[The role of 4-hydroxynonenal in assessment of chronic obstructive pulmonary disease severity]

To measure the levels of 4-hydroxynonenal (4-HNE), TNF-α and IL-6 in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and stable COPD, and therefore to explore the role of 4-HNE in the assessment of COPD severity.

A total of 242 patients with AECOPD, 182 males and 60 females, age 54 - 89 (mean 72 ± 8) years, 57 outpatients with stable COPD, 55 males and 2 females, age 38 - 76 (mean 60 ± 8) years, and 67 healthy controls, 49 males and 18 females, age 42 - 86 (mean 66 ± 10) years, were included in the study. Based on whether there were respiratory failure, chronic pulmonary heart disease or a history of smoking, the patients with AECOPD were divided into different subgroups. Patients with stable COPD were divided into different subgroups based on lung function or whether there was a history of smoking. The serum 4-HNE, TNF-α and IL-6 concentrations were measured by using enzyme-linked immune sorbent assay (ELISA).

The serum 4-HNE levels in patients with AECOPD or stable COPD (16 ± 4) mg/L, (15 ± 5) mg/L were higher than those in healthy controls (12 ± 4) mg/L (both P < 0.01). After control for age, the serum 4-HNE levels in patients with AECOPD were significantly higher than those in stable COPD (F = 7.93, P < 0.01). There were no differences in the serum 4-HNE among AECOPD patients of current smokers, non-smokers and ex-smokers (16 ± 4) mg/L, (17 ± 3) mg/L, (17 ± 4) mg/L. The serum 4-HNE in AECOPD patients with chronic pulmonary heart disease were particularly higher (17 ± 4) mg/L vs (15 ± 4) mg/L (F = 1.23, P < 0.01). There were no differences in the serum 4-HNE between stable COPD patients of current smokers and ex-smokers (14 ± 5) mg/L, (16 ± 4) mg/L (t = -1.44, P > 0.05). In patients with stable COPD, the serum 4-HNE levels were significantly correlated with FEV(1)% (r = -0.345, P < 0.01) and IL-6 (r = 0.363, P < 0.01).

The serum levels of 4-HNE in COPD patients with different smoking status were all significantly elevated, particular in patients with acute exacerbation and with pulmonary heart disease. In patients with stable COPD, the 4-HNE levels were negatively correlated with FEV(1)% and positively with serum IL-6 levels. It may be a valuable biomarkers for the assessment of COPD severity.