scholarly journals Oxidative Stress Markers in COPD Patients Admitted to Pulmonary Rehabilitation

2021 ◽  
Vol 15 (1) ◽  
pp. 68-75
Author(s):  
Carolina Romero-Dapueto ◽  
Rodrigo L. Castillo

Background: Chronic obstructive pulmonary disease (COPD) is a pathology, which leads to an irreversible and progressive reduction of the airflow, usually caused by smoking, but only present in 25% of smokers. Some mechanisms involved in the onset and progression of the disease are local and systemic factors such as inflammation, exacerbated immune response and the appearance of oxidative stress. For all these reasons, the use of oxidative stress parameters as progression markers or even as a way to monitor the response of any kind of non-pharmacological interventions, like the use of pulmonary rehabilitation (PR), is feasible. Aims: The study aims to determine markers of oxidative stress levels in plasma and erythrocytes in patients with COPD through the application of a PR protocol. Methods: The study included 25 patients diagnosed with COPD according to the GOLD criteria with a medical indication of PR and attendance at the gym in San José Hospital, Santiago, Chile. Blood samples were obtained before the start of the protocol, in the 10th session, and at the end of the protocol (20th session). These samples were stored for oxidative stress determinations: FRAP (ferric reducing ability of plasma), F2-isoprostanes, reduced (GSH)/oxidized (GSSG) ratio and antioxidant enzyme activity in the erythrocyte. In all stages, associations between events and clinical parameters in patients have been observed. The clinical parameters assessed were the six-minute walking test (6MWT), maximal inspiratory and expiratory pressure, the BODE index and Saint George’s respiratory questionnaire, which includes quality of life. Results: The intracellular and extracellular capacity (GSH/GSSG and FRAP) in patients in PR at the 10th session were 53.1 and 34% higher than basal values, respectively. Only the GSH/GSSG ratio was 38.2% lower at the 20th session, related in part with higher plasma and erythrocyte lipid peroxidation at baseline. This could be due to the high concentration of reactive oxygen species in the first sessions, which has been reported in the literature as the acute effect of controlled exercise. Blood lipid peroxidation was 43.34 and 58.34% lower at the 10th and 20th sessions, respectively, demonstrating the improvements in the oxidative parameters with long-term exercise. With respect to oxidative enzyme activity, superoxide dismutase and catalase showed higher values of activity at the 10th and 20th sessions compared to the baseline. In the clinical parameters of the PR, significant changes were found in the BODE index and Saint George’s questionnaire, with these results being associated with a less predictive mortality score and a better understanding of the disease. This may be because the patients achieved longer distances in the 6MWT and better understood the disease at the end of the PR. Conclusion: The goal of this study was to contribute to the pathophysiological basis for further research on COPD patients, a disease of high prevalence in Chile. This study could support the basis for non-pharmacological strategies such a PR.

Author(s):  
Sara Ilari ◽  
Laura Vitiello ◽  
Patrizia Russo ◽  
Stefania Proietti ◽  
Mirta Milic ◽  
...  

Chronic obstructive pulmonary disease (COPD) is a respiratory disease associated with airways inflammation and lung parenchyma fibrosis. The primary goals of COPD treatment are to re-duce symptoms and risk of exacerbations, therefore pulmonary rehabilitation is considered the key component of managing COPD patients. Oxidative airway damage, inflammation and re-duction of endogenous antioxidant enzymes are known to play a crucial role in the pathogenesis of COPD. Natural antioxidants have also recently been considered as they play an important role in metabolism, DNA repair and fighting the effects of oxidative stress. In this paper we evaluated the response of 105 elderly COPD patients to pulmonary rehabilitation (PR), based on high or low vegetable consumption, by analyzing clinical parameters and biological measure-ments at baseline and after completion of the three weeks PR. We found that high vegetable in-take in normal diet, without any specific intervention, can increase the probability to success-fully respond to rehabilitation (65.4% of responders ate vegetables daily vs. 40.0% of Non-Responders, p=0.033). Three weeks of pulmonary rehabilitation are probably too short to reveal a reduction of the oxidative stress and DNA damage, but are enough to show an im-provement in the patient's inflammatory state.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2787
Author(s):  
Sara Ilari ◽  
Laura Vitiello ◽  
Patrizia Russo ◽  
Stefania Proietti ◽  
Mirta Milić ◽  
...  

