Dr. J. Sauleda led a research group at the University Hospital Son Dureta (Palma Mallorca, Spain) and CIBER (Barcelona, Spain) that recently published the results of a study concerning chronic obstructive pulmonary disease (COPD) in the American Journal of Respiratory and Critical Care Medicine.  COPD, a disease where the respiratory passageways become narrowed, has become the fourth leading cause of death in the world over the past few years.

COPD is typically differentiated further into emphysema and severe, chronic bronchitis.  The bronchitis sufferers are those with inflammatory response in the larger airways (the bronchi); emphysema is associated with the inflammatory and destructive responses within the alveoli.  There has been mounting evidence that COPD may be an autoimmune disease (triggered by smoking and/or exposure to airborne pollutants), with the inflammation mediated by auto-immune antibodies and auto-reactive T cells.

The study, which was designed to elucidate the reality of that supposition,  involved 328 stable patients (at least three months after hospitalization for a COPD related incident) and 67 control subjects (total study census of 395).  Patient history (smoking, co-morbidity, body mass index [BMI], etc.), lung spirometry, and blood tests were effected for the subjects.   Roughly 1/3 of those manifesting COPD had elevated antinuclear antibodies (11 times that of the control group; 7 times that reported for normal subjects). [It has been reported that patients with “severe bronchitis” also have elevated antinuclear antibody levels.]  Moreover, ¼ manifested anti-tissue antibodies (4.5 times that of the control and of previously reported healthy subjects).  This last test segment (very high anti-tissue antibody levels) was associated with active smokers and was directly related to their impaired lung function (severe airflow limitations, gas transfer impediments).

No correlations with BMI, inhaled steroid use, serum CRP (C-Reactive protein), or the Charlson index were associated with the titers of these two antibodies.  Nevertheless, the autoimmune relationship was pronounced for those with more pronounced COPD disease; with the presence of auto-immune related antibodies on the order of 5 to 10 times those found in the control subjects.

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