Clinical and immunological characteristics of chronic obstructive pulmonary disease with frequent exacerbations associated with obliterating atherosclerosis of lower limb arteries

Abstract

Chronic obstructive pulmonary disease (COPD) is often associated with atherosclerotic cardiovascular disease (ASCVD), of which obliterating atherosclerosis of lower limb arteries or peripheral arterial disease (PAD) is an important component. The aim of the study was to evaluate the clinical, functional and immunological characteristics of COPD with the phenotype of frequent exacerbations in combination with PAD. Materials and methods. Four groups of COPD patients were included: 20 COPD patients with infrequent exacerbations without ASCVD, 20 COPD patients with frequent exacerbations without ASCVD, 20 patients with frequent exacerbations and PAD, and 20 COPD patients with a phenotype of frequent exacerbations and PAD. Data from 20 healthy controls were analysed for comparison. Clinical and spirometric data were evaluated. General clinical laboratory data and immunological markers (interleukin 1 beta (IL1b) and tumor necrosis factor (TNF) in exhaled breath condensate (EBC) and serum were analysed. Results. Higher levels of IL1b and TNF in EBC and serum were found in patients with COPD and PAD compared to COPD patients without ASCVD (p<0.05) and healthy controls (p<0.001). The high prevalence of COPD exacerbates the clinical and immunological characteristics of disease severity both without ASCVD and with concomitant PAD. Conclusions. COPD with the phenotype of frequent exacerbations and PAD is characterized by greater severity of local and systemic inflammation, which corresponds to increased inflammatory markers in EBC and serum.