Studying the initial role of oxidative stress in the pathogenesis of chronic obstructive pulmonary disease on the background of arterial hypertension gives prospects for adequate pharmacological correction of this comorbid pathology taking into account all pathogenetic aspects. This is due to oxidative stress which is the causative factor in the delicate balance of the thiol-disulfide system, and also triggers the launch of the caspase mechanism of neutrophil apoptosis with progression and mutual burdening of nosologies. The aim of the study was to evaluate the metabolism of a biologically active tripeptide (consisting of γ-glutamic acid residues, cysteine and glycinute) and thiol-disulfide balance in patients with chronic obstructive pulmonary disease and arterial hypertension. Material and methods. During the study we examined 59 patients. They were divided into 3 subgroups: 23 patients were diagnosed with stage II hypertension disease and stage II chronic obstructive pulmonary disease without a clinically significant concomitant pathology, average age 51.72±1.22 (49.33-54.09) years, gender composition: 22 men and 1 woman, smoking status can be compared with patients with chronic obstructive pulmonary disease. The 2nd group comprised 18 patients with hypertension disease of both sexes aged from 33 to 67 years (average age 50.74±1.49 (47.81-53.76), the ratio of men/ women 17/83%), stage II hypertension disease I-III degree, and different cardiovascular risk, without adequate systematic antihypertensive therapy. The 3rd group included 18 patients with chronic obstructive pulmonary disease stage II, the average age was 50.32±0.99 (48.22-52.16) years (gender: 14 men and 4 women), the disease duration was 7.52±1.14. At the same time, 80% were active smokers, the pack-year index was 17.23±2.69, and 23.53% indicated a harmful professional factor (production). The state of the thiol-disulfide system was studied on the content of oxidized and reduced glutathione, SH-groups and the activity of enzymes - glutathione-S-transferase, glutathione reductase and glutathione peroxidase in serum. Results and discussion. Enzymatic activity of glutathione-S-transferase, glutathione reductase and glutathione peroxidase in the group of patients with hypertension was maximum, while it was significantly higher than the corresponding indicators of groups of patients with chronic obstructive pulmonary disease and especially with comorbidity. The ratio of reduced/ oxidized forms of glutathione demonstrates the greatest potential of the thiol-disulfide system in hypertension – 7.97±0.15 u. and low values for comorbidity – 3.81±0.34 u., and the percentage difference between the three groups was statistically significant in each case according to this ratio: arterial hypertension vs. chronic obstructive pulmonary disease – 23.57% (P<0.05), arterial hypertension vs arterial hypertension + chronic obstructive pulmonary disease – 109.19% (P<0.05), chronic obstructive pulmonary disease vs. arterial hypertension + chronic obstructive pulmonary disease – 69.29% (P<0.05). Conclusion. We found that comorbid pathology of chronic obstructive pulmonary disease and arterial hypertension leads to significant changes in the glutathione chain of the thiol-disulfide system due to a decrease in its reduced intermediates (the level of glutathione and reduced thiol groups decreases significantly), an increase in the level of oxidized glutathione and the total amount of oxidized thiols against a background of decreasing enzyme activity glutathione-S-transferase, glutathione reductase and glutathione peroxidase, more significantly than the presence of a single disease in the form of chronic obstructive pulmonary disease or hypertension.
Keywords: thiol-disulfide system, chronic obstructive pulmonary disease, arterial hypertension, glutathione, antioxidant system
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