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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
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)
E-mail: drrajendrak1@rediffmail.com
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.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
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.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
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
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
IL-6 And IL-8 Levels İn Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease
Correspondence Address :
Dr. Handan Akbulut, Department ofImmunology,Firat Medical Center,23119,Elazig,(Turkey),Ph:+90.424.2333555,ext:2168,
Fax:+90.424.2388096,E-mail:handanakbulut@yahoo.com MailingAddress:Firat University,FiratTip Merkezi,Immünoloji 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
Introduction
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.
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.
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