, Volume 38, Issue 2, pp 616–622 | Cite as

Evaluation of IL-8 Nasal Lavage Levels and the Effects of Nasal Involvement on Disease Severity in Patients with Stable Chronic Obstructive Pulmonary Disease

  • Hacer Celik
  • Serdar Akpinar
  • Hayriye Karabulut
  • Pinar Oktar
  • Berna Dursun
  • Huyla Celenk Erguden
  • Sibel Gunay
  • Tugrul Sipit


Interleukin 8 (IL-8) is used to evaluate the severity of inflammation in the airways. The aim of this study was to evaluate patients with chronic obstructive pulmonary disease (COPD) for the presence of upper respiratory tract involvement by questioning patients regarding nasal symptoms and by measuring levels of IL-8 in nasal lavage material. A total of 47 COPD patients and 23 healthy controls were enrolled in this study. Pulmonary function tests were performed for all participants who were asked to complete a Sinonasal Outcome Test-20 (SNOT-20) questionnaire on the same day, as a measure of quality of life. Median IL-8 level in nasal lavage specimens of COPD patients with stable disease was higher than that of healthy controls. An increase in cigarette pack-years was significantly associated with an increase in nasal IL-8 levels. Similarly, IL-8 levels correlated positively with stage of COPD. A significant link between number of visits to the emergency department and stage of disease was observed. Patients with COPD had a significantly higher mean SNOT-20 severity score compared to healthy controls. Proper management of sinonasal disease may help to decrease the number of COPD attacks and consequently improve quality of life.


COPD integrated airway theory nasal lavage IL-8 SNOT-20 


Conflict of interest

We (all authors) declare that there is no conflict of interests among the authors. There is no financial support.


