Evaluation of the total antioxidant status (TAS) and total oxidant status (TOS) levels in stable and acute exacerbation periods of patients with COPD

Chronic Obstructive Pulmonary Disease (COPD); is a common, preventable, and treatable disease characterized by persistent airflow restriction, usually associated with progressive chronic inflammatory response of airways and lungs to harmful gases and particulates. Oxidant-antioxidant imbalance is an important mechanism in the pathogenesis of COPD. There are several mechanisms that can lead to oxidative stress in COPD. Inflammation, infections, hypoxia, smoking, low antioxidant response are the main ones. In this study, we aimed to evaluate and compare the oxidant-antioxidant systems according to healthy persons in COPD patients with stable controls and episodes. The study was carried out between May 2017 and April 2018 in Abant Izzet Baysal University Medical Faculty Department of Pulmonary Diseases. The study was conducted from patients with COPD (21 stable COPD patients and 21 COPD patients with exacerbations) who were referred to the pulmonary disease clinic and were previously diagnosed by a physician based on GOLD 2015 criterias. The healty control group was included the study from patients' healty relatives and healty nurses. Gender, age, body mass index of all participants included in the study were recorded; The cigarette story was questioned. Pulmonary function tests were performed on serum samples with arterial blood gas; white blood cell, hemoglobin, hematocrit, platelet, neutrophil%, MCV, CRP, sedimentation, TAS and TOS levels were studied and recorded. COPD exacerbation and stabilization groups were compared between themselves and healthy control group. Using SPSS 22.0 program, COPD exacerbation and stabilization groups were compared with each other and healthy control group and analyzed by parametric or nonparametric methods according to their distribution characteristics. There was a statistically significant difference between the three groups in FEV1 / FVC, FEV1, FVC, pCO2, pO2,% SpO2, white blood cell count, neutrophil percentage, CRP and ESR values. Hemoglobin, hematocrit, MCV, platelet and pH levels were not statistically different between the three groups. There was no statistically significant difference in TAS levels between the three groups in order to evaluate the oxidant-antioxidant mechanism, but there was a significant difference between TOS and OSI levels. Although COPD exacerbation and stabilization groups were compared among the groups, there was a statistically significant difference between TOS, OSI, FEV1, FVC, pO2,% SpO2, CRP and neutrophil% levels. Positive correlation between WBC and TOS was detected in the analyzes performed and no correlation was found in other parameters. In our study, it was found that statistically significant changes were observed in TAS, TOS and OSI levels in the evaluation of oxidant-antioxidant imbalance in COPD patients. Oxidant stress was found to be significantly increased in all COPD patients, especially in patients with COPD exacerbations. Despite the increase in oxidant stress, no increase in antioxidant levels was observed in patients with stable COPD and COPD exacerbations.