Association between tumor necrosis factor-α and chronic obstructive pulmonary disease: a systematic review and meta-analysis

医学 慢性阻塞性肺病 荟萃分析 内科学 肿瘤坏死因子α 置信区间 肺病 子群分析 严格标准化平均差 肿瘤坏死因子α 到期 疾病 胃肠病学 呼吸系统
作者
Yang Yao,Jing Zhou,Xin Diao,Shengyu Wang
出处
期刊:Therapeutic Advances in Respiratory Disease [SAGE Publishing]
卷期号:13 被引量:57
标识
DOI:10.1177/1753466619866096
摘要

Background: Patients diagnosed with chronic obstructive pulmonary disease (COPD) have increased risks for a series of physical and mental illnesses. Tumor necrosis factor-α (TNF-α) has been reported to participate in the development of COPD and its complications. However, the values of blood TNF-α level used in the diagnosis of COPD remains controversial. In view of this, we performed a systematic review and meta-analysis to evaluate the correlation between TNF-α level and COPD. Methods: We searched PubMed, Web of Science, Embase and CNKI up to May 2018. The selection criteria were set according to the PICOS framework. A random-effects model was then applied to evaluate the overall effect sizes by calculating standard mean difference (SMD) and its 95% confidence intervals (CIs). Results: A total of 40 articles containing 4189 COPD patients and 1676 healthy controls were included in this meta-analysis. The results indicated a significant increase in TNF-α level in the COPD group compared with the control group (SMD: 1.24, 95% CI: 0.78–1.71, p < 0.00001). According to the subgroup analyses, we noted that TNF-α level was associated with predicted first second of forced expiration (FEV 1 ) (%) and study region. However, no association between TNF-α level and COPD was found when the participants were nonsmokers, and the mean age was less than 60 years. Conclusions: Our results indicated that TNF-α level was increased in COPD patients when compared with healthy controls. Illness progression and a diagnosis of COPD might contribute to higher TNF-α levels. However, the underlying mechanism still remains unknown and needs further investigation. The reviews of this paper are available via the supplemental material section.
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