  1. 1.
    Mathers, C.D., and D. Loncar. 2006. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine 3: 442.CrossRefGoogle Scholar
  2. 2.
    American Thoracic Society. 1995. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine 152(5 Pt 2): S77–S121.Google Scholar
  3. 3.
    Chung, K.F. 2001. Cytokines in chronic obstructive pulmonary disease. European Respiratory Journal 18(Suppl. 34): 50–59.CrossRefGoogle Scholar
  4. 4.
    Pease, J.E., and I. Sabroe. 2002. The role of interleukin-8 and its receptors in inflammatory lung disease: implication for therapy. American Journal of Respiratory Medicine 1: 19–25.PubMedCrossRefGoogle Scholar
  5. 5.
    Nihlen, U., M. Andersson, C.G. Lofdahl, et al. 2003. Nasal neutrophil activity and mucinous secretory responsiveness in COPD. Clinical Physiology and Functional Imaging 23: 38–42.CrossRefGoogle Scholar
  6. 6.
    Hurst, J.R., T.M. Wilkinson, W.R. Perera, et al. 2005. Relationships among bacteria, airway, lower airway, and systemic inflammation in COPD. Chest 127: 1219–1226.PubMedCrossRefGoogle Scholar
  7. 7.
    Kim, J.S., and B.K. Rubin. 2007. Nasal and sinus inflammation in chronic obstructive pulmonary disease. COPD 4: 163–166.PubMedCrossRefGoogle Scholar
  8. 8.
    Hurst, J.R., T.M. Wilkinson, G.C. Donaldson, et al. 2004. Upper airway symptoms and quality of life in chronic obstructive pulmonary disease (COPD). Respiratory Medicine 98: 767–770.PubMedCrossRefGoogle Scholar
  9. 9.
    Montnemery, P., C. Svensson, E. Adelroth, et al. 2001. Prevalence of nasal symptoms and their relation to self-reported asthma and chronic bronchitis/emphysema. European Respiratory Journal 17: 596–603.PubMedCrossRefGoogle Scholar
  10. 10.
    Farmer, S.G., and D.W.P. Hay. 1991. The airway epithelium: physiology, pathophysiology and pharmacology. In Lung biology in health and disease, ed. C. Lenfant. USA: Marcel Dekker Inc.Google Scholar
  11. 11.
    Hens, G., B.M. Vanaudenaerde, D.M.A. Bullens, et al. 2008. Sinonasal pathology in nonallergic asthma and COPD: “united airway diseaseˮ beyond the scope of allergy. Allergy 63: 261–267.PubMedCrossRefGoogle Scholar
  12. 12.
    Barnes, P.J., S.D. Shapiro, and R.A. Pauwels. 2003. Chronic obstructive pulmonary disease: molecular and cellular mechanisms. European Respiratory Journal 22: 672–688.PubMedCrossRefGoogle Scholar
  13. 13.
    Yamamto, C., T. Yoneda, M. Yoshikawa, et al. 1997. Airway inflammation in COPD assessed by sputum levels of interleukin-8. Chest 112: 505–510.CrossRefGoogle Scholar
  14. 14.
    Perng, D.W., H. Huang, H.M. Chen, et al. 2004. Characteristics of airway inflammation and bronchodilator reversibility in COPD. Chest 126: 375–381.PubMedCrossRefGoogle Scholar
  15. 15.
    Chang, C., and W. Yao. 2014. Time course of inflammation resolution in patients with frequent exacerbations of chronic obstructive pulmonary disease. Medical Science Monitor 20: 311–320.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Feng, E., R. Wan, S. Yang, et al. 2013. Expression levels of induced sputum IL-8 and IL-10 and drug intervention effects in patients with acute exacerbated COPD complicated with chronic cor pulmonale at high altitude. Exp Ther Med 6: 747–752.PubMedCentralPubMedGoogle Scholar
  17. 17.
    Callebaut, I., V. Hox, S. Bobic, et al. 2013. Effect of nasal anti-inflammatory treatment in chronic obstructive pulmonary disease. American Journal of Rhinology & Allergy 27: 273–277.CrossRefGoogle Scholar
  18. 18.
    Barnes, P.J. 2004. Mediators of chronic obstructive pulmonary disease. Pharmacological Reviews 56: 515–548.PubMedCrossRefGoogle Scholar
  19. 19.
    Hurst, J.R., W.R. Perera, T.M. Wilkinson, et al. 2006. Systemic and upper and lower airway inflammation at exacerbation of chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine 173: 71–78.PubMedCrossRefGoogle Scholar
  20. 20.
    Hill, A.T., E.J. Campbell, S.L. Hill, et al. 2000. Association between airway bacterial load and markers of airway inflammation in patients with stable chronic bronchitis. American Journal of Medicine 109: 288–295.PubMedCrossRefGoogle Scholar
  21. 21.
    O’ Donnell, R.A., C. Peebles, J.A. Ward, et al. 2004. Relationship between peripheral airway dysfunction, airway obstruction and neutrophilic inflammation in COPD. Thorax 59: 837–842.CrossRefGoogle Scholar
  22. 22.
    Feghali, C.A., and T.M. Wright. 1997. Cytokines in acute and chronic inflammation. Fronties in Bioscience 2: d12–d26.Google Scholar
  23. 23.
    Pelegrino, N.R., Tanni, S.E., Amaral, R.A. et al. 2012. Effects of active smoking on airway and systemic inflammation profiles in patients with chronic obstructive pulmonary disease. American Journal of Medicine Sciences. 7. [Epub ahead of print]Google Scholar
  24. 24.
    Macnee, W. 2005. Pathogenesis of chronic obstructive pulmonary disease. Proceedings of the American Thoracic Society 2: 258–266.PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Roberts, N.J., S.J. Loyd-Own, F. Rapado, et al. 2003. Relationship between chronic nasal and respiratory symptoms in patients with COPD. Respiratory Medicine 97: 909–1004.PubMedCrossRefGoogle Scholar
  26. 26.
    Wakabayashi, Y., Y. Usui, Y. Okunuki, et al. 2011. Increases of vitreous monocyte chemotactic protein 1 and interleukin 8 levels in patients with concurrent hypertension and diabetic retinopathy. Retina 31: 1951–1957.PubMedCrossRefGoogle Scholar
  27. 27.
    Mirza, S., M. Hossain, C. Mathews, et al. 2012. Type 2-diabetes is associated with elevated levels of TNF-alpha, IL-6 and adiponectin and low levels of leptin in a population of Mexican Americans: a cross-sectional study. Cytokine 57: 136–142.PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    Gokalp, D., A. Tuzcu, M. Bahceci, et al. 2009. Levels of proinflammatory cytokines and hs-CRP in patients with homozygous familial hypercholesterolaemia. Acta Cardiologica 64: 603–609.PubMedCrossRefGoogle Scholar
  29. 29.
    Boekholdt, S.M., R.J. Peters, C.E. Hack, et al. 2004. IL-8 plasma concentrations and the risk of future coronary artery disease in apparently healthy men and women: the EPIC-Norfolk prospective population study. Arteriosclerosis, Thrombosis, and Vascular Biology 24: 1503–1508.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Hacer Celik
    • 1
  • Serdar Akpinar
    • 1
  • Hayriye Karabulut
    • 2
  • Pinar Oktar
    • 3
  • Berna Dursun
    • 1
  • Huyla Celenk Erguden
    • 1
  • Sibel Gunay
    • 1
  • Tugrul Sipit
    • 1
  1. 1.Department of PulmonaryAtaturk Chest Disease and Chest Surgery Training and Research HospitalAnkaraTurkey
  2. 2.Department of Otolaryngology and AudiologyAnkara Kecioren Research and Training HospitalAnkaraTurkey
  3. 3.Department of BiologyGazi UniversityAnkaraTurkey

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