RESUMO
Objectives: Chronic obstructive pulmonary disease [COPD] is one of the leading causes of morbidity and mortality around the world. Preliminary studies have evaluated the association between innate immunity including Toll-like receptors [TLRs] and airway samples of patients with COPD. The role of TLRs in peripheral blood neutrophils is poorly understood. Hence, this study aimed to investigate the role of TLR2 and TLR4 in peripheral blood neutrophils of COPD patients
Methods: A total of 101 COPD cases and an equal number of healthy controls participated in this case-control study. Peripheral blood neutrophils were isolated from all participants and cultured for 24 hours through lipopolysaccharide [LPS] stimulation. The gene expressions of TLR2 and TLR4 were assessed by real-time polymerase chain reaction. The protein levels of interleukin [IL]-8 and matrix metalloproteinase [MMP]-9 were measured in neutrophils cell culture supernatants using enzyme-linked immunosorbent assay [ELISA]
Results: The levels of IL-8 and MMP-9 were significantly higher in patients with COPD compared to healthy controls. Similarly, the gene expression of TLR2 and TLR4 were increased in LPS stimulated peripheral blood neutrophils of patients with COPD. Smoke pack years was positively correlated with IL-8 levels and negatively correlated with forced expiratory volume in the first second % [r = -0.33; p = 0.023] and FEV1/forced vital capacity [FVC] [r = -0.27; p = 0.011]
Conclusions: The increased expression of TLR2 and TLR4 suggests its role in disease pathogenesis of COPD. Smoke pack years was negatively associated with spirometric parameters in COPD patients. This may help to predict the smokers without COPD who risk developing the condition in the future
RESUMO
Numerous studies have confirmed the high prevalence of hypertension among type 2 diabetics, and that intensive hypertensive treatment is more beneficial to diabetics than non diabetics. The aim of this study is to assess blood pressure control in patients with type 2 diabetes mellitus and to study the types of antihypertensives used. A retrospective study was conducted on hypertensive diabetics followed at a health center in Oman within a year. Patients' age, sex, duration of diabetes, hypertension and the type of antihypertensive used were noted. Patients were classified according to the degree of systolic and diastolic BP control into 4 groups. 210 patients with a mean age of 53.7 +/- 9.1 years were included with a 2:5 male to female ratio. The mean duration of diabetes was found to be 9 years and 7 years for hypertension. 10% of the subjects were in the systolic group I, 23% in group II, 23% in group III and 41% in group IV. While 56% were in diastolic group I, 19% in group II, 16% in group III, and 7% in group IV. Angiotensin converting enzyme-inhibitors [ACE] were used in 50% of the subjects followed by a combination of angiotensin receptor blockers [ARB] with diuretic in 40%. B blockers were used in 38% of the patients. Calcium channel blockers were used in 18%, while diuretics were used in 16% of the patients. Only 30% of the BP of the hypertensive diabetics met the recommended BP for diabetics. More effort should be dedicated to control the BP in diabetics. Physicians should be careful in the selection of hypertensive medications, because in some combinations, they are not useful