Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
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My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
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Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2009 | Month : February | Volume : 3 | Issue : 1 | Page : 1285 - 1288 Full Version

IL-6 And IL-8 Levels İn Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Published: February 1, 2009 | DOI:
AKBULUT H.H. *, OZDEN M. **, DEVECİ F.***, MUZ M. H. ****

*,** Department of Immunology ,***,**** Department ofPulmonary Medicine,Firat University, Faculty of Medicine,Elazig,(Turkey)

Correspondence Address :
Dr. Handan Akbulut, Department ofImmunology,Firat Medical Center,23119,Elazig,(Turkey),Ph:+90.424.2333555,ext:2168,
Fax:+90.424.2388096, MailingAddress:Firat University,FiratTip Merkezi,ImmĂĽnoloji Anabilim Dalı, Elazig 23119,(TURKEY)


Background: Chronic Obstructive Pulmonary Disease (COPD) is characterized by an abnormal inflammatory response of airways due to inhalation of harmful gases and particles. Frequent exacerbations are associated with increased pulmonary and systemic inflammation. Interleukin-6 (IL-6) and interleukin-8 (IL-8) are systemic inflammation markers.
Aim: The relationship of serum IL-6 and IL-8 levels in patients of exacerbated COPD with pulmonary function tests (PFT), forced expiratory volume in one second (FEV1), FEV1/ forced vital capacity (FVC) values, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were studied.
Methods and Materials: Twenty-seven patients with exacerbated COPD and 20 healthy controls were included in the study. In addition to acute exacerbation therapy, antibiotics were used in all patients.
Results: The mean duration of antibiotic usage was 14.1±7.3 days and the mean FEV1 value was 34.11±10.43. Pretreatment and post treatment IL-6 and IL-8 levels were measured by the ELISA method. Pretreatment IL-6 and IL-8 levels were found to be significantly higher in acute excacerbation cases, when compared to levels in the healthy control group and post treatment levels. But no correlation was found between IL-6, IL-8 levels and CRP, ESR values and FEV1, FEV1/ FVC values.
Conclusion: We conclude that cases of exacerbated COPD with greater degrees of obstruction of the airways have higher levels of cytokines in serum. The serum levels of these cytokines can therefore be utilised as the clinical and prognostic parameters for evaluation of the disease status and the therapy executed for the same.


IL-6, IL-8, Chronic obstructive pulmonary disease

Some patients of COPD are prone to frequent exacerbations, which are important determinants of health status (3). Cytokines are extracellular signal proteins (less than 80 kDa) formed by various types of cells in the body. IL-6 is secreted by monocytes, macrophages, T cells, B cells, fibroblasts, epithelial cells of the airway and endothelial cells. IL-8, also known as CXCL8, is a CXC chemokine that is a potent chemoattractant for neutrophils. In general, monocytes, tissue and alveolar macrophages, pulmonary epithelium, cells of the smooth muscles of the airway, eosinophils, fibroblasts, and endothelial cells are its important sources (5), (6). The levels of many cytokines are known to be raised in serum in COPD (7), but their contribution to disease severity is still unknown. In this study, the relationship between the levels of IL-6 and IL-8 in the serum of patients with exacerbation of COPD, and PFT; FEV1, FEV1/FVC values CRP, and ESR were studied.

Material and Methods

Twenty-seven COPD patients with exacerbation of disease, reporting to the Pulmonary Diseases Clinic of the Firat Medical Center, Firat University, (Elazıg, Turkey) were enrolled. The patients had no other pulmonary disease conditions like asthma, bronchiectasis, pneumonia, tuberculosis, or lung cancer. In addition to acute exacerbation therapy, antibiotics were used in all patients. The diagnosis of COPD was made, based on the American Thoracic Society and European Respiratory Society’s criteria, with exacerbation identified according to the definition by Anthonisen et al. which is based on an increase in symptoms of dyspnea, sputum volume and sputum purulence with or without symptoms of upper respiratory infection and then subdivided depending on the number of symptoms (8),[ 9]. The control group included 20 non-smoking, healthy volunteers with laboratory findings within normal limits and no complaints. Spirometric tests were performed in all subjects in the pre and post-treatment period according to international guidelines using a Fukuda Denshi Spirosift 500 (10),(11). The reversibility of airway obstruction was assessed according to GOLD (12). Indices of airflow obstruction, FEV1 and FEV1/FVC were measured. FEV1 and FVC were expressed as percentages of predicted values (FEV1 % and FVC %), according to the prediction equations of the European Respiratory Society (13).

