Thiol/disülfid homeostazının kronik obstrüktif akciğer hastalığı ile ilişkili mortalitedeki etkisi

Year 2021, Volume: 46 Issue: 2, 566 - 573, 30.06.2021

Hacı Mehmet Çalışkan , Bilal İlanbey , Duygu Zorlu , Zamir Ertürk , Burak Çelik , Süleyman Ersoy

https://doi.org/10.17826/cumj.852885

Abstract

Amaç: Bu çalışmada Hiperkapnik solunum yetmezliği (HSY) olan kronik obstrüktif akciğer hastalarındaki mortalite (KOAH) ile thiol/disülfid homeostazisi arasındaki ilişki araştırılmıştır.
Gereç ve Yöntem: Bu kesitsel prospektif çalışma, solunum yetmezliği nedeniyle acil servise başvuran 64 hiperkapnik solunum yetmezliği (HSY) hastası ve 40 sağlıklı kontrol dahil olmak üzere toplam 104 kişiden oluşmaktadır. HRF hastaları ayrıca 1 ay sonra mortalite meydana gelenler (n = 14) ve hayatta kalanlar olarak iki alt gruba ayrıldı. Thiol/Disülfid homeostazı, Erel ve Neselioğlu tarafından geliştirilen yeni ve otomatik bir ölçme yöntemi kullanılarak değerlendirildi.
Bulgular: Total thiol (TT) ve native thiol (NT) seviyeleri, HSY grubunda kontrol grubuna göre anlamlı derecede daha düşüktü, oysa ortalama disülfid (Ds)/ TT ve Ds / NT değerleri önemli ölçüde daha. Disülfid seviyelerinde ise guruplar arasında önemli bir fark yoktu. Ayrıca Hayatta kalan HRF hastalarının Ds, Ds / TT ve Ds / NT değerleri, ölen HRF hastalarınınkinden önemli ölçüde daha düşüktü. Biz bu makalede Disülfid’in KOAH'da mortalitenin bir göstergesi olabileceğini bulduk (duyarlılık:% 85.7, özgüllük:% 70, EAA: 0.793,% 95 CI: 0.673-0.884, p <0.001).
Sonuç: Tihiol/Disülfid parametreleri acil servislerde ve hastanelerde hiperkapnik solunum yetmezliği tanısında ve prognozun öngörülmesi ve iyileştirilmesinde kullanılabilir.

Keywords

Acil servis, hiperkapnik solunum yetmezliği, oksidatif stres, thiol

Supporting Institution

Yok

Project Number

Proje değil

Thanks

Dr Yusuf Dursun'a katkılarından dolayı teşekkür ediyoruz

The effect of thiol/disulfide homeostasis on chronic obstructive pulmonary disease-related mortality

Abstract

Purpose: Our study investigates the correlation between thiol/disulfide homeostasis and mortality among chronic obstructive pulmonary disease (COPD) patients with hypercapnic respiratory failure (HRF).
Materials and Methods: This cross-sectional prospective study comprises a total of 104 subjects, including 64 HRF patients admitted to the Emergency service due to respiratory failure and 40 healthy controls. HRF patients were further divided into two subgroups as those in whom mortality occured after 1 month (n=14), and those who survied (n=50). Thiol/disulfide homeostasis was evaluated using a novel and automated assay developed by Erel and Neselioglu.
Results: The total thiol (TT) and native thiol (NT) levels were significantly lower in the HRF group than the control group, whereas the mean disulfide (Ds)/TT and Ds/NT values were significantly higher. The Ds levels were not significantly different between the groups. On the other hand, Ds, Ds/TT, and Ds/NT values of surviving HRF patients were significantly lower than those of the HRF patients who died. In this article we found that Ds may be an indicator of mortality in COPD (sensitivity: 85.7%, specificity: 70%, AUC: 0.793, 95% CI: 0.673-0.884, p<0.001).
Conclusion: Thiol/disulfide parameters may be used in emergency service and hospitals in the diagnosis of HRF, and for the prediction and improvement of prognosis.

