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Xue H, Chen Q, Lan X, Xu H, Yang H, Lin C, Xue Q, Xie B. Preventing CXCL12 elevation helps to reduce acute exacerbation of COPD in individuals co-existing type-2 diabetes: A bioinformatics and clinical pharmacology study. Int Immunopharmacol 2024; 132:111894. [PMID: 38569426 DOI: 10.1016/j.intimp.2024.111894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 03/05/2024] [Accepted: 03/15/2024] [Indexed: 04/05/2024]
Abstract
AIMS To investigate the immunology shared mechanisms underlying chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2DM) and examine the impact of anti-diabetic drugs on acute exacerbation of COPD (AECOPD). METHODS We analyzed GSE76925, GSE76894, GSE37768, and GSE25724 to identify differentially expressed genes. Hub-genes were identified through protein-protein interaction network analysis and evaluated by the receiver operating characteristic curve. CXCL12 emerged as a robust biomarker, and its correlation with lung function and CD8+ T cells were further quantified and validated. The activated signaling pathways were inferred through Gene set enrichment analysis (GSEA). The retrospective clinical analysis was executed to identify the influence of dipeptidyl peptidase-4 inhibitors (DPP-4i) on CXCL12 and evaluate the drug's efficacy in AECOPD. RESULTS The significant up-regulation of CXCL12 expression in patients with two diseases were revealed. CXCL12 exhibited a negative correlation with pulmonary function (r = -0.551, p < 0.05). Consistent with analysis in GSE76925 and GSE76894, the positive correlation between the proportion of CD8+ T cells was demonstrated(r=0.469, p<0.05). GSEA identified "cytokines interaction" as an activated signaling pathway, and the clinical study revealed the correlation between CXCL12 and IL-6 (r=0.668, p<0.05). In patients with COPD and T2DM, DDP-4i treatment exhibited significantly higher serum CXCL12, compared to GLP-1RA. Analysis of 187 COPD patients with T2DM indicated that the DPP-4i group had a higher frequency of AECOPD compared to the GLP-1RA group (OR 1.287, 95%CI [1.018-2.136]). CONCLUSIONS CXCL12 may represent a therapeutic target for COPD and T2DM. GLP-1RA treatment may be associated with lower CXCL12 levels and a lower risk of AECOPD compared to DPP-4i treatment. CLINICAL TRIAL REGISTRATION China Clinical Trial Registration Center(ChiCTR2200055611).
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Affiliation(s)
- Hong Xue
- Provincial School of Clinical Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Qianshun Chen
- Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Thoracic Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Xiuyan Lan
- Provincial School of Clinical Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Hang Xu
- Provincial School of Clinical Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Haitao Yang
- Provincial School of Clinical Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Changjian Lin
- Provincial School of Clinical Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Qing Xue
- The Third Clinical Medical College, Fujian Medical University, Ningde Municipal Hospital, Ningde 352100, Fujian, China; Ningde Municipal Hospital of Ningde Normal University, Ningde 352100, Fujian, China.
| | - Baosong Xie
- Provincial School of Clinical Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China.
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Engström G, Lampa E, Dekkers K, Lin YT, Ahlm K, Ahlström H, Alfredsson J, Bergström G, Blomberg A, Brandberg J, Caidahl K, Cederlund K, Duvernoy O, Engvall JE, Eriksson MJ, Fall T, Gigante B, Gummesson A, Hagström E, Hamrefors V, Hedner J, Janzon M, Jernberg T, Johnson L, Lind L, Lindberg E, Mannila M, Nilsson U, Persson A, Persson HL, Persson M, Ramnemark A, Rosengren A, Schmidt C, Skoglund Larsson L, Sköld CM, Swahn E, Söderberg S, Torén K, Waldenström A, Wollmer P, Zaigham S, Östgren CJ, Sundström J. Pulmonary function and atherosclerosis in the general population: causal associations and clinical implications. Eur J Epidemiol 2024; 39:35-49. [PMID: 38165527 PMCID: PMC10811042 DOI: 10.1007/s10654-023-01088-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024]
Abstract
Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50-64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.