Therapy was initiated in patients with combinations of inhalational β2 agonist, inhalational ipratropium bromide and inhalational steroid treatment. In addition to this, antibiotic (macrolide or beta lactam group) treatment was instituted in all COPD patients who had all the three cardinal symptoms (dyspnoea, increasing of sputum volume and sputum purulence). Approval of the ethics committee was taken for the study. Prior written informed consent was obtained from each patient after giving a brief explanation about the study.

Determination Of Cytokine Levels
Pre and post treatment venous blood samples (5 ml) were obtained from all patients. The blood samples were centrifuged at 5000 rpm for 10 min; sera collected, were stored at -80 0C until assayed. Similarly, blood samples were obtained from the control group; serum was separated and stored at -80 0C. IL-6 and IL-8 levels in all serum samples were measured simultaneously by the ELISA method. A commercial kit was used for this purpose, and the study was performed according the kit procedure (Medgenix, Biosource International, Camarillo, USA). Pre treatment and post treatment CRP levels (nephelometric technique, Dade Behring BN II) and ESR (Westerngren method) were also measured.

Statistical Analysis
Statistical analyses were made by the SPSS 11.0 version for Windows. Wilcoxon’s Signed Ranks Test was used for evaluations within groups and Mann Whitney-U Tests were used for comparisons between groups. Correlations between parameters were evaluated with Spearman correlation analysis. P values <0.05 were accepted as statistically significant.


The demographic characteristics of subjects enrolled into the study are shown in (Table/Fig 1). The mean duration of antibiotic use was 14.1±7.3 day and the mean FEV1 value was 34.11±10.43 (%). Pretreatment and post treatment serum IL-6 and IL-8 levels were measured by the ELISA method. Mean serum cytokines, CRP, ESR levels and FEV1, FEV1/FVC values of patients and of healthy control groups both pre-treatment and post-treatment, are presented in (Table/Fig 2). Pretreatment IL-6 and IL-8 levels in acute exacerbation cases were found to be significantly higher as compared to that of the healthy control group as well as post treatment. But no correlation was found between IL-6, IL-8 levels and CRP, ESR, FEV1, FEV1/ FVC values.


In this study, the relationship between the levels of pro inflammatory cytokines and therapy in patients with exacerbated COPD were studied. In this study, the pre treatment levels of IL-6 and IL-8 were found to be higher (statistically significant) in patients of COPD pre and post treatment when compared to the control group (p<0.05).

Exacerbations of COPD lead to increase in the number of patients reporting to the hospital and the frequency of admissions. It also adversely affects the quality of life of the patients and restricts their daily activities(14). Such patients demonstrate elevated airway cytokine levels, suggesting the presence of increased inflammation that may increase their susceptibility to exacerbation. Inflammatory response during COPD exacerbation is variable, but increases in interleukin-6 (IL-6) levels during the exacerbation are related to the presence of a common cold. The reduction of COPD exacerbations can have an important impact on the considerable morbidity and mortality associated with COPD (3).

Patell IS et al. reported that within the COPD group, the IL-6 and IL-8 response was lower in the cells of patients taking inhaled corticosteroids and the study had demonstrated significant differences between primary airway epithelial cytokine production in patients with chronic obstructive pulmonary disease and smokers with normal pulmonary function, both constitutively and in response to an inflammatory stimulus(15).

In the study by Bhowmik and colleagues, it was found that there was a relationship between the exacerbation frequency and the level of sputum cytokines. The levels of IL-6 and IL-8 were found to be increased in the sputum of patients who had been stable at the baseline and who experienced frequent exacerbations as compared to those who experienced infrequent exacerbations. During exacerbation, increases were found in the level of IL-6 in induced sputum, and the levels of IL-6 were higher when exacerbations were associated with symptoms of common cold (16). Increased levels of IL-6, IL-1 beta, tumour necrosis factor-alfa and IL-8 in sputum have been measured (6).

