD patients with acute exacerbation, who were initially diagnosed or did not receive standardized treatment in our hospital from Sep. 2015 to May 2016, were included in this study. According to serum level of IL-8, the patients were divided into high IL-8 group (<62 pg/mL) and low IL-8 group (≥62 pg/mL). The blood test results, serum levels of immunoglobulin E (IgE), IL-8, IL-6, tumor necrosis factor α (TNF-α), and superoxide dismutase (SOD), fractional exhaled nitric oxide (FeNO) and pulmonary function parameters were compared between the two groups. The interval time between beginning of follow-up and the first moderate to severe acute exacerbation and the times of acute exacerbation were recorded and compared between the two groups during one-year follow-up. Univariate analysis between serum IL-8 and variables was performed by Spearman correlation analysis. Cox regression was used to analyze the relative risk (RR) of acute exacerbation of the COPD patients in the two groups. Kaplan-Meier curve was used to analyze the proportion of the patients without acute exacerbation and hazard ratio (HR) during the follow-up in the two groups. Results The median levels of IL-8 were 170.00 (111.00, 472.00) pg/mL and 22.40 (7.90, 34.45) pg/mL in the high IL-8 group (n=47) and low IL-8 group (n=65), respectively. The proportion of allergic rhinitis cases and COPD assessment test (CAT) score were significantly higher in the high IL-8 group than those in the low IL-8 group (51.06% [24/47] vs 10.77% [7/65], P<0.01; 24.81±5.10 vs 19.38±4.27, P<0.01). The acute exacerbation times were significantly more in the high IL-8 group than those in the low IL-8 group (1.5 [1.0, 2.5] vs 1.0 [0.0, 1.5], P<0.01). Before inhaling bronchodilators, the high IL-8 group had significantly lower forced expiratory flow at 25%-75% of forced vital capacity (FEF25%-75%), FEF25%-75% as percentage of predicted, forced expiratory flow at 75% of forced vital capacity (FEF75%) and FEF75% as percentage of predicted versus the low IL-8 group ([0.73±0.55] L/min vs [1.26±1.15] L/min, [23.89±16.64]% vs [35.21±26.88]%, [0.32±0.19] L/min vs [0.57±0.53] L/min, and [25.32±13.27]% vs [39.97±29.42]%, all P<0.05). The serum IL-8 level was significantly negatively correlated with diffusion capacity for carbon monoxide as percentage of predicted (DLCO%Pred; r=-0.402 1, P=0.001 8), and the DLCO%Pred was significantly lower in the high IL-8 group than that in the low IL-8 group ([51.52±26.41]% vs [72.98±18.70]%, P=0.029). The cumulative risk of acute exacerbation was significantly higher in high IL-8 group than that in the low IL-8 group, with RR being 3.75 (95% confidence interval [CI] 1.200-11.716, P=0.029). The median interval time to the first acute exacerbation was significantly shorter in the high IL-8 group than that in the low IL-8 group (HR=3.066, 95% CI 1.053-8.927, P=0.039). Conclusion Serum IL-8 can be used as a predictive biomarker for acute exacerbation of COPD patients, which may involve allergic constitution, small airway function deterioration, and decreased diffuse capacity among these patients.
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Ebola virus disease (EVD) caused by Eora igs(EBOV) is one of the most violent infectious disease so far. It is so highly infective and fatal that there has beenno effective treatment until now. Ebola viral infection can cause a series of immune responses. Specific and nonspecific antistl innate immune deficiency in the hosts is a recognized important reason for EVD associated death. This paper reviewsheinfluence of EBOV on innate immune reaction of humans and the corresponding countermeasures.
