Necip İLHAN, İlhami ÇELİK, Elif ALTUNTAŞ, Tevfik TURGUT, M. Hamdi MUZ, Figen DEVECİ

KOAH'lı hastalarda oksidan-antioksidan düzeyleri

Oksidan-antioksidanlar arası dengesizliğin kronik obstrüktif akciğer hastalığı (KOAH)'nın patogenezinden sorumlu olduğu, bu dengesizlikte sigara içiminin de rol oynadığı belirtilmektedir. Bu çalışmada, sigara içenlerde ve KOAH patogenezinde oksidan-antioksidan dengesizliği ve akciğer fonksiyonları ile arasındaki ilişkinin araştırılması amaçlandı. Çalışma Fırat Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Anabilim Dalı'nda prospektif olarak yapıldı. Yirmi KOAH'h, 20 sigara içen ve 20 sigara içmeyen sağlıklı, toplam 60 erkek olguda plazma malonildialdehid (MDA), eritrosit redükte glutatyon (GSH) ve katalaz de-ğerlerine bakıldı. Olgulara solunum fonksiyon testi yapılarak FEV1, FVC, FEV1/FVC değerleri ölçüldü. KOAH'lı, sigara içen ve sigara içmeyen sağlıklı olgularda plazma MDA değerleri sırasıyla 1.44 ± 0.23 nmol/ml, 1.51 ± 0.27 nmol/mL ve 1.29 ± 0.13 nmol/mL, eritrosit GSH değerleri sırasıyla 0.33 ± 0.13$mu$mol/g.Hb, 0.34 ±0.17 $mu$mol/g.Hb ve 0.44 ± 0.14 $mu$mol/g.Hb, katalaz değerleri ise sırasıyla 22.82 ± 17.47 k/g.Hb, 32.88 ± 22.36 k/g.Hb ve 55.73 ± 26.56 k/g.Hb idi. Her üç parametrede de sigara içen olgularla KOAH'lı olgular arasında fark saptanmazken, KOAH'h olgularla sigara içmeyenler arasında (MDA için p= 0.001, GSH için p= 0.028 ve katalaz için p< 0.001) ve sigara içenlerle içmeyen olgular arasında (MDA için p= 0.035, GSH için p= 0.016 ve katalaz için p= 0.005) istatistiksel fark olduğu gözlendi. Üç grupta da FEV1 (% beklenen) ve FEV1/FVC (% beklenen) ile eritrosit katalaz, GSH ve plazma MDA değerleri arasında anlamlı korelasyon bulunamadı. KOAH'h olgularda ve sigara içen kişilerde sistemik olarak oksidan-antioksidan dengesizliği olduğu, ancak antioksidan kapasitedeki azalma ve/veya oksidan kapasitedeki artmanın, hem KOAH'lı hem de sigara içen bireylerde hava yolu obstrüksiyonunun spirometrik ölçümleriyle korele olmadığı gözlendi ve sigara kullanımının plazma lipid peroksidasyonu ve eritrosit antioksidan aktivitede dengesizliğe yol açarak oksidatif stresi arttırdığı sonucuna varıldı.

The levels of oxidant and antioxidant in patients with COPD

It is determinate that oxidant-antioxidant imbalance is responsible for pathogenesis of chronic obstructive pulmonary dise-ase (COPD) and smoking is playing a part in the pathogenesis. It was aimed to investigate the oxidant-antioxidant imbalance in smokers and pathogenesis of COPD and their relations with lung functions. This study was done prospectiuely in FÎrat University Medical Faculty, Department of Chest Diseases. The leuels of plasma malonyldialdehyde (MDA), erythrocy-te reducted glutathione (GSH) and erythrocyte catalase were studied in 20 patients with COPD, in 20 smokers and in 20 nonsmokers. All of the cases were male. Pulmonary function tests were done to all cases and the predicted values of FEV1, FVC, and FEV1/FVC were measured. The levels of plasma MDA: 1.44 ± 0.23 nmol/mL, 1.51 ± 0.27 nmol/mL and 1.29 ± 0.13 nmol/mL, the levels of erythrocyte CSH: 0.33 ± 0.13 $$mol/g.Hb, 0.34 ±0.17 $mu$mol/g.Hb and 0.44 ± 0.14 $mu$mol/g.Hb and the levels of catalase were 22.82 ± 17.47 k/g.Hb, 32.88 ± 22.36 k/g.Hb and 55.73 ± 26.56 k/g.Hb in patients with COPD, smokers and healthy nonsmokers respectiuely. There was no significance in each three parameters between smokers and patients with COPD. A significant difference was observed in each three parameters between nonsmokers and patients with COPD (MDA: p= 0.001, GSH: p= 0.028 and catalase: p< 0.001) and between smokers and nonsmokers (MDA: p= 0.035, GSH: p= 0.016 and catalase: p= 0.005). In all three groups, no significant correlation was found between FEV] (predicted %), FEV]/FVC (predicted %) and the ualu.es of erythrocyte catalase, GSH and plasma MDA. In this study, there was an oxidant-antioxidant imbalance systemically in smokers and in patients with COPD. Howeuer, decreasing in the antioxidant capacity and/or increasing in the oxidant capacity either not correlate with spirometric measurements of airway obstruction in smokers or in patients with COPD were observed. We concluded that the use of cigarette increased oxidatiue stress by causing plasma lipid peroxidation and imbalance in erythrocyte antioxidant capacity.

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