Background

Patients with chronic obstructive pulmonary disease (COPD) have increased susceptibility to respiratory tract infection, which contributes to disease progression and mortality, but mechanisms of increased susceptibility to infection remain unclear.

Objectives

The aim of this study was to determine whether glucose concentrations were increased in airway samples (nasal lavage fluid, sputum, and bronchoalveolar lavage fluid) from patients with stable COPD and to determine the effects of viral infection on sputum glucose concentrations and how airway glucose concentrations relate to bacterial infection.

Methods

We measured glucose concentrations in airway samples collected from patients with stable COPD and smokers and nonsmokers with normal lung function. Glucose concentrations were measured in patients with experimentally induced COPD exacerbations, and these results were validated in patients with naturally acquired COPD exacerbations. Relationships between sputum glucose concentrations, inflammatory markers, and bacterial load were examined.

Results

Sputum glucose concentrations were significantly higher in patients with stable COPD compared with those in control subjects without COPD. In both experimental virus-induced and naturally acquired COPD exacerbations, sputum and nasal lavage fluid glucose concentrations were increased over baseline values. There were significant correlations between sputum glucose concentrations and sputum inflammatory markers, viral load, and bacterial load. Airway samples with higher glucose concentrations supported more Pseudomonas aeruginosa growth in vitro.

Conclusions

Airway glucose concentrations are increased in patients with stable COPD and further increased during COPD exacerbations. Increased airway glucose concentrations might contribute to bacterial infections in both patients with stable and those with exacerbated COPD. This has important implications for the development of nonantibiotic therapeutic strategies for the prevention or treatment of bacterial infection in patients with COPD.

中文翻译：

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气道葡萄糖在慢性阻塞性肺疾病患者细菌感染中的作用

 背景

慢性阻塞性肺疾病（COPD）患者对呼吸道感染的易感性增加，从而导致疾病进展和死亡率，但感染易感性增加的机制仍不清楚。

 目标

本研究的目的是确定稳定期 COPD 患者气道样本（鼻腔灌洗液、痰液和支气管肺泡灌洗液）中的葡萄糖浓度是否升高，并确定病毒感染对痰液葡萄糖浓度的影响以及气道葡萄糖浓度如何变化。与细菌感染有关。

 方法

我们测量了从稳定期慢性阻塞性肺病患者以及肺功能正常的吸烟者和非吸烟者收集的气道样本中的葡萄糖浓度。测量了实验诱发的 COPD 恶化患者的血糖浓度，这些结果在自然获得性 COPD 恶化的患者中得到了验证。检查痰葡萄糖浓度、炎症标志物和细菌负荷之间的关系。

 结果

与无慢性阻塞性肺病的对照受试者相比，稳定期慢性阻塞性肺病患者的痰葡萄糖浓度显着较高。在实验性病毒诱导的慢性阻塞性肺病恶化和自然获得性慢性阻塞性肺病恶化中，痰液和鼻腔灌洗液的葡萄糖浓度均高于基线值。痰葡萄糖浓度与痰炎症标志物、病毒载量和细菌载量之间存在显着相关性。葡萄糖浓度较高的气道样本支持更多的铜绿假单胞菌体外生长。

 结论

稳定期 COPD 患者的气道葡萄糖浓度升高，并且在 COPD 恶化期间进一步升高。气道葡萄糖浓度升高可能会导致慢性阻塞性肺病稳定期和加重期患者的细菌感染。这对于开发预防或治疗慢性阻塞性肺病患者细菌感染的非抗生素治疗策略具有重要意义。