Wiener klinische Wochenschrift

, Volume 119, Issue 13–14, pp 428–434 | Cite as

Oxidative stress in patients with COPD and pulmonary hypertension

  • Pavol Joppa
  • Darina Petrášová
  • Branislav Stančák
  • Zuzana Dorková
  • Ružena Tkáčová
Original Article


OBJECTIVE: Oxidative stress plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Oxidant/antioxidant imbalance has also been reported in various forms of pulmonary hypertension. The present study aimed to assess systemic oxidative stress, as reflected by serum malondialdehyde (MDA) concentrations and activities of antioxidant enzymes in erythrocytes [glutathione peroxidase (GPX), superoxide dismutase (SOD) and catalase (CAT)] in patients with and without pulmonary hypertension secondary to COPD. PATIENTS AND METHODS: Seventy-five patients (58 male) with COPD (mean age 65.1 ± 1.2 years; mean smoking history 35.6 ± 3.8 pack-years) were studied. Twenty-one healthy non-smokers served as a control group. Pulmonary function was evaluated with body plethysmography; mean and systolic pulmonary artery pressures (Ppa) were assessed with Doppler echocardiography. Serum concentrations of MDA and activities of GPX, SOD and CAT in washed red blood cells were measured using spectrophotometry. RESULTS: Pulmonary hypertension was present in 28 patients with COPD (systolic Ppa: 46.4 ± 2.3 mmHg; mean Ppa: 26.0 ± 1.9 mmHg) and absent in 47 (systolic Ppa: 22.9 ± 0.8 mmHg; mean Ppa: 13.4 ± 0.6 mmHg). Compared with the healthy control group, all the patients (with or without pulmonary hypertension) had higher serum MDA concentrations (1.5 ± 0.1 versus 2.3 ± 0.1 versus 2.3 ± 0.1 nmol/mL, ANOVA, P < 0.001) and lower erythrocyte GPX activity (51.3 ± 3.2 versus 42.2 ± 2.0 versus 41.3 ± 2.5 U/g Hb, P = 0.029), whereas SOD (1121.1 ± 29.0 versus 1032.6 ± 21.8 versus 1032.7 ± 36.2 U/g Hb, P = 0.063) and CAT activities (4.9 ± 0.2 versus 4.6 ± 0.1 versus 4.7 ± 0.2 U/g Hb; P= 0.454) were similar. No differences were observed in serum MDA concentrations or activities of GPX, SOD and CAT in erythrocytes between COPD patients with and without pulmonary hypertension. CONCLUSION: The study demonstrates the presence of oxidative/antioxidative imbalance in the systemic circulation in patients with COPD: compared with healthy subjects, COPD patients had higher serum MDA concentrations and lower GPX activity in erythrocytes. The magnitudes of the increase in MDA and reduction in GPX activity were similar in COPD patients with pulmonary hypertension and in those with normal pulmonary artery pressures.


COPD Pulmonary hypertension Oxidative stress Lipid peroxidation Antioxidants 

Oxidativer Stress bei Patienten mit COPD und pulmonaler Hypertonie


ZIEL: Der oxidative Stress spielt eine wichtige Rolle bei der Entstehung der chronisch obstruktiven Lungenerkrankung (COPD). Ein Ungleichgewicht zwischen Oxidantien und Antioxidantien wurde auch bei verschiedenen Formen der pulmonalen Hypertonie beschrieben. Ziel der vorliegenden Studie war, den oxidativen Stress, wie er durch die Konzentrationen des Malondialdehyds (MDA) und die Aktivitäten der antioxydativen Enzyme Gluthathion Peroxidase (GPX), Superoxid Dismutase (SOD) und Katalase (CAT) reflektiert wird, bei Patienten mit und ohne COPD-bedingter pulmonaler Hypertonie zu erfassen. PATIENTEN UND METHODEN: 75 Patienten (58 Männer) mit einer COPD (mittleres Alter 65,1 ± 1,2 Jahre, Raucher-Anamnese: 35,6 ± 3,8 Pack Years) wurden untersucht. 21 gesunde Nichtraucher stellten die Kontrollgruppe dar. Die Lungenfunktion wurde durch Body Plethysmographie, der mittlere und der systolische Druck in der Pulmonalarterie (Ppa) durch Doppler-Echokardiographie erhoben. Die Serumkonzentrationen der MDA und die Aktivitäten der GPX, SOD und CAT wurden mittels Spektrophotometrie gemessen. ERGEBNISSE: Eine pulmonale Hypertonie lag bei 28 Patienten vor (systolische Ppa: 46,4 ± 2,3 mmHg; mittlere Ppa: 26,0 ± 1,9 mmHg) während 47 Patienten mit COPD einen normalen Druck in der Pulmonalarterie aufwiesen (systolische Ppa: 22,9 ± 0,8 mmHg; mittlere Ppa: 13,4 ± 0,6 mmHg). Im Vergleich zur gesunden Kontrollgruppe hatten sowohl die Patienten ohne als auch die mit pulmonaler Hypertonie höhere MDA Konzentrationen (1,5 ± 0,1 versus 2,3 ± 0,1 versus 2,3 ± 0,1 nmol/mL, ANOVA, p < 0,001) und niedrigere Erythrozyten GPX-Aktivitäten (51,3 ± 3,2 versus 42,2 ± 2,0 versus 41,3 ± 2,5 U/g Hb, p = 0,029). Die Aktivitäten der SOD und CAT waren in allen untersuchten Gruppen ähnlich (SOD: 1121,1 ± 29,0 versus 1032,6 ± 21,8 versus 1032,7 ± 36,2 U/g Hb, p = 0,063; CAT: 4,9 ± 0,2 versus 4,6 ± 0,1 versus 4,7 ± 0,2 U/g Hb; p = 0,454). Der statistische Vergleich der Serumkonzentrationen der MDA bzw. der Aktivitäten aller Enzyme bei den Patienten mit pulmonaler Hypertonie mit den bei den Patienten mit normalem Pulmonalarteriendruck erhobenen Werten ergab keine Signifikanz. SCHLUSSFOLGERUNG: Die vorliegende Studie zeigt das Vorliegen eines oxidativ/antioxidativen Ungleichgewichtes im systemischen Kreislauf von Patienten mit COPD: Im Vergleich zu Gesunden hatten die COPD Patienten höhere MDA Serumkonzentrationen und niedrigere GPX Erythrozyten-Aktivität. Die vergleichsweise Erhöhung der MDA-Konzentrationen, bzw. Erniedrigung der GPX-Aktivität war unabhängig vom Vorliegen einer pulmonalen Hypertonie.


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Pavol Joppa
    • 1
  • Darina Petrášová
    • 2
  • Branislav Stančák
    • 3
  • Zuzana Dorková
    • 1
  • Ružena Tkáčová
    • 1
  1. 1.Department of Respiratory Medicine and Tuberculosis, Faculty of MedicineP.J. Šafárik University and L. Pasteur Teaching HospitalKošiceSlovakia
  2. 2.Institute of Experimental Medicine, Faculty of MedicineP.J. Šafárik UniversityKošiceSlovakia
  3. 3.East-Slovakian Institute for Cardiovascular DiseasesKošiceSlovakia

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