COPD is a common preventable and treatable disease, is
characterized by persistant air flow limitation that is usually progressive
and associated with an enhanced chronic inflammatory response in the
airways and the lung to noxious particles or gases. Exacerbations and
comorbidities contribute to the overall severity in individual patients
(GOLD, 2016).
Acute exacerbation of chronic obstructive pulmonary disease is
defined as acute event characterized by aworsening of the patientꞌs
respiratory symptoms that is beyond normal day to day variations and
leads to achange in medications (GOLD, 2016).
Erythropoietin is an endogenous glycoprotein hormone that
controls erythropoiesis, or red blood cell production. It is
a cytokine (protein signaling molecule) for erythrocyte (red blood cell)
precursors in the bone marrow. Human EPO has a molecular weight of 34
kDa. Also called hematopoietin or hemopoietin. (The American
Heritage® Stedman's Medical Dictionary., 2004)
Diminished arterial oxygen content associated with anemia or
hypoxia is the major stimulus for EPO production and usually produces
an exponential increase (Jelkmann et al., 1992).
It has long been known that COPD causes polycythemia secondary
to erythrocytosis caused by hypoxia present in advanced cases of COPD
(Wedzicha et al., 1983). However, it was shown in several studies that
some COPD patients had anemia rather than erythrocytosis (Attaran et
al., 2009).
Summary
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The aim of this work is to assess the changes in erythropoietin in
COPD patients during exacerbation and after remission.
This study was created on 50 subjects, 40 COPD patients from
those attending the Chest Department at Banha University Hospitals in
the period between December 2014 and December 2015 plus 10 age
matched apparently healthy control subjects. After application of
inclusion and exclusion criteria, patients demographic data , pulmonary
function results and blood level of erythropoietin hormone (measured by
ELISA) were recorded.
It was found that:
As expected pulmonary function parameters (FEV1% predected)
were significantly lower in patients than in control due to air way
obstruction in COPD patients.
Level of erythropoietin hormone were siginificantly higher in
patients than control , also were siginificantly higher in grade ( II,
III) than grade ( I, IV) COPD patients.
Erythropoietin hormone level were siginificantly higher in aneamic
than non aneamic COPD patients.
Erythropoietin hormone level were siginificantly higher during
remission than during exacerbation of COPD.
Level of erythropoietin hormone were siginificantly inversely
related to oxygen saturation & both of HB and HCT in COPD
patients. |