Jornal Brasileiro de Pneumologia (Oct 2007)
Perfil celular do escarro induzido e sangue periférico na doença pulmonar obstrutiva crônica Induced sputum and peripheral blood cell profile in chronic obstructive pulmonary disease
Abstract
OBJETIVO: Determinar o perfil celular e subgrupos linfocitários CD4+ e CD8+ no escarro induzido (EI) e sangue venoso periférico (SVP) de pacientes com doença pulmonar obstrutiva crônica (DPOC). MÉTODOS: Foram quantificadas as celularidades total e específica, incluindo subgrupos linfocitários T CD4+ e CD8+, do EI e SVP de 85 pessoas (38 pacientes com DPOC sem agudização, 29 tabagistas sem obstrução e 18 não-tabagistas). Os testes não-paramétricos de Mann-Whitney e Spearman foram usados na análise estatística, considerando como significante o p OBJECTIVE: To determine cell profiles, as well as to identify CD4+ and CD8+ lymphocyte subgroups, in induced sputum (IS) and peripheral venous blood (PVB) of patients with chronic obstructive pulmonary disease (COPD). METHODS: Total cell counts and counts of individual cell types, including CD4+ and CD8+ T lymphocytes, were determined in the IS and PVB of 85 subjects (38 with COPD without exacerbation, 29 smokers without obstruction and 18 nonsmokers). Mann-Whitney and Spearman non-parametric tests were used in the statistical analysis, and values of p < 0.05 were considered statistically significant. RESULTS: Comparing the IS of subjects with COPD to that of nonsmokers, neutrophil, eosinophil and CD8+ T lymphocyte counts were higher (respectively p = 0.005, p < 0.05 and p < 0.05), whereas the percentage of macrophages was lower (p = 0.003). There were weak linear correlations (r² < 0.1) between each cell type in IS and forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio. Eosinophil and CD8+ T lymphocyte counts were also higher in PVB (p = 0.04 and p = 0.02). CONCLUSIONS: In patients with stable COPD, CD8+ T lymphocyte counts were higher in PVB, whereas total leukocyte counts were similar to those of the other two groups analyzed, suggesting systemic inflammatory involvement. The CD8+ T lymphocyte count in blood can be a useful marker of systemic inflammation and can help identify smokers who already present a COPD inflammatory pattern.
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