KMID : 0338420180330040745
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The Korean Journal of Internal Medicine 2018 Volume.33 No. 4 p.745 ~ p.752
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Clinical significance of nuclear factor erythroid 2-related factor 2 in patients with chronic obstructive pulmonary disease
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Ban Woo-Ho
Kang Hyeon-Hui Kim In-Kyoung Ha Jick-Hwan Joo Hyon-Soo Lee Jong-Min Lim Jeong-Uk Lee Sang-Haak Rhee Chin-Kook
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Abstract
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Background/Aims: Several studies have identified a role for nuclear factor erythroid 2-related factor 2 (Nrf2) in the development of chronic obstructive pulmonary disease (COPD). However, the relationship between the plasma Nrf2 level and the extent of systemic inflammation associated with COPD status remains unclear.
Methods: Patients diagnosed with COPD were recruited from St. Paul¡¯s Hospital, The Catholic University of Korea, between July 2009 and May 2012. Patients were classified into two groups according to the severity of their symptoms on initial presentation, a COPD-stable group (n = 25) and a COPD-exacerbation group (n = 30). Seventeen patients were enrolled as a control group (n = 17). The plasma levels of Nrf2 and other systemic inf lammatory biomarkers, including interleukin 6 (IL-6), surfactant protein D (SP-D), and C-reactive protein (CRP), were measured. We collected clinical data including pulmonary function test results, and analyzed the relationships between the biomarker levels and the clinical parameters.
Results: Plasma Nrf2 and CRP levels significantly increased in a stepwise manner with an increase in inflammatory status (control vs. COPD-stable vs. COPD-exacerbation) (p = 0.002, p < 0.001). Other biomarkers of systemic inflammation (IL-6, SP-D) exhibited similar tendencies, but significant differences were not apparent. Furthermore, we observed negative correlations between the plasma level of Nrf2 and both the forced expiratory volume in 1 second (FEV1) (r = ?0.339, p = 0.015) and the forced expiratory ratio (FEV1/forced vital capacity [FVC]) (r = ?0.342, p = 0.014). However, CRP level was not correlated with any measured parameter.
Conclusions: Plasma Nrf2 levels gradually increased in line with disease severity and the extent of systemic inflammation in patients with COPD.
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KEYWORD
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Lung diseases, Chronic obstructive, NF-E2-related factor 2, Biomarkers
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