Evaluation of oxidative stress and effectiveness of low-dose glucocorticoid therapy on exacerbation of chronic obstructive pulmonary disease

J Gerontol A Biol Sci Med Sci. 2007 Apr;62(4):459-64. doi: 10.1093/gerona/62.4.459.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) and its exacerbation are considered to be related to oxidative stress. We determined the levels of reactive oxygen metabolites (ROM) and a biological antioxidant potential (BAP) in blood before and after the exacerbation.

Methods: For these determinations, the Free Radical Analytical System 4 was used. Twenty-one male patients were divided into two groups.

Results: Group A patients (n = 11, for whom the disease was end-stage) showed high ROM levels and low BAP levels. Meanwhile, Group B patients (n = 10, for whom the disease was not end-stage but the exacerbation was repeated) exhibited variable ROM levels corresponding to the symptoms. Before the exacerbation, ROM levels increased. After administering high-dose glucocorticoids, the exacerbation disappeared and ROM levels decreased to the baseline. To suppress the relapse, the Group B patients were medicated with low-dose glucocorticoids by inhalation and systemic administration. Then, ROM levels did not increase or the relapse did not occur. BAP levels continued to be low, and were restored after a stable state was obtained.

Conclusion: Overproduction of ROM may precede exacerbation of COPD, and the low-dose glucocorticoid therapy may be effective to suppress its overproduction and to preserve COPD in a stable state.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adult
  • Aged
  • Aged, 80 and over
  • Antioxidants / metabolism
  • Dose-Response Relationship, Drug
  • Forced Expiratory Volume
  • Glucocorticoids / administration & dosage*
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Oxidative Stress*
  • Pulmonary Disease, Chronic Obstructive / blood
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / metabolism
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Reactive Oxygen Species / metabolism
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antioxidants
  • Glucocorticoids
  • Reactive Oxygen Species