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Backgrounds: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is closely related to disease mortality. Systemic inflammation is considered to be involved in the pathogenesis of AECOPD. The current study aimed to investigate the clinical significance of the classic chemokine interleukin (IL)-8 in serum during AECOPD. Materials and Methods: In this current cross sectional, observational study, 50 patients with AECOPD, 25 patients with stable COPD and 25 healthy nonsmokers as the control group were selected. Clinical characteristics and spirometry data were collected. All patients were classified as grade 1-4 based on forced expiratory volume in 1 second (FEV1) after bronchodilation according to the GOLD severity classification and were divided into frequent exacerbation (FE) group (≥2 times/year) and non-frequent exacerbation (NFE) group (<1 time/year) according to acute exacerbation (AE) times in the previous 12 months before the visit. The serum IL-8, IL-6, tumor necrosis factor (TNF)-α, and superoxide dismutase levels were measured by the enzyme-linked immunosorbent assay technique. Results: Serum IL-8 levels increased sequentially from controls [9.45 pg/mL (ranged: 6.85-38.4)], to stable [51.60 pg/mL (ranged: 22.4-131.1)], and exacerbation stage [129 pg/mL (ranged: 57.7-374)]. The level of serum IL-8 was significant higher in patients with FE than that of patients with NFE (209.0 pg/mL (ranged: 115-472) vs 65.6 pg/mL (ranged: 11.2-149.3), P=0.008). A receiver operating characteristics curve (ROC) generated to evaluate IL-8, IL-6, and TNF-α levels to discriminate between patients with and without exacerbation showed that the total area under the curve (AUC) was 0.71 (95% confidence interval (CI): 0.5764-0.8381; P=0.003), 0.54 (95%CI: 0.4048-0.6943; P=0.54), and 0.52 (95%CI: 0.3912-0.6656; P= 0.7). Conclusion: Serum IL-8 is a sensitive, easy-to-measure, and inexpensive biomarker to give an indication of the course of COPD during exacerbation, and is a target to be explored further as a predictor to distinguish the patients prone to exacerbation. [ABSTRACT FROM AUTHOR]

Background: To explore the clinical significance of serum interleukin-8 (IL-8) level as a biomarker for uncontrolled asthma in order to improve our understanding of asthma phenotypes and facilitate the development of new therapeutic agents in the future. Materials and Methods: A total of 246 uncontrolled asthma patients and 50 healthy controls were selected from an outpatient clinic during October 2015 and April 2016. The clinical data were collected, and the levels of IL-8, IL-6, tumor necrosis factor-α (TNF-α), and immunoglobulin (IgE) were measured in peripheral blood via ELISA assay. The level of serum IL-8 was compared between the glucocorticosteroid groups, receiving inhaled corticosteroids (ICs), oral corticosteroids (OCs), and intravenous corticosteroids (GCs), respectively. Changes in the serum IL-8 level were compared between asthmatics with good and poor glucocorticosteroid responsiveness. Results: The serum IL-8 level in uncontrolled asthmatics (87.45 pg/mL; 5-7500) was significantly higher than that of the healthy controls (10.9 pg/mL; 6.8-39.65; P< 0.001). The increase in the serum IL-8 level above the normal range occurred in 58.13% of uncontrolled asthmatics. The area under curve (AUC) for serum IL-8 level, indicative of uncontrolled asthma, was 0.816 (95% CI, 0.7605 to 0.8721; P< 0.0001), which was greater than the AUC of fractional exhaled nitric oxide (AUC, 0.711; 95% CI, 0.6057 to 0.8153; P= .0188). The serum IL-8 level showed a significant positive relationship with blood neutrophil count (P= 0.0004), neutrophil percentage (P= 0.027), serum TNF-α protein (P< 0.0001), forced expiratory volume/forced vital capacity (FEV1/FVC) ratio (P< 0.05), and rate of FEV1 change after bronchodilation. The level of IL-8 in patients requiring OCs or GCs treatment was significantly higher than that of ICs patients (186 and 235 pg/mL vs. 61 pg/mL; P< 0.0001). The reduction in the serum IL-8 level was more significant in asthmatic patients with good responsiveness (277 pg/mL (65.3-3124) to 67.8 pg/mL (5-1408); P< 0.0001), compared to those with poor responsiveness (218 pg/mL (64.8-7500) vs. 197 pg/mL (56.9-5238); P= 0.49). Conclusion: The increase in serum IL-8 level can be used as a preferable biomarker to identify asthma status and initial treatment in asthmatics. The change in IL-8 level also reflects the response to glucocorticosteroids in uncontrolled asthma. These exploratory results suggest an association between the pathophysiology, inflammation, and clinical outcomes of asthma. This raises the possibility of developing new agents for IL-8 inhibition and helps provide more precise and personalized asthma care. [ABSTRACT FROM AUTHOR]