Publication date: Available online 9 May 2019
Source: Journal of Allergy and Clinical Immunology
Author(s): Yorihiko Kyogoku, Hisatoshi Sugiura, Tomohiro Ichikawa, Tadahisa Numakura, Akira Koarai, Mitsuhiro Yamada, Naoya Fujino, Yutaka Tojo, Katsuhiro Onodera, Rie Tanaka, Kei Sato, Hirohito Sano, Shun Yamanaka, Koji Itakura, Ayumi Mitsune, Tsutomu Tamada, Takaaki Akaike, Masakazu Ichinose
Abstract
Graphical abstract
Background
Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) has frequent exacerbations, and a poor quality of life and prognosis compared to COPD alone. However, the pathogenesis of ACO has not been fully elucidated yet.
Objectives
The aim of this study was to investigate nitrosative stress, which causes a redox imbalance and tissue inflammation in the airways of patients with ACO, and to evaluate the relationship between nitrosative stress and the clinical course in the study subjects.
Methods
Thirty healthy subjects and 56 asthmatic patients participated in this study. The asthmatic patients were divided into 33 asthmatic patients and 23 ACO patients. The study subjects had been followed prospectively for 2 years to evaluate the clinical course. Nitrosative stress was evaluated by the production of 3-nitrotyrosine (3-NT) in sputum cells.
Results
The production of 3-NT was significantly enhanced in the ACO patients compared to the asthmatic patients. The amounts of reactive persulfides and polysulfides, newly identified powerful antioxidants, were significantly decreased in the ACO group. The baseline levels of 3-NT were significantly correlated with the frequency of exacerbations and decline of FEV1 adjusted by age, smoking history, and blood eosinophil counts. The 3-NT positive cells were also significantly correlated with the amounts of pro-inflammatory chemokines and cytokines.
Conclusions
These findings suggested that greater nitrosative stress occurred in the airways of patients with ACO and the degree of nitrosative stress was correlated with an impairment of the clinical course. Nitrosative stress might be related to the pathogenesis of ACO.
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