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oai:repisalud.isciii.es:20.500.12105/226252025-04-25T09:32:44Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967col_20.500.12105_16972

00925njm 22002777a 4500 dc Perez de Llano, Luis Alejandro author García-Cosío, Borja author Iglesias, Amanda author de las Cuevas, Natividad author Soler-Cataluna, Juan Jose author Izquierdo, Jose Luis author Lopez-Campos, Jose Luis author Calero, Carmen author Plaza, Vicente author Miravitlles, Marc author Torrego, Alfons author Martinez-Moragon, Eva author Soriano, Joan B author Lopez Vina, Antolin author Bobolea, Irina author CHACOS Study Grp author 2018 Introduction: The asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is a clinical condition that combines features of those two diseases, and that is difficult to define due to the lack of understanding of the underlying mechanisms. Determining systemic mediators may help clarify the nature of inflammation in patients with ACO. Objectives: We aimed at investigating the role and interaction of common markers of systemic inflammation (IL-6, IL-8, and tumor necrosis factor-alpha), Th2-related markers (periostin, IL-5, and IL-13), and IL-17 in asthma, COPD, and ACO. Methods: This is a cross-sectional study of patients aged >= 40 years with a post-bronchodilator forced expiratory volume in the first second/forced vital capacity < 0.70 recruited from out-patient clinics in tertiary hospitals with a clinical diagnosis of asthma, COPD, or ACO. ACO was defined by a history of smoking > 10 pack-years in a patient with a previous diagnosis of asthma or by the presence of eosinophilia in a patient with a previous diagnosis of COPD. Clinical, functional, and inflammatory parameters were compared between categories using discriminant and network analysis. Results: In total, 109 ACO, 89 COPD, and 94 asthma patients were included. Serum levels (median [interquartile range]) of IL-5 were higher in asthma patients than in COPD patients (2.09 [0.61-3.57] vs 1.11 [0.12-2.42] pg/mL, respectively; p=0.03), and IL-8 levels (median [interquartile range]) were higher in COPD patients than in asthma patients (9.45 [6.61-13.12] vs 7.03 [4.69-10.44] pg/mL, respectively; p < 0.001). Their values in ACO were intermediate between those in asthma and in COPD. Principal component and network analysis showed a mixed inflammatory pattern in ACO in between asthma and COPD. IL-13 was the most connected node in the network, with different weights among the three conditions. Conclusion: Asthma and COPD are two different inflammatory conditions that may overlap in some patients, leading to a mixed inflammatory pattern. IL-13 could be central to the regulation of inflammation in these conditions. Perez De Llano L, Cosio BG, Iglesias A, De las Cuevas N, Soler-Cataluna JJ, Izquierdo JL, et al. Mixed Th2 and non-Th2 inflammatory pattern in the asthma-COPD overlap: a network approach. Int J Chronic Obstr Pulm Dis. 2018;13:591-601. 10.2147/COPD.S153694 1178-2005 International Journal of Chronic Obstructive Pulmonary Disease http://hdl.handle.net/20.500.13003/17165 29483774 L620650592 2-s2.0-85042034034 https://hdl.handle.net/20.500.12105/22625 425324600001 Asthma mechanisms COPD mechanisms Inflammatory cytokines Overlap Network analysis IL-13 Mixed Th2 and non-Th2 inflammatory pattern in the asthma-COPD overlap: a network approach