Routes of implementation and factors of escalation of systemic inflammatory response in comorbidity of chronic obstructive pulmonary disease and chronic pancreatitis

Abstract

The study aimed to determine mechanisms of implementation of systemic inflammatory syndrome in patients with comorbidity of chronic obstructive pulmonary disease and chronic pancreatitis. A total of 238 patients have been examined: 131 patients with chronic obstructive pulmonary disease in combination with chronic pancreatitis (main group) and 107 patients with an isolated chronic obstructive pulmonary disease (comparison group). Standard values were obtained while examining 20 almost healthy patients of the same age and gender, who made up the control group. Concentrations of cytokines: interleukin-1β, -2, -4, -6, -8 and tumor necrosis factor-α, quantification of C-reactive protein and ceruloplasmin activity in the blood serum has been de- termined. Statistical analysis has been performed on workstation by means of “Microsoft Excel” and “STATISTICA 6.0” software. The study showed that chronic obstructive pulmonary disease exacerbation was accompanied with a significant increase in the activity of systemic inflammation mediators – the cytokine cas- cade and acute phase reactants, in both groups of patients with chronic obstructive pulmonary disease. However, the comparative analysis of the examined groups has proved the significant dif- ference in cytokine status of patients with comorbidity of chronic obstructive pulmonary disease and chronic pancreatitis and in patients with isolated chronic obstructive pulmonary disease. Sig- nificant differences were found out in all investigated indices – IL-1β, IL-2, IL-4, IL-6 and TNF-α, except IL-8. Similar trends were observed in the concentrations of acute phase proteins – C-reac- tive protein and ceruloplasmin, whose levels in patients with comorbid disorders were significantly higher than those figures of persons with isolated chronic obstructive pulmonary disease. Thus, it can be concluded that the presence of concomitant chronic pancreatitis in patients with chronic obstructive pulmonary disease potentiates activation of systemic inflammatory re- sponse that can be caused by formation of autoimmune reactions in an organism thereby contrib- uting to a rapid progression of the pathological process and earlier formation of complications.