Evaluation of plasma antimicrobial peptide LL-37 and nuclear factor-kappaB levels in stable chronic obstructive pulmonary disease
Received 28 August 2018
Accepted for publication 28 December 2018
Published 25 January 2019 Volume 2019:14 Pages 321—330
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Charles Downs
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Pelin Uysal,1 Gonul Simsek,2 Sinem Durmus,3 Volkan Sozer,4 Hulya Aksan,5 Sibel Yurt,6 Caglar Cuhadaroglu,1 Filiz Kosar,6 Remise Gelisgen,3 Hafize Uzun3
1Department of Chest Diseases, Faculty of Medicine, Mehmet Ali Aydinlar University, Atakent Hospital, Istanbul, Turkey; 2Department of Physiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey; 3Department of Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey; 4Department of Biochemistry, Yildiz Technical University, Istanbul, Turkey; 5Deparment of Biochemistry, Faculty of Medicine, Halic University, İstanbul, Turkey; 6Clinic of Chest Diseases, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, İstanbul, Turkey
Background: Antimicrobial peptides are effectors of host defence against infection and inflammation and can encourage wound repair.
Objectives: The objectives of this study were to investigate the plasma antimicrobial peptide LL-37 and nuclear factor-kappaB (NF-κB) levels in patients with stable COPD compared with a control group and to highlight their importance in immune inflammation.
Methods: One hundred and thirty-eight stable COPD patients and 33 control subjects were enrolled in the study. The COPD patients were classified into four groups based on FEV1 (groups I–IV) and also divided into “low-risk and high-risk” groups (groups A–B [low risk], C–D [high risk]).
Results: Plasma LL-37 levels were significantly lower while plasma NF-κB levels of the COPD patients were significantly higher than those of the control subjects (P<0.001, both). LL-37 levels were significantly lower in group IV than in groups I, II, and III (P<0.01, all). NF-κB levels were significantly higher in groups III and IV than in groups I and II (P<0.05, both). There was a positive correlation between FEV1 and FEV1/FVC in all COPD patients (r=0.742, P<0.001) and in group D (r=0.741, P<0.001). Furthermore, there was an inverse correlation between LL-37 and NF-κB in both the groups C (r=-0.566, P<0.001) and D (r=-0.694, P<0.001) and group C+D combined (r=-0.593, P<0.001). Furthermore, in group C, LL-37 and FEV1 were positively correlated (r=0.633, P<0.001).
Conclusion: Our study indicated that plasma LL-37 and NF-κB may play an important role in chronic immune inflammation. Decreased LL-37 levels may be particularly high risk for patients in stage IV disease. The role of LL-37 as a target for treatment of the immune system and COPD must be widely evaluated.
Keywords: COPD, inflammation, antimicrobial peptide LL-37, nuclear factor kappaB
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