Nasal cytology analysis in stable COPD patients

Introduction: No clear relationship between Chronic Obstructive Pulmonary Disease (COPD) and nasal inflammation has been demonstrated. Some studies showed controversial results. Aims: To evaluate nasal cytology in stable COPD patients (pts) and to compare these data with exacerbations and severity of disease. Methods: We enrolled 41 pts with stable COPD and 14 pts as control group. Pulmonary function test and nasal cytology were performed; a venous sampling for blood count was collected. COPD pts were divided in exacerbators and non-exacerbators and classified in spirometric stages according to recommendation from Global Intiative for Chronic Obstructive Pulmonary Disease. T-student test and chi-quadro test were used. Results: There was no difference in nasal cytology between COPD pts and the control group. Pathological nasal cytology was observed in 14 COPD pts (34.1%) and nasal patterns were distribuited as follows: 8 neutrophilic, 1 eosinophilic, 3 neutrophilic and eosinophilic and 2 with mast cells. Nasal bacteria were found in 8 pts. Moreover, in COPD group there was no difference in nasal cytology between exacerbators and non-exacerbators and no correlations emerged between spirometric stages and nasal inflammation. We also found higher peripheral neutrophil to lymphocyte ratio in COPD pts with nasal cytological abnormalities compared to pts without nasal inflammation (p= 0.005). Conclusions: In this study, no correlation between nasal cytology and clinical and functional parameters was found in stable COPD pts. Despite these data, our results suggested the presence of a pro-inflammatory state in COPD pts with nasal cytological abnormalities. The relationship between COPD, nasal and systemic inflammation needs further investigations.