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Affiliation(s)
- Gunnar Engström
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden.
| | - Erik Lampa
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Koen Dekkers
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Yi-Ting Lin
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden
- Department of Family Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Kristin Ahlm
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Håkan Ahlström
- Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden
- BFC, Uppsala University Hospital, Uppsala, Sweden
- Antaros Medical AB, Mölndal, Sweden
| | - Joakim Alfredsson
- Department of Cardiology, Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Sciences, Linköping University, Linköping, Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Blomberg
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - John Brandberg
- Department of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kenneth Caidahl
- Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Physiology, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg, Sweden
| | - Kerstin Cederlund
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Olov Duvernoy
- Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden
| | - Jan E Engvall
- CMIV, Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden
- Department of Clinical Physiology; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Maria J Eriksson
- Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Tove Fall
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Bruna Gigante
- Division of Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Science, Danderyd University Hospital, Stockholm, Sweden
| | - Anders Gummesson
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Genetics and Genomics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Emil Hagström
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Viktor Hamrefors
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Jan Hedner
- Pulmonary Department, Sleep Disorders Center, Sahlgrenska University Hospital, Gothenburg, Sweden
- Center of Sleep and Wake Disorders, Sahlgrenska Academy, Gothenburg University, Göteborg, Sweden
| | - Magnus Janzon
- Department of Cardiology, Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Sciences, Linköping University, Linköping, Sweden
| | - Tomas Jernberg
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Linda Johnson
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Lars Lind
- Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Maria Mannila
- Heart and Vascular Theme, Department of Cardiology, and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Ulf Nilsson
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Anders Persson
- CMIV, Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden
- Department of Radiology, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Sciences, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Hans Lennart Persson
- Respiratory Medicine, Department of Medical and Health Sciences (IMH), Linköping University, Linköping, Sweden
| | - Margaretha Persson
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Anna Ramnemark
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medicine Geriatrics and Emergency Medicine, Sahlgrenska University Hospital Östra Hospital, Gothenburg, Sweden
| | - Caroline Schmidt
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - C Magnus Sköld
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital Solna, Stockholm, Sweden
- Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eva Swahn
- Department of Cardiology, Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Sciences, Linköping University, Linköping, Sweden
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Kjell Torén
- Section of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Waldenström
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Per Wollmer
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Suneela Zaigham
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Carl Johan Östgren
- CMIV, Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Johan Sundström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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Cazzola M, Rogliani P, Ora J, Calzetta L, Lauro D, Matera MG. Hyperglycaemia and Chronic Obstructive Pulmonary Disease. Diagnostics (Basel) 2023; 13:3362. [PMID: 37958258 PMCID: PMC10650064 DOI: 10.3390/diagnostics13213362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/20/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) may coexist with type 2 diabetes mellitus (T2DM). Patients with COPD have an increased risk of developing T2DM compared with a control but, on the other side, hyperglycaemia and DM have been associated with reduced predicted levels of lung function. The mechanistic relationships between these two diseases are complicated, multifaceted, and little understood, yet they can impact treatment strategy. The potential risks and benefits for patients with T2DM treated with pulmonary drugs and the potential pulmonary risks and benefits for patients with COPD when taking antidiabetic drugs should always be considered. The interaction between the presence and/or treatment of COPD, risk of infection, presence and/or treatment of T2DM and risk of acute exacerbations of COPD (AECOPDs) can be represented as a vicious circle; however, several strategies may help to break this circle. The most effective approach to simultaneously treating T2DM and COPD is to interfere with the shared inflammatory substrate, thus targeting both lung inflammation (COPD) and vascular inflammation (DM). In any case, it is always crucial to establish glycaemic management since the reduction in lung function found in people with diabetes might decrease the threshold for clinical manifestations of COPD. In this article, we examine possible connections between COPD and T2DM as well as pharmacological strategies that could focus on these connections.
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Affiliation(s)
- Mario Cazzola
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy
| | - Paola Rogliani
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy
- Division of Respiratory Medicine, University Hospital Fondazione Policlinico Tor Vergata, 00133 Rome, Italy
| | - Josuel Ora
- Division of Respiratory Medicine, University Hospital Fondazione Policlinico Tor Vergata, 00133 Rome, Italy
| | - Luigino Calzetta
- Unit of Respiratory Disease and Lung Function, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
| | - Davide Lauro
- Unit of Endocrinology and Metabolic Diseases, Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00173 Rome, Italy
- Division of Endocrinology and Diabetes, University Hospital Fondazione Policlinico Tor Vergata, 00133 Rome, Italy
| | - Maria Gabriella Matera
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania ‘Luigi Vanvitelli’, 81138 Naples, Italy
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