Inflammatory markers in acute exacerbations of obstructive pulmonary disease: predictive value in relation to smoking history

The aim of this study was to investigate the relationship between the effec t of emergency treatment and inflammatory markers in patients with acute ex acerbations of obstructive pulmonary disease, especially with respect to sm oking history. We investigated 50 unselected patients with acute bronchial obstruction. Blood, urine and sputum samples were taken and analysed for eo sinophil and neutrophil markers. The patients were observed for at least 2 h and recordings of forced expiratory volume in 1 s (FEV1) were taken. They were re-examined after 1 and 4 weeks. The absolute levels of inflammatory markers did not differ significantly between non- or short-term smokers (le ss than or equal to 5 pack-years) and long-term smokers (> 5 pack-years) wi th the exception of myeloperoxidase in serum (S-MPO), which was higher in l ong-term smokers. The patients with higher levels of eosinophil markers bef ore emergency treatment experienced a greater improvement in lung function. In non- or short-term smokers this relationship was found in blood and uri ne, whereas in long-term smokers it was seen in sputum. No correlation was found between neutrophil markers and changes in lung function. We conclude that patients with obstructive pulmonary disease with acute exacerbations a nd high levels of eosinophil markers respond well to treatment. (C) 1999 HA RCOURT PUBLISHERS LTD.