Pathological features of mild chronic obstructive pulmonary disease and their correlation with inflammatory factors

doi:10.11958/20231360

Abstract

Abstract:

Objective To explore the pathological features of lung tissue in mild chronic obstructive pulmonary disease (COPD) and their association with inflammatory factors. Methods A total of 70 patients who underwent surgery for small lung nodule were prospectively included, and were divided into the normal group (n=10), the mild COPD group (n=50) and the moderate and severe COPD group (n=10). The pathological changes of lung tissue were evaluated after HE, Masson and EVG staining. The expression levels of SMA, Actin and CD31 proteins were detected by immunohistochemistry staining. Tumor necrosis factor α (TNF-α), interleukin-10 (IL-10) protein and mRNA levels were detected by immunohistochemistry and qPCR. Results Pulmonary tissue in mild COPD showed widening of alveolar septum, dilation of small airways, mild thickening of blood vessel wall and inflammatory reaction dominated by lymphocyte infiltration. Immunohistochemistry staining showed that contents of SMA and Actin proteins in mild COPD lung tissue were higher than those in the normal group (P<0.05). In addition, the TNF-α mRNA and the positive rate of TNF-α in lung tissue of mild COPD were significantly higher than those in the normal group, while the IL-10 mRNA was significantly lower than that of the normal group (all P<0.05). SMA and Actin were positively correlated with the positive expression of inflammatory cytokine TNF-α, but negatively correlated with the positive expression of IL-10 (all P<0.05). Conclusion The main pathological changes of lung tissue in mild COPD include small lung blood vessel remodeling ocharacterized by thickening of small blood vessel smooth muscle layer and lymphocyte-dominated inflammatory response, while the increase of pro-inflammatory factor TNF-α and decrease of anti-inflammatory factor IL-10 are associated with pathological changes of COPD.

Key words: pulmonary disease, chronic obstructive, myocytes, smooth muscle, actins, tumor necrosis factor-alpha, interleukin-10

CLC Number:

R563

Figures/Tables 7

References 15

[1]	梁振宇, 王凤燕, 陈子正, 等. 2023年GOLD慢性阻塞性肺疾病诊断、管理及预防全球策略更新要点解读[J]. 中国全科医学, 2023, 26(11):1287-1298.
	LIANG Z Y, WANG F Y, CHEN Z Z, et al. Interpretation of the 2023 GOLD Global Strategy Update for the Diagnosis,Management and Prevention of Chronic Obstructive Pulmonary Disease[J]. Chin Gen Pract, 2023, 26(11):1287-1298. doi:10.12114/j.issn.1007-9572.2023.0052.
[2]	SANDELOWSKY H, WEINREICH U M, AARLI B B, et al. COPD- do the right thing[J]. BMC Fam Pract, 2021, 22(1):244. doi:10.1186/s12875-021-01583-w.
[3]	LAREAU S C, FAHY B, MEEK P, et al. Chronic Obstructive Pulmonary Disease (COPD)[J]. Am J Respir Crit Care Med, 2019, 199(1):1-2. doi:10.1164/rccm.1991P1.
[4]	KARNATI S, SEIMETZ M, KLEEFELDT F, et al. Chronic obstructive pulmonary disease and the cardiovascular system:vascular repair and regeneration as a therapeutic target[J]. Front Cardiovasc Med, 2021, 8:649512. doi:10.3389/fcvm.2021.649512.
[5]	FAZLEEN A, WILKINSON T. Early COPD:current evidence for diagnosis and management[J]. Ther Adv Respir Dis, 2020, 14:1753466620942128. doi:10.1177/1753466620942128.
[6]	何永鸿, 强丽, 王宋平. 阿托伐他汀钙对COPD模型大鼠肺血管重塑的影响及机制探讨[J]. 天津医药, 2021, 49(6):598-602.
	HE Y H, QIANG L, WANG S P. Effect and mechanism of atorvastatin calcium on pulmonary vascular remodeling in COPD model rats[J]. Tianjin Med J, 2021, 49(6):598-602. doi:10.11958/20203011.
[7]	郭晓桐, 范玉春, 郝斌威, 等. 慢性阻塞性肺疾病患者肺小动脉重塑对肺动脉压的影响[J]. 中华结核和呼吸杂志, 2018, 41(6):477-483.
	GUO X T, FAN Y C, HAO B W, et al. Effect of pulmonary arteriolar remodeling on pulmonary artery pressure in patients with chronic obstructive pulmonary disease[J]. Chin J Tuberc Respir Dis, 2018, 41(6):477-483. doi:10.3760/cma.j.issn.1001-0939.2018.06.009.
[8]	李水霞, 孙丽蓉, 苏日娜, 等. CD34+细胞和血管内皮功能与慢性阻塞性肺疾病急性期的相关性[J]. 中国老年学杂志, 2021, 41(14):2984-2987.
	LI S X, SUN L R, SU R N, et al. Association of CD34+ cell and vascular endothelial function with the acute phase of chronic obstructive pulmonary disease[J]. Chin J Gerontol, 2021, 41(14):2984-2987. doi:10.3969/j.issn.1005-9202.2021.14.022.
[9]	THEODORAKOPOULOU M P, BAKALOUDI D R, DIPLA K, et al. Vascular endothelial damage in COPD:current functional assessment methods and future perspectives[J]. Expert Rev Respir Med, 2021, 15(9):1121-1133. doi:10.1080/17476348.2021.1919089.
[10]	LI K, YE X, XU M, et al. MiR-23a-3p alleviates cigarette smoke extract-induced pulmonary vascular endothelial cell apoptosis by targeting DNAJB1 in emphysema[J]. Clin Respir J, 2023. doi:10.1111/crj.13707.
[11]	SZUCS B, SZUCS C, PETREKANITS M, et al. Molecular characteristics and treatment of endothelial dysfunction in patients with COPD:a review article[J]. Int J Mol Sci, 2019, 20(18):4329. doi:10.3390/ijms20184329.
[12]	SILVA B, LIRA F S, RAMOS D, et al. Severity of COPD and its relationship with IL-10[J]. Cytokine, 2018, 106:95-100. doi:10.1016/j.cyto.2017.10.018.
[13]	郑鑫蓥, 夏之, 肖琳琳, 等. COPD肺组织中MAL、IL-10、TNF-α的表达[J]. 临床肺科杂志, 2022, 27(7):999-1002,1009.
	ZHENG X Y, XIA Z, XIAO L L, et al. Expression of MAL,IL-10,TNF-α in lung tissue of COPD[J]. Clin Pulm Med, 2022, 27(7):999-1002,1009.
[14]	罗杰, 刘维佳. IL-6、GATA6在大鼠肺动脉平滑肌细胞中的表达及对细胞增殖的影响[J]. 天津医药, 2020, 48(11):1025-1030,1137.
	LUO J, LIU W J. Expression of IL-6 and GATA6 in rat pulmonary artery smooth muscle cells and their effects on cell proliferation[J]. Tianjin Med J, 2020, 48(11):1025-1030,1137. doi:10.11958/20200939.
[15]	KIM H Y, KIM H S. Sulfatase 1 mediates IL-10-induced dimethylarginine dimethylaminohydrolase-1 expression and antiproliferative effects in vascular smooth muscle cells of spontaneously hypertensive rats[J]. Cytokine, 2021, 137:155344. doi:10.1016/j.cyto.2020.155344.

