Sputum Biomarkers in Wood and Tobacco Smoke Etiotypes of Chronic Obstructive Pulmonary Disease.

Introduction: There is a need to better understand the etiotypes of chronic obstructive pulmonary disease (COPD) beyond the tobacco-smoke (TS-COPD). Wood smoke COPD (WS-COPD) is characterized by greater airway compromise, milder emphysema, and slower rate of lung function decline than TS-COPD. However, it is unclear if these two etiotypes of COPD have differences in sputum biomarker concentrations. Objective was to compare sputum levels of selected sputum biomarkers between WS-COPD and TS-COPD, and healthy controls. Methods: Eighty-eight women (69±12 years) were recruited and classified into: WS-COPD (n=31), TS-COPD (n=29) and controls (n=28). Using ELISA, we determined induced sputum levels of metalloproteinase 9 (MMP-9), chemokine ligand 5 (CCL5), interleukin-8 (IL-8), chemokine ligand 16 (CCL16/HCC-4) and vascular endothelial growth factor (VEGF-1). Differences were analyzed by Kruskal-Wallis and Mann-Whitney-U tests and correlation between airflow limitation and biomarkers by Spearman's test. Results: At similar degree of airflow obstruction, anthropometrics and medications use, the level of sputum CCL5 was higher in TS-COPD than WS-COPD (p=0.03) without differences in MMP-9, IL-8, CCL16/HCC-4, and VEGF-1. Women with WS-COPD and TS-COPD showed significantly higher sputum levels of MMP-9, IL-8 and CCL5 compared with controls (p<0.001). FEV1% predicted correlated negatively with levels of MMP-9 (rho:-0.26; P=0.016), CCL5 (rho:-0.37; P=0.001), IL-8 (rho:-0.42; P<0.001) and VEGF (rho:-0.22; P=0.04). Conclusion: While sputum concentrations of MMP-9, IL-8, and CCL5 were higher in COPD women compared with controls, women with TS-COPD had higher levels of CCL5 compared with those with WS-COPD. Whether this finding relates to differences in pathobiological pathways remains to be determined.

Quality of life at 3 and 6 months in military personnel with a history of thoracic trauma suffered in combat.

OBJECTIVE: To measure the score and variation in the SF-36 quality of life questionnaire at 3 and 6 months of evaluation in military personnel with a history of chest trauma in combat. METHOD: Comparative study between military with chest trauma and healthy military personnel from 2011 to 2016, evaluating the SF-36 quality of life questionnaire. RESULTS: 45 subjects were analyzed, 25 with a history of chest trauma and 10 healthy controls with combat experience. 25 of the cases were evaluated at 3 months and 11 at 6 months. The average age was 28.2 years (standard deviation: 7.22), and 76% had projectile wounds with a high-speed firearm. 44 % (11/25) of the subjects with chest trauma at three months of assessment presented a lot of limitation for the performance of moderate activities (p < 0.001) and only 5% (1/20) of the controls reported a lot of limitation (p < 0.001). CONCLUSIONS: There is significant deterioration in the quality of life in all domains through the SF-36 questionnaire in patients with chest trauma at 3 and 6 months after the evaluation.

OBJETIVO: Medir el puntaje y la variación en el cuestionario de calidad de vida SF-36 a los 3 y 6 meses de valoración en militares con antecedente de trauma de tórax en combate. MÉTODO: Estudio comparativo entre militares con trauma de tórax y militares sanos entre los años 2011 y 2016, evaluando el cuestionario de calidad de vida SF-36. RESULTADOS: Se analizaron 45 sujetos, 25 con antecedente de trauma de tórax y 10 controles sanos con experiencia en combate. De los sujetos con trauma, 25 se evaluaron a los 3 meses y 11 a los 6 meses. El promedio de edad fue de 28.2 años (desviación estándar: 7.22). El 76% tuvieron heridas por proyectil con arma de fuego de alta velocidad. El 44% (11/25) de los sujetos con trauma de tórax, a los 3 meses de valoración, presentaba mucha limitación para la realización de actividades moderadas (p < 0.001) y solo el 5% (1/20) de los controles referían mucha limitación (p < 0.001). CONCLUSIONES: Hay un deterioro significativo en la calidad de vida en todos los dominios del cuestionario SF-36 en pacientes con trauma de tórax a los 3 y 6 meses de la valoración.