Michael Dreher1, Lisa Schulte2, Tobias Müller3, Emelie Ekkernkamp4, Andreas Zirlik2. 1. Department of Cardiology, Pneumology, Angiology and Intensive Care Medicine, University Hospital Aachen, Germany. Electronic address: mdreher@ukaachen.de. 2. Department of Cardiology and Angiology I, University Heart Center Freiburg, Germany. 3. Department of Cardiology, Pneumology, Angiology and Intensive Care Medicine, University Hospital Aachen, Germany. 4. Department of Pneumology, University Hospital Freiburg, Germany.
Abstract
BACKGROUND: Noninvasive positive pressure ventilation (NPPV) using effective pressure levels to reduce chronic hypercapnia improves survival in stable hypercapnic COPD. However, the underlying mechanisms remain unclear. This study investigated the influence of effective NPPV on a panel of cytokines and established cardiovascular biomarkers. METHODS: Peripheral blood samples were drawn before and three months after the initiation of NPPV and analyzed by flow cytometric bead array and ELISA. RESULTS: Twenty COPD patients (forced expiratory volume in 1 s 31 ± 17% predicted) were included. NPPV (inspiratory positive airway pressure 23 ± 4 mbar; breathing frequency 17 ± 2/min) significantly improved arterial carbon dioxide pressure (PaCO2), both during daytime spontaneous breathing (p = 0.005) and nighttime ventilation (p < 0.001). Serum interleukin (IL)-10 levels were slightly reduced (p = 0.016), whereas IL-1 (p = 0.073) and IL-12 (p = 0.089) showed only a tendency towards change over time. Pro-brain natriuretic peptide (proBNP) significantly decreased by a mean of 578 ± 1332 ng/L after three months' NPPV (p = 0.017 vs baseline). No other significant changes in cardiovascular biomarkers occurred. The decrease in PaCO2 during daytime spontaneous breathing was positively correlated with the reduction in proBNP (correlation coefficient 0.613; p = 0.0197). CONCLUSION: Effective NPPV impacts on systemic inflammation in COPD patients. Furthermore, reductions in PaCO2 during NPPV were associated with decreases in proBNP levels. Future studies are needed to clarify these findings in a larger cohort of COPD patients. CLINICAL TRIAL REGISTRATION: DRKS00007644 (German Clinical Trials Register; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=resultsExt).
BACKGROUND: Noninvasive positive pressure ventilation (NPPV) using effective pressure levels to reduce chronic hypercapnia improves survival in stable hypercapnic COPD. However, the underlying mechanisms remain unclear. This study investigated the influence of effective NPPV on a panel of cytokines and established cardiovascular biomarkers. METHODS: Peripheral blood samples were drawn before and three months after the initiation of NPPV and analyzed by flow cytometric bead array and ELISA. RESULTS: Twenty COPDpatients (forced expiratory volume in 1 s 31 ± 17% predicted) were included. NPPV (inspiratory positive airway pressure 23 ± 4 mbar; breathing frequency 17 ± 2/min) significantly improved arterial carbon dioxide pressure (PaCO2), both during daytime spontaneous breathing (p = 0.005) and nighttime ventilation (p < 0.001). Serum interleukin (IL)-10 levels were slightly reduced (p = 0.016), whereas IL-1 (p = 0.073) and IL-12 (p = 0.089) showed only a tendency towards change over time. Pro-brain natriuretic peptide (proBNP) significantly decreased by a mean of 578 ± 1332 ng/L after three months' NPPV (p = 0.017 vs baseline). No other significant changes in cardiovascular biomarkers occurred. The decrease in PaCO2 during daytime spontaneous breathing was positively correlated with the reduction in proBNP (correlation coefficient 0.613; p = 0.0197). CONCLUSION: Effective NPPV impacts on systemic inflammation in COPDpatients. Furthermore, reductions in PaCO2 during NPPV were associated with decreases in proBNP levels. Future studies are needed to clarify these findings in a larger cohort of COPDpatients. CLINICAL TRIAL REGISTRATION: DRKS00007644 (German Clinical Trials Register; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=resultsExt).
Authors: Marieke Leontine Duiverman; Petra Maagh; Friederike Sophie Magnet; Claudia Schmoor; Maria Paola Arellano-Maric; Axel Meissner; Jan Hendrik Storre; Peter Jan Wijkstra; Wolfram Windisch; Jens Callegari Journal: Respir Res Date: 2017-05-02
Authors: Ana Hernandez-Voth; Javier Sayas Catalan; Marta Corral Blanco; Rodrigo Alonso Moralejo; Virginia Perez Gonzalez; Alicia De Pablo Gafas; Alba Castaño Menendez; Lourdes Juarros Monteagudo; Victoria Villena Garrido Journal: Int J Chron Obstruct Pulmon Dis Date: 2022-01-18