Schmidt Ioanas M. reported that the sputum levels of cytokines were significantly increased as compared to serum levels(17). In the study by Kochetkova EA, changes in the cytokine status in COPD patients was established and an increase in pro-inflammatory cytokines and change in anti-inflammatory cytokines was observed. There was hyper production of serum pro- inflammatory cytokines (IL-1 beta, IL-6, IL-8, TNF-alpha) dependent on FEV1 (18).

Exacerbation of COPD is associated with greater nasal, sputum, and serum inflammation than that seen in a stable state. During exacerbation, inflammatory markers were found to be highly correlated within nasal wash and serum, but not sputum[ 19].

The results of this study are in concordance with similar studies performed earlier. IL-6 and IL-8 levels were found to be significantly higher during COPD exacerbation as compared to the healthy control group and post treatment levels. But no significant correlation was found between IL-6, IL-8 levels and CRP, ESR, FEV1 and FEV1/ FVC values.


Cases of exacerbated COPD with greater degrees of obstruction of the airways have higher levels of cytokines in serum. This can be interpreted to mean that these cytokines are related to the clinical and prognostic parameters and can be useful for evaluation of the therapy instituted for the disease.


Lomas DA. Chronic obstructive pulmonary disease. Thorax 2002; 57: 735.
GOLD Scientific Committe. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: NHLBI/WHO Global initiative for chronic obstructive pulmonary disease (GOLD) workshop report. . 2004.
Jadwiga A, Wedzicha MD. Exacerbations, Etiology and Pathophsiologic Mechanisms. Chest 2002; 121: 136-41.
Chung KF. Cytokines. In: Barnes PJ, Drazen JM, Rennard S, Thomson NC, editors. Asthma and COPD: basic mechanisms and clinical management. London: Academic Press; 2002. 261-71.
Pease JE, Williams TJ. Chemokines. In: Barnes PJ, Drazen JM, Rennard S, Thomson NC, editors. Asthma and COPD: basic mechanisms and clinical management. London: Academic Press; 2002. 255-60.
Chung KF. Cytokines in chronic obstructive pulmonary disease.Eur Respir J 2001; 18: 50-59.
Keatings VM, Collins PD, Scott DM, et al. Differences in interleukin-8 and tumor necrosis factor-α in induced sputum from patients with chronic obstructive pulmonary disease or asthma. Am J Resp Crit Care Med 1996; 153: 530-34.
Celli BR, MacNee W, committee members. Standarts for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004; 23: 932-46.
Anthonisen NR, Manfreda J, Warren CPW, et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987; 106(2): 196-204.
British Thorasic Society, Association of Respiratory Technicians and Physiologists. Guidelines for the measurement of respiratory function. Respir Med 1994; 88: 165-94.
American Thoracic Society. Standartization of spirometry: 1987 update. Am Rev Respir Dis 1987; 136: 1286-96.
Global Initiative for Chronic Obstructive Lung Disease. NHLBI/WHO workshop report. April 2001, publication number 2701.
Standardized lung function testing. European Community for Steel and Coal, Official Statement of the European Respiratory Society. Eur Respir J 1993, 6, Suppl. 16.
Seemungal Tar, Donaldson GC, Paul EA, et al. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998; 157: 1418-22.
Patel IS, Roberts NJ, Lloyd-Owen SJ, et al.Airway epithelial inflammatory responses and clinical parameters in COPD. Eur Respir J 2003; 22: 94-99.
Bhownik A, Seemungal TAR, Sapsford RJ, et al. Relation of sputum inflammatory markers to symptoms and physiological changes at COPD exacerbations. Thorax 2000; 55: 114-200.
Schmidt-Ioanas M, Pletz MW, de Roux A, et al. Apoptosis of peripheral blood neutrophils in COPD exacerbation dose not correlate with serum cytokines. Respir Med 2006; 100: 639-47.
Kochetkova EA, Volkova MV, Surovenko TN, et al. Cytokine status in patients with chronic obstructive pulmonary disease and its relationship with bone tissue functional state. Ter Arkh 2004; 76: 23-27.
Hurst JR, Perera WR, Wilkinson TM, et al. Systemic and upper and lower airway inflammation at exacerbation of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006; 173: 71-78.

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