Effect of lianhuaqingwen capsules on airway inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease

Abstract

Chronic obstructive pulmonary disease (COPD) is characterized by a chronic inflammatory response that is worsened by acute exacerbations. Lianhuaqingwen (LHQW) has anti-inflammatory and immune regulatory functions and may inhibit the airway inflammation that occurs during an acute exacerbation of COPD. In this study, 100 participants were recruited and randomly assigned, 1 : 1, to the LHQW and the conventional groups, which were treated, respectively, with LHQW capsules and conventional Western medicine or only conventional Western medicine. The scores of the CAT scale and levels of inflammatory cytokines in blood and sputum were measured during treatment. In addition, subjects were subdivided into high-risk and low-risk subgroups. The CAT scores in the LHQW group and high-risk subgroup were clearly improved from the 5th day, but the other groups improved only after treatment was completed. Expression levels of IL-8, TNF- α , IL-17, and IL-23 in the sputum and of IL-8 and IL-17 in the blood were significantly decreased after treatment, and similar results were found in subgroups. These data suggested that LHQW capsules can accelerate the improvement of AECOPD patients, especially for the high-risk subgroup, and the mechanism of action may be related to the decreased release of inflammatory mediators.

Figure 1

The patients flow chart.

Figure 2

Changes in the CAT scores for the LHQW and conventional groups before and after treatment. The CAT scores were recorded before treatment and on the 3rd, 5th, and 7th days. (a) Changes in CAT score for the treatment groups; (b) changes in CAT score for the high-risk subgroups; (c) changes in CAT score for the low-risk subgroups. Each data point represents the mean score (n = 50). *P < 0.05 compared with the pretreatment CAT score in the LHQW group, **P < 0.01 compared with the pretreatment CAT score in the LHQW group, ^# P < 0.05 compared with the pretreatment CAT score in the conventional group, and ^## P < 0.01 compared with the pretreatment CAT score in the conventional group.

Figure 3

IL-8, TNF-α, IL-17, and IL-23 levels in the sputum of the LHQW and conventional groups before and after treatment. (a) Levels of IL-8 (pg/mL); (b) levels of TNF-α (pg/mL); (c) levels of IL-17 (pg/mL); and (d) levels of IL-23 (pg/mL). Each bar indicates the mean ± SD value (SD: standard deviation, n = 50). *P < 0.05 compared with values before treatment and **P < 0.01 compared with values before treatment.

Figure 4

IL-8, TNF-α, IL-17, and IL-23 levels in the blood of patients in the LHQW and conventional groups before and after treatment. (a) Levels of IL-8 (pg/mL); (b) levels of TNF-α (pg/mL); (c) levels of IL-17 (pg/mL); and (d) levels of IL-23 (pg/mL). Each bar indicates the mean ± SD (SD: standard deviation, n = 50). *P < 0.05 compared with values before treatment and **P < 0.01 compared with values before treatment.