Chronic obstructive pulmonary disease (COPD) is a respiratory disease associated with airways inflammation and lung parenchyma fibrosis. The primary goals of COPD treatment are to reduce symptoms and risk of exacerbations, therefore pulmonary rehabilitation is considered the key component of managing COPD patients. Oxidative airway damage, inflammation and reduction of endogenous antioxidant enzymes are known to play a crucial role in the pathogenesis of COPD. Recently, also natural antioxidants have been considered as they play an important role in metabolism, DNA repair and fighting the effects of oxidative stress. In this paper we evaluated the response of 105 elderly COPD patients to pulmonary rehabilitation (PR), based on high or low vegetable consumption, by analyzing clinical parameters and biological measurements at baseline and after completion of the three weeks PR. We found that daily vegetable intake in normal diet, without any specific intervention, can increase the probability to successfully respond to rehabilitation (65.4% of responders ate vegetables daily vs. 40.0% of non-responders, p = 0.033). The association was especially evident in subjects ≥ 80 year of age (OR = 17.0; p < 0.019). Three weeks of pulmonary rehabilitation are probably too short to reveal a reduction of the oxidative stress and DNA damage, but are enough to show an improvement in the patient’s inflammatory state.


Author(s):  
Sara Ilari ◽  
Laura Vitiello ◽  
Patrizia Russo ◽  
Stefania Proietti ◽  
Mirta Milic ◽  
...  

Chronic obstructive pulmonary disease (COPD) is a respiratory disease associated with airways inflammation and lung parenchyma fibrosis. The primary goals of COPD treatment are to re-duce symptoms and risk of exacerbations, therefore pulmonary rehabilitation is considered the key component of managing COPD patients. Oxidative airway damage, inflammation and re-duction of endogenous antioxidant enzymes are known to play a crucial role in the pathogenesis of COPD. Natural antioxidants have also recently been considered as they play an important role in metabolism, DNA repair and fighting the effects of oxidative stress. In this paper we evaluated the response of 105 elderly COPD patients to pulmonary rehabilitation (PR), based on high or low vegetable consumption, by analyzing clinical parameters and biological measure-ments at baseline and after completion of the three weeks PR. We found that high vegetable in-take in normal diet, without any specific intervention, can increase the probability to success-fully respond to rehabilitation (65.4% of responders ate vegetables daily vs. 40.0% of Non-Responders, p=0.033). Three weeks of pulmonary rehabilitation are probably too short to reveal a reduction of the oxidative stress and DNA damage, but are enough to show an im-provement in the patient's inflammatory state.


Author(s):  
Jose L. Gonzalez-Montesinos ◽  
Jorge R. Fernandez-Santos ◽  
Carmen Vaz-Pardal ◽  
Jesus G. Ponce-Gonzalez ◽  
Alberto Marin-Galindo ◽  
...  

Chronic obstructive pulmonary disease (COPD) patients are characterised for presenting dyspnea, which reduces their physical capacity and tolerance to physical exercise. The aim of this study was to analyse the effects of adding a Feel-Breathe (FB) device for inspiratory muscle training (IMT) to an 8-week pulmonary rehabilitation programme. Twenty patients were randomised into three groups: breathing with FB (FBG), oronasal breathing without FB (ONBG) and control group (CG). FBG and ONBG carried out the same training programme with resistance, strength and respiratory exercises for 8 weeks. CG did not perform any pulmonary rehabilitation programme. Regarding intra group differences in the value obtained in the post-training test at the time when the maximum value in the pre-training test was obtained (PostPRE), FBG obtained lower values in oxygen consumption (VO2, mean = −435.6 mL/min, Bayes Factor (BF10) > 100), minute ventilation (VE, −8.5 L/min, BF10 = 25), respiratory rate (RR, −3.3 breaths/min, BF10 = 2), heart rate (HR, −13.7 beats/min, BF10 > 100) and carbon dioxide production (VCO2, −183.0 L/min, BF10 = 50), and a greater value in expiratory time (Tex, 0.22 s, BF10 = 12.5). At the maximum value recorded in the post-training test (PostFINAL), FBG showed higher values in the total time of the test (Tt, 4.3 min, BF10 = 50) and respiratory exchange rate (RER, 0.05, BF10 = 1.3). Regarding inter group differences at PrePOST, FBG obtained a greater negative increment than ONBG in the ventilatory equivalent of CO2 (EqCO2, −3.8 L/min, BF10 = 1.1) and compared to CG in VE (−8.3 L/min, BF10 = 3.6), VCO2 (−215.9 L/min, BF10 = 3.0), EqCO2 (−3.7 L/min, BF10 = 1.1) and HR (−12.9 beats/min, BF10 = 3.4). FBG also showed a greater PrePOST positive increment in Tex (0.21 s, BF10 = 1.4) with respect to CG. At PreFINAL, FBG presented a greater positive increment compared to CG in Tt (4.4 min, BF10 = 3.2) and negative in VE/VCO2 intercept (−4.7, BF10 = 1.1). The use of FB added to a pulmonary rehabilitation programme in COPD patients could improve tolerance in the incremental exercise test and energy efficiency. However, there is only a statically significant difference between FBG and ONBG in EqCO2. Therefore, more studies are necessary to reach a definitive conclusion about including FB in a pulmonary rehabilitation programme.


