Oxidative Stress Biomarkers in Chronic Obstructive Pulmonary Disease Exacerbations: A Systematic Review

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease characterized by a not fully reversible airflow limitation associated with an abnormal inflammatory response. Exacerbations of COPD are of major importance in the acceleration of disease progression, in healthcare costs, and negatively affect the patient’s quality of life. Exacerbations are characterized by a further increase in the airway inflammation likely driven by oxidative stress. In order to deepen the knowledge about this topic, several studies have focused on oxidative stress biomarkers levels. This review summarizes the literature findings about oxidative stress biomarkers in exacerbated COPD patients compared to ones in the stable state. Methods: a systematic search in electronic databases Pubmed, Web of Science, Scopus and Google Scholar from inception to January 2021, was conducted using the terms: “oxidative stress”, “chronic obstructive pulmonary disease” or “COPD”, “exacerbation”. Results: 23 studies were selected for the systematic review. They showed the presence of an imbalance between oxidant and antioxidant molecules in favor of the former in exacerbation of COPD. Conclusions: future studies using standardized methods in better characterized population are needed. However, this review suggests that targeting oxidative stress could be useful in monitoring the disease progression in COPD patients and especially in those more susceptible to exacerbations.

Oxidative Stress Promotes Corticosteroid Insensitivity in Asthma and COPD

“…In asthma and COPD, RONS (e.g., superoxide, hydrogen peroxide, hydroxyl radicals, and nitrogen dioxide) levels are found to be increased in the plasma, sputum, and bronchoalveolar lavage tissue. This is illustrated by the substantial increases in the levels of oxidative stress biomarkers, including malondialdehyde (MDA), thiol oxidation, protein carbonyls, oxidized fatty acids, and exhaled nitric oxide (FeNO) [76,77].…”

Incorporating Biomarkers in COPD Management: The Research Keeps Going

“…No difference was observed in the MDA levels in the EBC of patients with AECOPD and stable COPD H 2 O 2 was highly elevated in both patients with AECOPD and stable COPD Zinellu E. [35] MDA was elevated in the EBC of COPD patients and was even higher in patients with an AECOPD Elevated levels of H 2 O 2 were found in both patients with AECOPD and stable COPD Barnes P.J. [41] 8-isoprostane Increased levels of 8-isoprostane were observed in COPD patients Chamitava L. [46] Koutsokera A.…”

“…No significant elevation of MPO and 8-isoprostane was found in patients with AECOPD Zinellu E. [35] Increased levels of 8-isoprostane were detected in COPD patients compared to non-smokers and smokers without COPD A positive association was observed between 8-isoprostane and pulmonary function parameters Comandini A. [44] MDA, SOD, GSH-Px Elevated levels of MDA, and reduced SOD and GSH-Px were observed in the sputum of patients with AECOPD compared to stable COPD A positive association was detected among these biomarkers in induced sputum Zinellu E. [35] Table 2. Cont.…”

“…Reduced glutathione levels were observed in severe AECOPD compared to stable COPD Zinellu E. [35] Lower levels of glutathione were observed in frequent AECOPD compared to stable COPD. Barnes P.J.…”

“…The existence of an essential equilibrium among the cellular oxidant and antioxidant mechanisms plays a crucial role in the preservation of the physiological function of the respiratory system. This disequilibrium of the oxidant-antioxidant mechanism is attributed to the increased oxidants and decreased antioxidants production which subsequently contributes to COPD severity [ 35 , 46 ]. Thus, oxidative stress has significant adverse effects like DNA and protein damage, and lipid destruction.…”