组别	n	年龄/岁	男性	吸烟史	饮酒史	BMI/（kg/m²）	上/中肺叶
正常组	10	67.5±4.9	4（40.0）	1（10.0）	0	25.7±2.2	4（40.0）
轻度COPD组	50	64.1±8.7	25（50.0）	20（40.0）	11（22.0）	24.1±3.6	34（68.0）
中重度COPD组	10	68.4±3.8	6（60.0）	5（50.0）	3（30.0）	25.7±3.6	6（60.0）
χ²、P或F		1.748	0.800	0.129^▲	0.184^▲	1.580	0.276^▲

组别	n	年龄/岁	男性	吸烟史	饮酒史	BMI/（kg/m²）	上/中肺叶
正常组	10	67.5±4.9	4（40.0）	1（10.0）	0	25.7±2.2	4（40.0）
轻度COPD组	50	64.1±8.7	25（50.0）	20（40.0）	11（22.0）	24.1±3.6	34（68.0）
中重度COPD组	10	68.4±3.8	6（60.0）	5（50.0）	3（30.0）	25.7±3.6	6（60.0）
χ²、P或F		1.748	0.800	0.129^▲	0.184^▲	1.580	0.276^▲

组别	n	CD31	SMA	Actin
正常组	10	0.50±0.03	0.32±0.03	0.47±0.03
轻度COPD组	50	0.49±0.04	0.35±0.05^a	0.51±0.06^a
中重度COPD组	10	0.45±0.03^ab	0.39±0.03^ab	0.56±0.04^ab
F		5.967^＊＊	8.741^＊＊	7.918^＊＊

组别	n	CD31	SMA	Actin
正常组	10	0.50±0.03	0.32±0.03	0.47±0.03
轻度COPD组	50	0.49±0.04	0.35±0.05^a	0.51±0.06^a
中重度COPD组	10	0.45±0.03^ab	0.39±0.03^ab	0.56±0.04^ab
F		5.967^＊＊	8.741^＊＊	7.918^＊＊

组别	n	胸膜 Masson	小血管 Masson	胸膜 EVG	小血管 EVG
正常组	10	20.2±3.2	19.3±2.7	10.4±1.4	11.7±1.7
轻度COPD组	50	21.3±3.0	21.4±3.2	9.7±1.1	12.5±2.0
中重度COPD组	10	23.1±2.3	24.0±3.0^ab	8.9±1.0^ab	14.2±1.8^ab
F		2.575	5.765^＊＊	4.347^＊＊	4.586^＊＊