Relationship of Serum Levels of IL-17, IL-18, TNF- α , and Lung Function Parameters in Patients with COPD, Asthma-COPD Overlap, and Bronchial Asthma.

Determination of markers of systemic inflammation is one of the important directions in the study of pathogenesis and improvement of diagnosis of chronic obstructive pulmonary disease (COPD), asthma-COPD overlap (ACO), and bronchial asthma (BA). The aim of our work was a comparative study of the features of changes in serum levels of IL-17, IL-18, and TNF-alpha in patients with COPD, ACO, and BA with various severity of the disease, as well as evaluation of the relationship between the level of these cytokines and lung ventilation function. A total of 147 patients with COPD (n=58), ACO (n=57), and BA (n=32) during a stable period have been examined in this study. The control group included 21 healthy nonsmokers with similar sex-age indicators. Serum levels of IL-17, IL-18, and TNF-alpha were determined by ELISA. The concentrations of these cytokines in the circulation in the studied patients with COPD, ACO, and BA were higher than those in healthy nonsmokers (p <= 0.001). IL-17 and IL-18 levels in the blood serum were comparable in all examined patients. The mean TNF-alpha concentrations in the circulation in COPD and ACO were significantly higher than those in BA (p<0.001). In patients with COPD, the levels of IL-17 and TNF-alpha increased progressively against the background of a decrease in numerous spirometric indicators, which allows us to consider these cytokines as systemic biomarkers of disease severity. In BA, the inverse correlations between the level of IL-17 and FEV1/FVC (%) and FEV1 have been found. In patients with ACO, the increase in IL-18 levels was associated with a decrease in FEV1 and TNF-alpha with FEV1/FVC (%). These findings indicate that IL-17, IL-18, and TNF-alpha can participate in the mechanisms of systemic inflammation and the genesis of disorders of airway obstruction in COPD, ACO, and BA. An increase in the levels of IL-17 and TNF-alpha may be associated with impaired bronchial patency in COPD and BA. The established associations of the IL-18 concentration in the blood serum and FEV1 only in patients with ACO allow using the level of IL-18 as a potential marker of the degree of impaired airway obstruction in this disease.