THE EFFECT OF CURRENT CIGARETTE SMOKING ON GRANULOCYTE TRAFFICKING IN COPD

P Ruparelia1, K Szczepura2, AM Peters2, ER Chilvers1

1University of Cambridge School of Clinical Medicine, Department of Medicine, Level 5, Box 157, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ.  2Department of Radiology, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ.

Introduction: 
Chronic obstructive pulmonary disease (COPD) is an inflammatory lung condition characterised by intense airway neutrophilia.  Smoking is the main aetiological factor.  We have used the transfusion of autologous 111indium (111In)-labelled granulocytes and whole body counting to assess granulocyte trafficking in ex-(XS) and currently smoking (CS) COPD patients.

Methods: 
We studied the trafficking of neutrophils in age and FeV1 matched CS-COPD patients (n=8) and XS-COPD patients (n=6) alongside non-smoker controls (NS.  n=12) and healthy smoker controls (HS.  n=5).  The participants were given autologous 111In-labelled granulocytes isolated using discontinuous plasma Percoll gradients and subjected to whole body counting on days 0,1,2,4,7 and 10.  Sputum was also collected daily for 10 days and measured for 111In.

Results:  
Granulocyte trafficking to the lungs was demonstrated by the presence of radioactivity in the sputum of COPD groups with maximum activity on day 2.  CS-COPD had increased neutrophil loss (7 day 111In retention: NS 94.5%; HS 93.5%; XS-COPD 94.2%; CS-COPD 91.6%; p<0.05).

Conclusion:
Low dose autologous 111In neutrophil retention affords a measure of neutrophil loss through the airways, which appears to be more intense in CS-COPD and may be a useful method for monitoring granulocyte flux in CS COPD.

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