The relationship between serum cathepsin levels and disease severity in patients with chronic obstructive pulmonary disease

doi:10.11958/20260087

Abstract

Abstract:

Objective To explore the relationship between serum cathepsin (Cat) B, Cat-L, Cat-S and inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A total of 224 COPD patients admitted to the respiratory department of Hebei Provincial Chest Hospital from January 2022 to December 2024 were collected as the research group, and 62 individuals participated in the health check-up during the same period were selected as the control group. The research group was divided into the acute exacerbation group (71 cases) and the stable group (153 cases) based on changes in the patient's condition. The modified medical research council (mMRC), forced expiratory volume in one second / forced vital capacity (FEV1/FVC) and COPD assessment test (CAT) score were used to assess respiratory distress. Enzyme linked immunosorbent assay was used to detect serum Cat-B, Cat-L and Cat-S levels. Pearson method was used to analyze the correlation between serum Cat-B, Cat-L, Cat-S and serum C-reactive protein (CRP), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10). Logistic multiple regression model was used to analyze the influencing factors of aggravation of COPD. Results Compared with the control group, the serum Cat-B level in the study group decreased, with levels in the acute exacerbation subgroup being lower than those in the stable subgroup (P<0.05). In contrast, Cat-L and Cat-S levels were increased in the study group, in which the acute exacerbation subgroup was higher than that in the stable subgroup (P<0.05). Cat-B was negatively correlated with CRP, IL-8, TNF-α, mMRC and CAT score (P<0.05), and Cat-B was positively correlated with IL-10 and FEV1/FVC (P<0.05). Cat-L and Cat-S showed correlations opposite to those of Cat-B with the above indicators (P<0.05). Elevated levels of Cat-L and Cat-S were identified as independent risk factors for acute exacerbation in COPD patients (P<0.05), whereas elevated FEV1/FVC ratio and Cat-B levels were independent protective factors (P<0.05). Conclusion Cat-B, Cat-L and Cat-S, as key biomarkers, participate in the progress of COPD by mediating inflammatory responses. Their dynamic changes have a significant impact on the acute exacerbation of the disease.

Key words: pulmonary disease, chronic obstructive, cathepsin B, cathepsin L, cathepsin S, acute exacerbation, inflammatory factor

CLC Number:

R563

Figures/Tables 5

References 23

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组别	n	Cat-B	Cat-L	Cat-S
对照组	62	1.43±0.31	1.75±0.27	13.06±2.19
研究组	224	0.95±0.28	6.33±0.99	28.53±3.48
t		11.788^＊＊	61.284^＊＊	42.726^＊＊

组别	n	Cat-B	Cat-L	Cat-S
对照组	62	1.43±0.31	1.75±0.27	13.06±2.19
研究组	224	0.95±0.28	6.33±0.99	28.53±3.48
t		11.788^＊＊	61.284^＊＊	42.726^＊＊

组别	n		年龄/岁		性别				BMI/（kg/m²）		病程/年		基础疾病
组别	n		年龄/岁		男		女		BMI/（kg/m²）		病程/年		高血压		过敏性鼻炎		肺心病
稳定组	153		61.14±5.54		92（60.13）		61（39.87）		22.39±1.62		2.28±0.45		10（6.54）		9（5.88）		14（9.15）
急性加重组	71		59.96±5.46		44（61.97）		27（38.03）		22.41±1.65		2.32±0.47		9（12.68）		8（11.27）		7（9.86）
χ²或t			1.490		0.069				0.128		0.653		2.355		2.005		0.029
组别		COPD家族史				生活习惯						mMRC/级		FEV1/FVC/%		CAT评分/分
组别		有		无		吸烟		饮酒		熬夜		mMRC/级		FEV1/FVC/%		CAT评分/分
稳定组		17（11.11）		136（88.89）		96（62.75）		92（60.13）		79（51.63）		1.26±0.44		70.34±8.79		13.14±3.25
急性加重组		14（19.72）		57（80.28）		44（61.97）		35（49.30）		30（42.25）		3.54±0.50		45.86±8.49		26.52±3.57
χ²或t		3.013				0.012		2.319		1.708		32.737^＊＊		19.607^＊＊		27.786^＊＊
组别		CRP/（mg/L）				IL-8/（ng/L）		TNF-α/（ng/L）		IL-10/（ng/L）		Cat-B/（μg/L）		Cat-L/（μg/L）		Cat-S/（μg/L）
稳定组		15.43±2.94				196.42±25.35		145.78±20.33		126.34±15.65		1.07±0.25		5.82±0.63		27.79±3.29
急性加重组		19.65±3.12				247.21±25.40		185.05±20.35		98.82±15.53		0.72±0.16		7.44±0.65		30.14±3.35
t		9.842＊＊				13.938＊＊		13.449＊＊		12.278＊＊		12.843＊＊		17.896＊＊		4.938＊＊

组别	n		年龄/岁		性别				BMI/（kg/m²）		病程/年		基础疾病
组别	n		年龄/岁		男		女		BMI/（kg/m²）		病程/年		高血压		过敏性鼻炎		肺心病
稳定组	153		61.14±5.54		92（60.13）		61（39.87）		22.39±1.62		2.28±0.45		10（6.54）		9（5.88）		14（9.15）
急性加重组	71		59.96±5.46		44（61.97）		27（38.03）		22.41±1.65		2.32±0.47		9（12.68）		8（11.27）		7（9.86）
χ²或t			1.490		0.069				0.128		0.653		2.355		2.005		0.029
组别		COPD家族史				生活习惯						mMRC/级		FEV1/FVC/%		CAT评分/分
组别		有		无		吸烟		饮酒		熬夜		mMRC/级		FEV1/FVC/%		CAT评分/分
稳定组		17（11.11）		136（88.89）		96（62.75）		92（60.13）		79（51.63）		1.26±0.44		70.34±8.79		13.14±3.25
急性加重组		14（19.72）		57（80.28）		44（61.97）		35（49.30）		30（42.25）		3.54±0.50		45.86±8.49		26.52±3.57
χ²或t		3.013				0.012		2.319		1.708		32.737^＊＊		19.607^＊＊		27.786^＊＊
组别		CRP/（mg/L）				IL-8/（ng/L）		TNF-α/（ng/L）		IL-10/（ng/L）		Cat-B/（μg/L）		Cat-L/（μg/L）		Cat-S/（μg/L）
稳定组		15.43±2.94				196.42±25.35		145.78±20.33		126.34±15.65		1.07±0.25		5.82±0.63		27.79±3.29
急性加重组		19.65±3.12				247.21±25.40		185.05±20.35		98.82±15.53		0.72±0.16		7.44±0.65		30.14±3.35
t		9.842＊＊				13.938＊＊		13.449＊＊		12.278＊＊		12.843＊＊		17.896＊＊		4.938＊＊

指标	CRP	IL-8	TNF-α	IL-10
Cat-B	-0.459^＊＊	-0.442^＊＊	-0.435^＊＊	0.411^＊＊
Cat-L	0.602^＊＊	0.589^＊＊	0.593^＊＊	-0.584^＊＊
Cat-S	0.571^＊＊	0.565^＊＊	0.576^＊＊	-0.590^＊＊