2021 ◽  
Vol 9 (10) ◽  
pp. 423-428
Author(s):  
Kishore Kumar Sharma ◽  
Mani Ram Kumhar ◽  
Mayank Shrivastav ◽  
Harsh Tak

Background & Objectives: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation and inflammation. Mean platelet volume (MPV) may be used as a marker of inflammation. We aimed to study the association between MPV and COPD patients during acute attack and relationship of MPV with severity of COPD by FEV1 (%predicted), BODE Index, PaO2, mMRC grade and 6MWD test. Methods: 100 patients with COPD (50 with acute exacerbation and 50 with stable COPD) and 30 healthy controls were enrolled in the study. Mean platelet volume (MPV), spirometry, arterial blood gases, body mass index, renal function tests and BODE index (body mass index, airflow obstruction,dyspnoea and exercise) were assessed. Level of MPV was compared between cases and controls. Results: Of 100 COPD patients, 87(87%) were male and 13(13%)were female.MPV was significantly higher in COPD patients than control and also higher in acute exacerbation group than stable COPD (p=0.001). Interpretation & Conclusions: In the present study,MPV remain in normal range in all COPD patients, but MPV values were significantly higher in COPD cases compared with control.Increased MPV was associated with acute exacerbation and also increasing with severity of COPD.


2013 ◽  
Vol 115 (12) ◽  
pp. 1796-1805 ◽  
Author(s):  
Fares Gouzi ◽  
Aldjia Abdellaoui ◽  
Nicolas Molinari ◽  
Edith Pinot ◽  
Bronia Ayoub ◽  
...  

Peripheral muscle dysfunction, associated with reductions in fiber cross-sectional area (CSA) and in type I fibers, is a key outcome in chronic obstructive pulmonary disease (COPD). However, COPD peripheral muscle function and structure show great heterogeneity, overlapping those in sedentary healthy subjects (SHS). While discrepancies in the link between muscle structure and phenotype remain unexplained, we tested whether the fiber CSA and the type I fiber reductions were the attributes of different phenotypes of the disease, using unsupervised clustering method and post hoc validation. Principal component analysis performed on functional and histomorphological parameters in 64 COPD patients {forced expiratory volume in 1 s (FEV1) = 42.0 [30.0–58.5]% predicted} and 27 SHS (FEV1 = 105.0 [95.0–114.0]% predicted) revealed two COPD clusters with distinct peripheral muscle dysfunctions. These two clusters had different type I fiber proportion (26.0 ± 14.0% vs. 39.8 ± 12.6%; P < 0.05), and fiber CSA (3,731 ± 1,233 vs. 5,657 ± 1,098 μm2; P < 0.05). The “atrophic” cluster showed an increase in muscle protein carbonylation (131.5 [83.6–200.3] vs. 83.0 [68.3–105.1]; P < 0.05). Then, COPD patients underwent pulmonary rehabilitation. If the higher risk of exacerbations in the “atrophic” cluster did not reach statistical significance after adjustment for FEV1 (hazard ratio: 2.43; P = 0.11, n = 54), the improvement of VO2sl after training was greater than in the nonatrophic cluster (+24 ± 16% vs. +6 ± 13%; P < 0.01). Last, their age was similar (60.4 ± 8.8 vs. 60.8 ± 9.0 yr; P = 0.87), suggesting a different time course of the disease. We identified and validated two phenotypes of COPD patients showing different muscle histomorphology and level of oxidative stress. Thus our study demonstrates that the muscle heterogeneity is the translation of different phenotypes of the disease.


