Study on the function of peripheral blood neutrophil extracellular traps in structural pulmonary disease complicated with chronic pulmonary aspergillosis

HUANG Bing-jing; LAI Guo-xiang; ZHANG Lei; YE Jia; CHU Jia-hui; ZHOU Xiao; YU Zong-yang; CHEN Yu-yan; Liu Wei

doi:10.19538/j.nk2023120111

Abstract：Objective To investigate the difference in the function of peripheral blood neutrophil extracellular traps(NETs)between structural pulmonary disease patients with chronic pulmonary aspergillosis(CPA)and those without CPA.Methods This was a prospective controlled study.The clinical data of 90 patients with structural pulmonary disease were collected from Department of Respiratory Medicine of the 900th Hospital of the Joint Logistic Support Force from September 2019 to January 2020.A case group(28 cases)and a control group(62 cases)were established according to whether there was chronic pulmonary aspergillosis.All patients underwent chest CT examination within 24 hours after admission,venous blood was collected for routine blood test,C-reactive protein(CRP)and procalcitonin(PCT)detection,and serum was collected for subsequent detection of aspergillus fumigatus specific IgG,serum galactomannan antigen(GM)and NETs related indicators,such as CitH3,NE,MPO,PTX-3 and LL-37.The 2x2 contingency table and point two series correlation analysis methods were used to analyze the relationships.The receiver operating characteristic curve(ROC)of the subjects was drawn and the sensitivity and specificity of each indicator in predicting the combination of CPA in structural lung disease patients were calculated.Results There was no significant difference in age,gender,neutrophil count,neutrophilic granulocyte percentage and PCT levels between the two groups(P＞0.05).The proportion of CRP≥7.2 mg/L in case group was higher than that in control group,and the difference was statistically significant(P＜0.05),and CRP was related to complication with CPA(r=0.247,P=0.016).The levels of CitH3,NE,anti-MPO,PTX-3 and LL-37 in the case group were significantly increased(P＜0.001),and showed positive correlation with complication with CPA[CitH3(r=0.600,P＜0.001),NE(r=0.687,P＜0.001),anti-MPO(r=0.880,P＜0.001),PTX-3(r=0.563,P＜0.001)and LL-37(r=0.838,P＜0.001)].When the levels of anti-MPO,NE,and LL-37 were 228.7 U/L,360.6 U/L,and 38.85 μg/L,respectively,the sensitivity of predicting structural pulmonary disease complicated with chronic pulmonary aspergillosis was 99.9％,89.3％and 99.9％and the specificity was 98.4％,82.3％and 98.4％.Conclusion The increase in NETs release is correlated with structural pulmonary disease combined CPA.The levels of anti-MPO,NE,and LL-37 can be used as predictors of structural pulmonary disease complicated with CPA.