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. 2018 Mar;12(3):1228-1239.
doi: 10.1111/crj.12656. Epub 2017 Jun 15.

Analysis of viral infection and biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease

Tiping Yin  1   2 , Zhaoqin Zhu  3 , Zhoufang Mei  1 , Jingjing Feng  1 , Wanju Zhang  3 , Yanchao He  1 , Jindong Shi  1 , Ling Qian  1 , Yi Liu  3 , Qihui Huang  1 , Yunwen Hu  3 , Zhijun Jie  1
Affiliations

Analysis of viral infection and biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease

Tiping Yin et al. Clin Respir J. 2018 Mar.

Abstract

Objective: To investigate viral infection in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Shanghai, and to analyze the clinical characteristics and biomarkers in viral infection.

Methods: This study included all consecutive patients who were admitted for a diagnosis of AECOPD during June 2013 to May 2015. Thirty-one stable COPD patients and 31 healthy controls were also recruited. Oropharyngeal samples were assessed, PCR for respiratory viruses were performed. Patients were divided into AECOPD virus-positive (+) group and AECOPD virus-negative (-) group according to viral detection. Luminex was used to detect the concentrations of inflammatory cytokines in the serum.

Results: A total of 264 patients were included with a mean age of 75 ± 0.5 years. There were 72 patients (27.3%) identified with viral positive, of whom two patients were detected with double viral infections (FluA + FluB and RSVA + HRV, respectively). The rate of viral detection was associated with season, highest in winter. Comparisons of clinical characteristics showed no significant differences between AECOPD virus+ group and AECOPD virus- group. However, serum concentrations of interferon-inducible protein-10 (IP-10) and interferon-gamma (IFN-γ) in virus+ AECOPD patients were significantly higher than those in the virus- AECOPD, stable COPD and healthy control groups (P < .05).

Conclusion: Viral infection was an important pathogen in AECOPD patients; the most common viruses included FluA, HRV and FluB. It was very difficult to diagnose the viral infection according to clinical characteristics. The increased of serum IP-10 and IFN-γ levels might be value to indicate viral infection in AECOPD.

Keywords: IP-10; acute exacerbation of chronic obstructive pulmonary disease; chronic obstructive pulmonary disease; cytokine; viral infection.

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Conflict of interest statement

The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Figures

Figure 1
Figure 1
The proportions of patients with a negative viral infection, dual viral infection and single viral infection from the 264 AECOPD patients. Abbreviation: AECOPD, acute exacerbation of chronic obstructive pulmonary disease
Figure 2
Figure 2
Identified viruses in 264 AECOPD patients. Abbreviations: FluA, influenza virus type A; HRV, rhinovirus; FluB, influenza virus type B; HADV, human adenovirus; RSVA, respiratory syncytial virus type A; HCoV, human coronavirus; HBoV, human Bocavirus; HMPV, human metapneumovirus; AECOPD, acute exacerbation of chronic obstructive pulmonary disease
Figure 3
Figure 3
Seasonal variability of viruses detected in 264 AECOPD patients. Abbreviations: FluA, influenza virus type A; FluB, influenza virus type B; HADV, human adenovirus; RSVA, respiratory syncytial virus type A; HRV, rhinovirus; AECOPD, acute exacerbation of chronic obstructive pulmonary disease
Figure 4
Figure 4
Correlations between IP‐10 concentrations and FEV1% predicted values in the AECOPD virus+ group (A) and AECOPD virus− group (B). Abbreviations: IP‐10, interferon‐γ inducible protein 10; FEV1, forced expiratory volume in one second; AECOPD, acute exacerbation of chronic obstructive pulmonary disease Note: P < .05 indicates statistical significance in the Spearman correlation test
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