2019 ◽  
Vol 15 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Jhonatan Betancourt-Peña ◽  
Vicente Benavides-Córdoba ◽  
Juan Carlos Avila-Valencia ◽  
Hamilton Elias Rosero-Carvajal

Background: The modified Medical Research Council scale (mMRC) is a standardized measure of the effect of dyspnea on the activities of the daily life of patients suffering from Chronic Obstructive Pulmonary Disease (COPD). The aim of this study was to determine the differences in the quality of life, tolerance to effort and symptoms among patients with COPD with lower (mMRC 0-1) and greater symptoms (mMRC ≥2). Methods: Cross-sectional study that included patients admitted to a pulmonary rehabilitation program and who were classified into 2 groups: a group containing the less symptomatic patients and another group with the more symptomatic ones. We collected these patients’ sociodemographic, clinical, anthropometric, anxiety, depression and quality of life (SGRQ) data. Likewise, the subjects performed the 6-minute walk test (6MWT). Finally, we measured the multidimensional BODE index score. Results: 130 subjects were included, 35 presenting an mMRC of 0 to1 and 95 having an mMRC ≥ 2, with an age of 70.87 ± 9.45 years old. The 6MWT distance, the VO2e, the total score of SGRQ, and its domains of activities and impact showed significant differences between the groups (p <0.05). Significant correlations were found in the group presenting an mMRC of 0-1 between the mMRC and the FEV1 (p = 0.028), and in the group with an mMRC ≥2 for the FVC (p = 0.031), the 6MWT distance (p = 0.000), the VO2e (p = 0.010) and the BODE index (p = 0.000). Conclusion: Patients with an mMRC of 0 to1 had better results in the 6MWT, the VO2e and the SGRQ in comparison with the most symptomatic ones.


2015 ◽  
Vol 93 (6) ◽  
pp. 574-580 ◽  
Author(s):  
Bożena Bukowska ◽  
Paulina Sicińska ◽  
Aneta Pająk ◽  
Aneta Koceva-Chyla ◽  
Tadeusz Pietras ◽  
...  

The study indicates, for the first time, the changes in both ATPase and AChE activities in the membrane of red blood cells of patients diagnosed with COPD. Chronic obstructive pulmonary disease (COPD) is one of the most common and severe lung disorders. We examined the impact of COPD on redox balance and properties of the membrane of red blood cells. The study involved 30 patients with COPD and 18 healthy subjects. An increase in lipid peroxidation products and a decrease in the content of -SH groups in the membrane of red blood cells in patients with COPD were observed. Moreover, an increase in the activity of glutathione peroxidase and a decrease in superoxide dismutase, but not in catalase activity, were found as well. Significant changes in activities of erythrocyte membrane enzymes in COPD patients were also evident demonstrated by a considerably lowered ATPase activity and elevated AChE activity. Changes in the structure and function of red blood cells observed in COPD patients, together with changes in the activity of the key membrane enzymes (ATPases and AChE), can result from the imbalance of redox status of these cells due to extensive oxidative stress induced by COPD disease.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Md. Ismail ◽  
Md. Faruk Hossain ◽  
Arifur Rahman Tanu ◽  
Hossain Uddin Shekhar

Background and Objective.Oxidative stress is intimately associated with many diseases, including chronic obstructive pulmonary disease (COPD). Study objectives include a comparison of the oxidative stress, antioxidant status, and lipid profile between COPD patients and controls and evaluation of the effect of spirulina intervention on oxidative stress, antioxidant status, and lipid profile of COPD patients.Methods.30 patients with COPD and 20 controls with no respiratory problems were selected. Global Initiative for Chronic Obstructive Lung Disease criteria were served as the basis of COPD diagnosis. The serum content of malondialdehyde (MDA), lipid hydroperoxide, glutathione (GSH), vitamin C, cholesterol, triglyceride (TG), and high density lipoprotein (HDL) was measured. The activity of superoxide dismutase (SOD), catalase (CAT), and glutathione-s-transferase (GST) was also measured. Two different doses, (500 × 2) mg and (500 × 4) mg spirulina, were given to two groups, each of which comprises 15 COPD patients.Results.All targeted blood parameters have significant difference(P=0.000)between COPD patients and controls except triglyceride (TG). Spirulina intake for 30 and 60 days at (500 × 2) mg dose has significantly reduced serum content of MDA, lipid hydroperoxide, and cholesterol(P=0.000)while increasing GSH, Vit C level(P=0.000), and the activity of SOD(P=0.000)and GST(P=0.038). At the same time, spirulina intake for 30 and 60 days at (500 × 4) mg dose has favorable significant effect(P=0.000)on all targeted blood parameters except for HDL(P=0.163).


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