Analysis of the relationship between the serum lipopolysaccharide level and other inflammation markers, clinical and functional characteristics of patients with COPD without exacerbation

Lipopolysaccharide (LPS) from gram-negative bacteria is considered a pathogenetic factor of many diseases. It is also known to include exacerbations of chronic obstructive pulmonary disease (COPD), but this effect has been little studied in stable COPD.

The aim of the study was to evaluate the relationship between serum LPS levels and inflammatory markers, clinical and functional characteristics of COPD without exacerbation.

Methods. The pilot study included 29 patients with COPD who did not have any exacerbations requiring antibacterial therapy or systemic steroids for 3 or more months and 27 patients without respiratory diseases, matched by age and gender (63.9 ± 6.3 years, 69% men). All patient data were taken from the database of National Medical Research Center for Therapy and Preventive Medicine. The differences were considered statistically significant at p < 0.05; and a trend (change of variables in one direction requiring further investigation) at p ≥ 0.05 – 0.075.

Results. The COPD group showed a tendency towards a lower LPS level (p = 0.062). The levels of TMAO and CRP were significantly lower in the control group (p < 0.05), and the fibrinogen and leukocyte levels did not differ. In the COPD group, a direct correlation was found between the LPS level and quality of life according to the CAT (COPD Assessment Test™) (r = 0.43; p = 0.019), an inverse correlation with the spirometry parameters (p < 0.05), and a trend towards an association between LPS and age (r = –0.34; p = 0.075), body mass index (r = 0.34; p = 0.072), waist circumference (r = 0.35; p = 0.064), and smoking status (r = 0.35; p = 0.061). No such relationships were seen in the control group. No relationship with exacerbations of COPD was found during the prospective follow-up (12 months).

Conclusion. The level of LPS tends to differ between patients with stable COPD and patients without COPD, and correlates with severity of symptoms and lung function impairment in COPD patients. Further larger studies in this area are advisable.

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