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Objective To summarize our experience on medical observation and treatment of 32 cases with suspected or probable Ebola virus disease (EVD) under level 4 personnel bio-protective condition in Liberia. Methods A total 32 suspected or probable EVD cases admitted in China Ebola Treatment Unk (ETU) in Liberia during January 14，2015 to March 14 were included in the present study. Khe doctors made the ward rounds under level C personal bio-protective conditions.1'hey were diagnosed by inquiring the detailed history and performing partial physical examination， and were given dihydroartemisinin piperaquine phosphate tablets (3 tablets，1/d &，levofloxacin (0. 5 g，1/d)，centrum (1 tablet，1/d &，oral rehydration satt (2 bags，3/d)，and nutrients (40 g，3/d) as basic treatments initially combined with supportive medication，which was aimed to relieve their symptoms. The clinical data， including the epidemiologic history， clinical symptoms and signs， diagnosis， treatment efticiency and adverse effects were retrospectively analyzed. Results The mean age of the 32 patients was (40. 53 13. 89) years old (ranging 14-83)，with 22 males and 10 females. The average time after the onset of illness was 4. 5(1-30) d. All the patients had fever， with the average maximum temperature being (38. 36 1. 01)C. The main symptoms included fatigue in 25 cases (78. 12X)，joint/muscle pain in 22 patients (68. 75X)，nausea/vomiting in 17 cases (53. 12X)，headache in 16 cases (50. 00X)，anorexia/loss of appetite in 15 cases (46. 88X)，diarrhea in 14 cases (43. 75X)，abdominal pain in 14 cases (43. 75X)，cough in 12 cases (37. 50X)，chest pain in 10 cases (31. 25X)，dyspnea in 5 cases (15. 62X)，dysphagia in 4 cases (12. 50X)，hiccup in 3 cases (9. 38X)， and gastrointestinal hemorrhage in 2 cases (6. 25X). The mean time of hospitalization was (3. 942. 29) d. The final clinical diagnosis were: acute gastroenteritis in 13 cases，acute respiratory tract infection in 7 cases， upper gastrointestinal bleeding in 1 case， ascites of unknown cause (suspected hepatoma) in 1 case， jaundice of unknown cause in 1 case，asthma exacerbation in 1 case，malaria in 1 case，and incomplete intestinal obstruction in 1 case. Twenty-six cases were discharged and 6 cases died，showing an improvement rate of 81. 25% (26/3z). The temperature restored the normal level in 23 cases and the mean time tt'took was (3. 511.60) d. The treatment was tolerable and there were no severe side effects. Conclusion Close medical, observation， professional inquiry and physical examination are important methods to make clinical diagnosis for suspected Ebola cases in ETU. Empiric therapy with oral drugs combined with supportive therapy is safe and effective for suspected or probable EVD patients in Liberia.
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Objective: To investigate the effect of bone morphogenetic protein-2 (BMP-2) on epithelial-mesenchymal transition (EMT) of lung cancer cells and its possible molecular mechanism. Methods: Human lung adenocarcinoma cancer A549 cells were treated with different concentrations of BMP-2 (10, 50 and 100 μg/mL) for 24 h. The protein expression levels of EMT markers including E-cadherin (E-cad), vimentin and matrix metalloproteinase-2 (MMP-2) were detected by immunohistochemistry and Western blotting. The migration and invasion capacities of A549 cells were examined by wound healing and Matrigel invasion assays. The apoptosis was analyzed by cytometry flow (FCM). The EMT, migration and invasion capabilities and the apoptosis of A549 cells treated with p38 mitogen-activated protein kinase (p38 MAPK)-specific inhibitor SB203580 combined with 100 μg/mL BMP-2 were detected. Results: BMP-2 could reduce E-cad expression and increase vimentin and MMP-2 protein expressions in A549 cells in a concentration-dependent manner. The wound healing rate of the intervention group (100 μg/mL BMP-2) was significantly higher than that of the blank control group (P < 0.05). The number of the cells penetrating the membrane was increased significantly (P < 0.05), and the early apoptosis rate of A549 cells was decreased through 100 μ g/mL BMP-2 stimulation (P < 0.05). p38MAPK pathway-specific inhibitor SB203580 could partially decrease the expression of E-cad (P = 0.039) and increase the expressions of vimentin and MMP-2 (P = 0.023, P = 0.040). As compared with the cells treated with BMP-2 alone, the combination of BMP-2 and SB203580 could decrease the wound healing rate of A549 cells (P = 0.029), the number of the cells pentrating the membrane was reduced (P = 0.009), and the early apoptosis rate of the cells was increased (P = 0.046). Conclusion: BMP-2 can promote the EMT of human lung adenocarcinoma cancer A549 cells in vitro, inhibit the early apoptosis, and increase the migration and invasion capacities of lung cancer cells. This process is associated with the activation of p38MAPK signaling pathway.
