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Increased circulating levels of ₁-antitrypsin and calprotectin are associated with reduced gas diffusion in the lungs

¹ Dept of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway, ² Center for Clinical Research, Haukeland University Hospital and Section for Medical Statistics, University of Bergen, Bergen, Norway and ³ Dept of Immunology and Transfusion Medicine, Ullevaal University Hospital, Oslo, Norway

CORRESPONDENCE: I. Welle, Dept of Thoracic Medicine, Haukeland Hospital, University of Bergen, N-5021, Bergen, Norway. Fax: 47 55975149

Keywords: ₁-antitrypsin, calprotectin, epidemiology, gas exchange in the lungs, inflammation, sex

Received: July 26, 2000
Accepted January 18, 2001

This study was supported by the Royal Norwegian Council for Scientific and Industrial Research, the Norwegian Research Council for Science and Humanities, and the Norwegian Asthma and Allergy Association.

The aim was to examine the relationship of serum inflammatory markers to the level of single-breath diffusing capacity of carbon monoxide (T_L,CO).

A stratified sample (n=1,121) of a Norwegian general population aged 18–73 yrs was examined. The inflammatory markers measured were calprotectin, a prominent protein in the cytosol fraction of neutrophil granulocytes, and ₁-antitrypsin (₁-AT), the major inhibitor of neutrophil elastase in the lower respiratory system. Both markers have increased circulating levels in the course of an acute inflammatory reaction.

Subjects with a T_L,CO<80% of predicted value had a higher level of both ₁-AT (p=0.003) and calprotectin (p<0.03) than those with a T_L,CO>100%. In multiple linear regression analyses, ₁-AT was still significantly associated with T_L,CO after adjusting for sex, age, smoking habits, haemoglobin, carboxyhaemoglobin, forced expiratory volume in one second and alveolar volume. In a similar analysis, no significant overall association was found between calprotectin and T_L,CO, but in a stratified analysis, calprotectin was significantly related to T_L,CO in females. However, no significant sex interaction in the relationship between the inflammatory markers and T_L,CO was found.

The findings suggest that increased levels of ₁-antitrypsin and of calprotectin are risk factors for decreased diffusing capacity of carbon monoxide.

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