Urinary 8-Hydroxydeoxyguanosine Is a Potential Indicator for Estimating Pulmonary Rehabilitation-Induced Oxidative Stress in COPD Patients

Abstract

Chronic obstructive pulmonary disease (COPD) is the most common chronic lung disease and is an important cause of morbidity worldwide. The aim of this study was to evaluate whether pulmonary rehabilitation (PR) improves the oxidant/antioxidant imbalance, exercise capacity and health-related quality of life (HRQL) in patients with different stages of COPD. Eighteen stable COPD patients participated in 8-week PR; the exercise intensity was set at 70% of the V 4 O 2 peak. Subjects were divided into 2 groups: moderate to severe (stages II/III: n = 12) and very severe COPD with FEV 1 < 30% predicted (stage IV: n = 6). In patients at stages II/III, PR improved exercise capacity (6-minute walking test: 431.2 ± 26.6 vs. 489.1 ± 26.5 m, P < 0.01 and shuttle walking test: 329.2 ± 41.4 vs. 378.2 ± 41.5 m, P < 0.01) and HRQL, whereas no significant change was observed in erythrocyte lipid peroxidation and urinary 8-hydroxydeoxyguanosine, a marker for DNA damage. In contrast, PR for stage IV patients did not improve exercise capacity and HRQL, but significantly increased urinary 8-hydroxydeoxyguanosine (14.5 ± 1.7 vs. 24.3 ± 2.6 ng/mg Cr, P < 0.05). In both groups, erythrocyte antioxidants (superoxide dismutase, glutathione peroxidase, and catalase) did not change significantly after PR. Thus, urinary 8-hydroxydeoxyguanosine is a useful indicator for the PR-induced oxidative stress in COPD patients. In conclusion, appropriate exercise program in COPD patients can improve exercise capacity and HRQL without further increase of oxidative stress. However, PR for very severe COPD patients enhanced exercise-induced oxidative stress.

Non-Invasive Measurement of Exercise-Induced Oxidative Stress in Response to Physical Activity. A Systematic Review and Meta-Analysis

“…A total of 4479 studies were initially identified, 3242 full-text articles screened, 43 peer-reviewed studies included in the Systematic Review [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ] and 11 articles included in the meta-analysis on DNA oxidation products [ 27 , 28 , 36 , 37 , 52 , 53 , …”

“…Refs. [ 27 , 28 , 32 , 35 , 36 , 39 , 41 , 42 , 43 , 44 , 46 , 47 , 48 , 49 , 51 , 53 , 54 , 55 , 57 , 59 , 60 , 61 , 63 , 66 , 67 ] reported significant oxidative stress changes due to physical activity. Oxidative stress biomarkers were generally increased after vigorous physical activity.…”

“…Refs. [ 32 , 39 , 42 , 43 , 46 , 47 , 48 , 49 , 54 , 55 , 57 , 59 , 60 , 67 ] reported increased oxidative stress biomarkers, including isoprostanes, DNA oxidation products, hydrogen peroxide, malondialdehyde and allantoin. [ 32 ] observed that urinary isoprostane increased after a 157.8-km-race in 8 professional-trained cyclists from Spain aged 25.7 ± 3.3 years.…”

Skeletal muscle dysfunction and oxidative stress in patients with chronic obstructive lung disease

“…However, to date, investigators have found that COPD patients exhibit only a minor increase or even a decrease in muscle antioxidant potential following exercise training 79,80) , although there is a lack of data about the relationship between exercise training and muscular antioxidant capacity in COPD patients. Even though endurance exercise training is performed as part of pulmonary rehabilitation, it could cause oxidative stress in patients with severe COPD 81,82) . For example, Barreiro et al 81) found increased nitrotyrosine (a marker for nitrosative stress) in quadriceps muscle of COPD patients after a 3-week endurance exercise program.…”

“…For example, Barreiro et al 81) found increased nitrotyrosine (a marker for nitrosative stress) in quadriceps muscle of COPD patients after a 3-week endurance exercise program. Nemoto et al 82) reported an increase in urinary 8-hydroxydeoxyguanosine (a marker for oxidized DNA) in COPD patients with very severe airflow obstruction, but not in moderate-to-severe COPD patients following an 8-week pulmonary rehabilitation program. It should be noted that even standard exercise programs could cause oxidative stress in COPD patients, particularly muscle-wasted or severely affected COPD patients.…”