Long-term home noninvasive mechanical ventilation increases systemic inflammatory response in chronic obstructive pulmonary disease: A prospective observational study

Gregorino Paone, Vittoria Conti, Giuseppe Biondi-Zoccai, Elena De Falco, Isotta Chimenti, Mariangela Peruzzi, Corrado Mollica, Gianluca Monaco, Gilda Giannunzio, Giuseppe Brunetti, Giovanni Schmid, V. Marco Ranieri, Giacomo Frati

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Long-term home noninvasive mechanical ventilation (NIV) is beneficial in COPD but its impact on inflammation is unknown. We assessed the hypothesis that NIV modulates systemic and pulmonary inflammatory biomarkers in stable COPD. Methods. Among 610 patients referred for NIV, we shortlisted those undergoing NIV versus oxygen therapy alone, excluding subjects with comorbidities or non-COPD conditions. Sputum and blood samples were collected after 3 months of clinical stability and analyzed for levels of human neutrophil peptides (HNP), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-alpha). Patients underwent a two-year follow-up. Unadjusted, propensity-matched, and pH-stratified analyses were performed. Results. Ninety-three patients were included (48 NIV, 45 oxygen), with analogous baseline features. Sputum analysis showed similar HNP, IL-6, IL-10, and TNF-alpha levels (P > 0.5). Conversely, NIV group exhibited higher HNP and IL-6 systemic levels (P <0.001) and lower IL-10 concentrations (P <0.001). Subjects undergoing NIV had a significant reduction of rehospitalizations during follow-up compared to oxygen group (P = 0.005). These findings were confirmed after propensity matching and pH stratification. Conclusions. These findings challenge prior paradigms based on the assumption that pulmonary inflammation is per se detrimental. NIV beneficial impact on lung mechanics may overcome the potential unfavorable effects of an increased inflammatory state.

Original languageEnglish
Article number503145
JournalMediators of Inflammation
Volume2014
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Immunology
  • Cell Biology
  • Medicine(all)

Fingerprint Dive into the research topics of 'Long-term home noninvasive mechanical ventilation increases systemic inflammatory response in chronic obstructive pulmonary disease: A prospective observational study'. Together they form a unique fingerprint.

Cite this