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Analysis of cytokine gene expression after treatment and pulmonary rehabilitation of acute exacerbation in COPD

Aims: Previously, antibody microarrays analysis revealed significant differences in the levels of 12 cytokines between stable COPD and acute exacerbation (AECOPD). Here we compared the expression of these cytokines at the mRNA level between stable COPD, AECOPD and various stages during the course of recovery from exacerbation. Patients and Methods: Sputum samples were collected from ex-smoker COPD patients in stable state (n=26) and from those in acute exacerbation (n=31) at hospital admission and discharge; after 6 weeks of early pulmonary rehabilitation and after 3 month of home recovery. Levels of BMP4, BMP6, IL1α, IL1R, IL6, IL8, M-CSF, MIG, Gro-α, CCL23, Rantes and Osteoprotegerin (OPG) mRNA were determined by real-time PCR using PPIA and GNB2L1 as housekeeping genes. Relative gene expressions were calculated using the pairwise fixed reallocation randomization test. Results: Compared to stable COPD, in AECOPD BMP4 was significantly up-regulated (2.7-fold), while BMP6, IL1α and MIG were down-regulated (3.1-, 2.4- and 4.9-fold; respectively). Increased expression (p Conclusion: Changes at the protein level are paralleled by changes in gene expression in AECOPD, however on a different time and amplitude scale. The level of several cytokines is not stabilized even after 5 month of recovery, indicating a long lasting effect of exacerbation on the status of COPD patients.