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Objective To observe the correlation between chronic obstructive pulmonary disease (COPD) assessment test (CAT) score and prognostic factors, so as to investigate the value of CAT score in predicting the prognosis of COPD. Methods A total of 81 patients with newly diagnosed COPD in our hospital during Jul. 2011 to Sep. 2012, without using inhaled corticosteroid (ICS)/long-acting β2 agonist (LABA) or long-acting antimuscarinic agent (LAMA), were divided into group A (low risk, less symptoms), B (low risk, more symptoms), C (high risk, less symptoms) and D (high risk, more symptoms) groups according to Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2011 edition), and the patients were given ICS/LABA or ICS/LABA+ LAMA treatment for 3 months. The CAT score, age, smoking quantity, pulmonary function indices, body mass index (BMI), 6-min walking distance (6MWD), modified medical British research council (mMRC) dyspnea scale, and the times of acute exacerbation of COPD (AECOPD) in previous one year were collected before and after treatment. The clinical characteristics analysis and correlation analysis were performed. Results The average age of the 81 COPD patients was (66.27±8.52) years, with 88.89% being males and 85.19% having smoking history. The proportions of group A, B, C and D were 8.64%, 30.86%, 4.94% and 55.56% before treatment, repectively. The values of the forced expiratory volumein one second (FEV1), predicted amount as a percentage of FEV1 (FEV1%Pred), forced vital capacity (FVC), predicted amount as a percentage of FVC (FVC% Pred), peak expiratory flow (PEF), predicted amount as a percentage of PEF (PEF%Pred), and 6MWD in CAT score ≥ 10 groups were significantly less than those in CAT score 10 group (P < 0. 05). The above parameterswere not significantly different between patients with CAT score being 10-20, 20-30 and ≥ 30 groups. mMRC scale and times of AECOPD in CAT score ≥20 groups were significantly higher than those in CAT score 10 group (P < 0. 05). No significant difference in FEV1/FVC was found in different CAT score groups. The CAT score was significantly correlated with mMRC scale (pre-treatment r2 = 0. 417, P lt; 0. 001; post-treatment r2 =0. 19, P < 0. 001), 6MWD (pretreatment r2 = 0. 320, P < 0. 001 post-treatment r2 = 0. 19, P < 0. 001), pre-treatment FEV1 (r2 = 0. 177, P = 0. 001 5), FEV1 %Pred(r2 = 0. 125, P = 0. 002), PEF(r2=0. 164, P = 0. 002 4), PEF%Pred (r2=0. 129, P = 0. 007 6), FVC (r2 = 0. 098, P=0. 021), FVC%Pred (r2 = 0. 094, P = 0. 024), FEV1/FVC(r2 = 0. 101, P = 0. 005 7), and AECOPD number (r2 = 0. 059, P = 0. 028); and not correlated with the quantity of smoking (r2 = 0. 041, P = 0. 083), BMI (r2 =0. 00, P = 0.89), and post-treatment FEV1 (r2 =0. 01, P = 0. 22) or FEV1 %Pred (r2 =0. 003, P = 0. 09). Conclusion COPD is prone to occur in the male smokers, with the highest proportion found in group D. CAT score has a good correlation with pre- and pos-- treatment mMRC scale and exercise capacity, suggesting it has a potential for predicting prognosis of COPD.
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Objective To investigate the effect of dexamethasone on polyinosinic: polycytidylic acid (PIC)-induced chemotactic factor expression in human bronchial epithelial (16hBE) cells and the underlying mechanism. Methods 16hBE cells were treated with different concentrations of PIC (0. 001, 0. 01, 0. 1, and 1 μg/ml) and dexamethasone (0.1, 1, and 10 μmol/L). IL-8 and IP-10 mRNA levels were detected by RT-PCR 6 h after stimulation. IL-8 and IP-10 protein levels in the culture supernatant were detected by ELISA 24 h after stimulation. NF-κB p65 subunit expression was detected by immunohistochemical staining. Results PIC concentration-dependently (0. 001, 0. 01, and 0. 1 μg/ml) increased the expression of IL-8 and IP-10 mRNA and protein compared with the control group, with significant differences found when PIC at 0.01 μ/ml and 0. 1 μ/ml (P<0. 05,P<0. 01). When the concentration of PIC was 1 μ/ml, the expressions of IL-8 and IP-10 were decreased at both mRNA and protein levels. Pretreatment with dexamethasone (1 μmol/L and 10 μmol/L) for 0. 5 h significantly inhibited the IL-8 and IP-10 expression at both mRNA and protein levels (P<0. 05, P<0. 01). Dexamethasone pretreatment (1 μmol/L) significantly inhibited PIC-induced NF-κB p65 subunit expression (P < 0. 01). Conclusion Glucocorticoids can suppress PIC-induced IL-8 and IP-10 expression in human bronchial epithelial cells, probably through activation of NF-κB pathway.