Activity of systemic inflammatory reaction in patients with chronic obstructive pulmonary disease in regard to small intestinal absorption function

Abstract

Aim. To study the effect of systemic inflammatory reaction in patients with chronic obstructive pulmonary disease (COPD) in association with absorption of the small intestine. Material and methods. Small intestinal absorption was studied in 93 COPD patients (22, 36 and 35 patients at stage I, II and III, respectively) in a clinically stable stage of the disease and in 35 healthy controls. The absorption was investigated biochemically and with application of radionuclide methods, blood concentration of TNFalpha was measured with enzyme immunoassay. Results. The small intestine of patients with moderate and severe COPD showed subnormal absorption of fats, protein, carbohydrates. With the disease progression, this disorder aggravated. The same trend was seen in relation to TNFalpha concentration. A strong direct correlation was found between a high concentration of TNFalpha and a low absorption of 131I-albumin and fatty acids, this high concentration correlated negatively with low absorption of d-xilose. Conclusion. Relationships between inflammation severity and small intestinal absorption of fats, protein, carbohydrates in patients with moderate and severe COPD means loss of essential nutrients, primarily protein and fats. This is important in understanding of pathobiological processes of development of extrapulmonary (intestinal) manifestations in COPD patients.

Keywords

• chronic obstructive pulmonary disease
• intestinal absorption
• systemic inflammation