CORRELATION OF C-REACTIVE PROTEIN AND COPD SEVERITY.

Chronic obstructive pulmonary disease (COPD) is a progressive pulmonary disease characterized by systemic inflammation. The aim of this study was to correlate the parameters of systemic inflammation, C-reactive protein (CPR) and total leukocyte count, with clinical indicators of the disease. Our study included 157 COPD patients, both outpatients and those hospitalized at the Knez Selo Department of Pulmonology of the Nis Clinical Centre during a six-month period, while in the phase of disease exacerbation. The symptoms of COPD in each patient were estimated by the COPD Assessment Test (CAT) and modified Medical Research Council (mMRC) dyspnea scale. The parameters of pulmonary function (FEV1 and FVC), acid-base status, body mass index, history of exacerbation and comorbidities were also evaluated. The level of CRP, but not leukocytes, showed significant correlation with the severity of clinical presentation according to GOLD classification. The higher the CRP concentration, the higher was the disease severity determined according to GOLD classification (p < 0.001). There was no statistically significant difference in CRP level and leukocyte count according to comorbidities (p = 0.29). The level of CRP was higher in patients with a high CAT score and mMRC scale (p < 0.001). The same trend was observed for leukocyte count when compared with CAT results, but not when correlated to mMRC scale. The level of CRP during COPD exacerbation can be an independent predictor of the disease severity and paraclinical findings.

MDR1 gene polymorphisms and P-glycoprotein expression in respiratory diseases.

BACKGROUND: P-glycoprotein (P-gp/MDR1), a member of the ATP-binding cassette (ABC) transporters super family, encoded by the ABCB1/MDR1 gene, is one of suggested respiratory tract protection components, found in various tissues with a barrier function, such as tracheobronchial epithelium and lung parenchyma. As an ATP-dependent pump, P-gp extrudes lipophilic particles out of cells and acts as a gatekeeper against numerous xenobiotics, with a protective role in mediating DNA damage, secretion of toxic compounds, apoptosis and the immune response. Therefore, a presence of MDR1 polymorphisms and altered P-gp expression may be important for pathogenesis of reduced lung inflammatory response on cigarette smoke exposure, as well as for the severity of chronic obstructive pulmonary disease and lung cancer pathogenesis and treatment efficacy. METHODS AND RESULTS: We have analyzed data available from experimental and clinical studies performed to establish the role of MDR1 polymorphisms, especially the 3435C>T variation, and P-gp expression in pathogenesis and clinical outcome of human respiratory diseases. CONCLUSIONS: Although there are indications that altered expression of P-gp and/or polymorphisms of MDR1 gene play an important role in respiratory diseases pathogenesis and treatment, their exact role and relevance are insufficiently investigated, with exception of certain chemotherapeutic agents' efficacy in lung cancer treatment. Further research in this field, including bigger series of patients, is necessary for better understanding of respiratory diseases' pathogenesis and treatment.