ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 14 of 45
УЖМБС 2021, 6(6): 112–122
Clinical Medicine

Quality of Life and Respiratory Disorders in Patients with Chronic Obstructive Pulmonary Diseases and Essential Hypertension: Look through the Prism of Apoptosis and Thiol-Disulfide Balance

Kraidashenko O. V., Tiagla O. S.

The purpose of the study was an assessment of the quality of life and respiratory disappearances in patients with chronic obstructive pulmonary disease and essential hypertension in the context of the study of apoptosis markers and a thiol-disulfide balance. Materials and methods. The results of the study are based on the data of a comprehensive examination and dynamic observation of 121 patients of both sexes aged 30 to 67 years, who were examined in the period 2016-2018 and received inpatient treatment at the municipal non-profit enterprise "Zaporizhzhya Regional Clinical Hospital" of Zaporizhzhya regional council. The patients were divided into 3 groups, comparable in age and sex: the main group included 40 patients with chronic obstructive pulmonary disease stage II-III (moderate) in combination with essential hypertension stage II of different cardiovascular risk (mean age 50.81±0.99 years); the 1st comparison group included 48 patients with chronic obstructive pulmonary disease stage II-III (mean age 50.7±1.53 years); the second comparison group consisted of 33 patients with essential hypertension stage II with different cardiovascular risk (mean age 51.68±1.22 years). To determine the reference values of the studied indicators, 20 healthy individuals were examined as a control group. Results and discussion. In patients with chronic obstructive pulmonary disease, in combination with essential hypertension, a reliable element of the pro-apoptotic marker of Caspase-7 was established compared with the group of patients with an isolated essential hypertension and a group of patients with chronic obstructive pulmonary disease (by 3.73 and 2.16 times, respectively; p <0.05). The highest level of Caspase-9 was noted in the group of patients with the comorbidity of the chronic obstructive pulmonary disease and essential hypertension, and exceeded the same indicator in patients with essential hypertension by 60% and chronic obstructive pulmonary disease by 85.83% (p <0.05). The comorbidity of the flow of chronic obstructive pulmonary disease and essential hypertension is accompanied by a violation of thiol-disulfide balance and the antioxidant properties of the body. This is confirmed by the lower activity of antioxidant glutathion-dependent enzymes (glutathione transferase, glutathione reductase and glutathione peroxidase) compared with patients with monopathology (2.57±0.32, 0.87±0.13 and 4.25±0.63 μmol/(min*g protein), respectively; p <0.05), with a decrease in the ratio of reduced/oxidized glutathione forms (3.81±0.34 conventional units; p <0.05). At the same time, in patients with chronic obstructive pulmonary disease and essential hypertension, a decrease in the potential of a thiol-disulfide system was noted by 2 times when compared with essential hypertension patients and 1.7 times – when compared with the chronic obstructive pulmonary disease group (p <0.05). Conclusion. According to the results of single-factor dispersion analysis, the key characteristic of the quality of life (on the St. George’s Respiratory Questionnaire scale) the following factors are most significantly influenced: the index of patch-years (F = 21.80; p <0.01), the duration of the chronic obstructive pulmonary disease (f = 19.35; p <0.01), forced expiratory volume 1 (F = 21.80; p <0.01), elderly age (F = 9.49; p <0.01), as well as activation of apoptotic mechanisms (F = 11.90; p <0.01), the intensification of free-radical reactions (F = 8.60; p <0.01), a violation of a thiol-disulfide balance (F = 10.69; p <0.01), the expression level of the ST2 protein (F = 14.42; p <0.01)

Keywords: chronic obstructive pulmonary disease, essential hypertension, apoptosis, thiol-disulfide balance, quality of life

Full text: PDF (Ukr) 316K

  1. Vogelmeier CF, Román-Rodríguez M, Singh D, Han MK, Rodríguez-Roisin R, Ferguson GT. Goals of COPD treatment: Focus on symptoms and exacerbations. Respir Med. 2020 May;166:105938.
  2. Poh TY, Mac Aogáin M, Chan AK, Yii AC, Yong VF, Tiew PY, et al. Understanding COPD-overlap syndromes. Expert Rev Respir Med. 2017 Apr;11(4):285-298.
  3. Soriano JB, Polverino F, Cosio BG. What is early COPD and why is it important? Eur Respir J. 2018 Dec 6;52(6):1801448.
  4. Zhu B, Wang Y, Ming J, Chen W, Zhang L. Disease burden of COPD in China: a systematic review. Int J Chron Obstruct Pulmon Dis. 2018 Apr 27;13:1353-1364.
  5. Wouters EFM, Wouters BBREF, Augustin IML, Houben-Wilke S, Vanfleteren LEGW, Franssen FME. Personalised pulmonary rehabilitation in COPD. Eur Respir Rev. 2018 Mar 28;27(147):170125.
  6. Guerreiro I, Soccal PM. Les phénotypes de la BPCO [COPD and phenotypes]. Rev Med Suisse. 2019 Nov 13;15(671):2082-2086. [French].
  7. Lareau SC, Fahy B, Meek P, Wang A. Chronic Obstructive Pulmonary Disease (COPD). Am J Respir Crit Care Med. 2019 Jan 1;199(1):P1-P2.
  8. Mouronte-Roibás C, Leiro-Fernández V, Fernández-Villar A, Botana-Rial M, Ramos-Hernández C, Ruano-Ravina A. COPD, emphysema and the onset of lung cancer. A systematic review. Cancer Lett. 2016 Nov 28;382(2):240-244.
  9. O'Donnell DE, Milne KM, James MD, de Torres JP, Neder JA. Dyspnea in COPD: New Mechanistic Insights and Management Implications. Adv Ther. 2020 Jan;37(1):41-60.
  10. Rogliani P, Ora J, Puxeddu E, Cazzola M. Airflow obstruction: is it asthma or is it COPD? Int J Chron Obstruct Pulmon Dis. 2016 Nov 30;11:3007-3013.
  11. Raskin J, Marks T, Miller A. Phenotypes and Characterization of COPD: a pulmonary rehabilitation perspective. J Cardiopulm Rehabil Prev. 2018 Jan;38(1):43-48.
  12. Rabe KF, Hurst JR, Suissa S. Cardiovascular disease and COPD: dangerous liaisons? Eur Respir Rev. 2018 Oct 3;27(149):180057.
  13. Cassady SJ, Reed RM. Pulmonary Hypertension in COPD: A Case Study and Review of the Literature. Medicina (Kaunas). 2019 Aug 2;55(8):432.
  14. Morgan AD, Zakeri R, Quint JK. Defining the relationship between COPD and CVD: what are the implications for clinical practice? Ther Adv Respir Dis. 2018 Jan-Dec;12:1753465817750524.
  15. Terry PD, Dhand R. Inhalation Therapy for Stable COPD: 20 Years of GOLD Reports. Adv Ther. 2020 May;37(5):1812-1828. Erratum in: Adv Ther. 2021 Sep;38(9):4986-4988.
  16. Barnes PJ. COPD 2020: new directions needed. Am J Physiol Lung Cell Mol Physiol. 2020 Nov 1;319(5):L884-L886.