Keywords

Emergency service, hypercapnic respiratory failure, oxidative stress, thiol

Project Number

Proje değil

References

• Referans 1. Global health estimates 2016: Deahts by cause a, sex, by country an by region: 2000 - 2016. Geneva, WHO; 2018.
• Referans 2. Senior RM. Chronic obstructive pulmonary disease: epidemiology, pathophysiology, and pathogenesis. Pulm dis and dis. 1997;659.
• Referans 3. Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet. 2007;370(9589):765-773.
• Referans 4. Markou NK, Myrianthefs PM, Baltopoulos GJ. Respiratory failure: an overview. Crit Care Nurs Q. 2004;27(4):353-379.
• Referans 5. Rodriguez-Roisin R, MacNee W. Pathophysiology of chronic obstructive pulmonary disease. Eur Resp Mon. 2006;38:177.
• Referans 6. Domej W, Oettl K, Renner W. Oxidative stress and free radicals in COPD– implications and relevance for treatment. Int J Chron Obstruct Pulmon Dis. 2014;9:1207.
• Referans 7. Douglas RM, Ryu J, Kanaan A, et al. Neuronal death during combined intermittent hypoxia/hypercapnia is due to mitochondrial dysfunction. Am J Physiol. 2010;298(6):C1594-C1602.
• Referans 8. Kaplan M, Ates I, Yuksel M, et al. Thiol/disulphide homeostasis in celiac disease. World J Gastrointest Pharmacol Ther. 2017 May 6;8(2):120-126.
• Referans 9. Ates I, Ozkayar N, Altay M, et al. Is disulphide/thiol ratio related to blood pressure in masked hypertension? Clin Exp Hypertens. 2016;38(2):150-4.
• Referans 10. Babaoglu E, Kilic H, Hezer H, et al. Comparison of thiol/disulphide homeostasis parameters in patients with COPD, asthma and ACOS. Eur Rev Med Pharmacol Sci. 2016;20(8):1537-1543.
• Referans 11. Levey AS, Berg RL, Gassman JJ, et al. Creatinine filtration, secretion and excretion during progressive renal disease. Modification of Diet in Renal Disease (MDRD) Study Group. Kidney Int Suppl. 1989 Nov;27:S73-80.
• Referans 12. Rodriguez-Roisin R, Rabe KF, Vestbo J, et al. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 20th anniversary: a brief history of time. Eur Respiratory Soc; 2017.
• Referans 13. Rahman I, MacNee W. Oxidant/antioxidant imbalance in smokers and chronic obstructive pulmonary disease. Thorax. 1996;51(4):348.
• Referans 14. Gülbay B, Patogenez AT. İnflamasyon. Güncel Bilgiler Işığında Kronik Obstrüktif Akciğer Hastalığı Ankara: Bil Tıp Yay. 2003:21-33.
• Referans 15. Yuksel M, Ates I, Kaplan M, et al. The dynamic thiol/disulphide homeostasis in inflammatory bowel disease and its relation with disease activity and pathogenesis. Int J Colorectal Dis. 2016 Jun;31(6):1229-31.
• Referans 16. Kundi H, Ates I, Kiziltunc E, et al. A novel oxidative stress marker in acute myocardial infarction; thiol/disulphide homeostasis. Am J Emerg Med. 2015 Nov;33(11):1567-71.
• Referans 17. Ates I, Altay M, Yilmaz FM, et al. Dynamic thiol/disulfide homeostasis in patients with autoimmune subclinical hypothyroidism. Endocr Res. 2016 Nov;41(4):343-349.
• Referans 18. Orhan Z, Köksal N, Gökırmak M, et al. Oxidative stress in acute exacerbations of copd and the effect of therapy on oxidant-antioxidant balance. Resp Dis. 2003;14:5-10.
• Referans 19. Weinberger B, Laskin JD, Sunil VR, et al. Sulfur mustard-induced pulmonary injury: therapeutic approaches to mitigating toxicity. Pulm Pharmacol Ther 2011;24(1):92-99.
• Referans 20. Sengoren Dikis O, Acat M, Casim H, et al. The relationship of thiol/disulfide homeostasis in the etiology of patients with obstructive sleep apnea: a case-control study. The Aging Male. 2019:1-8.
• Referans 21. Eroğlu O, Badem ND, Baccıoğlu A, et al. Significance of thiol/disulphide homeostasis and ischemia modified albumin levels in chronic obstructive pulmonary disease. Eur Res J.5(2):250-257.
• Referans 22. Nar R, Çalış AG. Assessment of dynamic thiol/disulfide homeostasis in patients with asthma. Med Lab. 2018;42(3):99-104.
• Referans 23. Şahin Ü, Ünlü M, Sütçü R, et al. The effect of treatment of exacerbations of chronic obstructive pulmonary disease on oxidant/antioxidant imbalance. Tuber Torax. 2000;48:317-24.
• Referans 24. Akbas A, Kilinc F, Sener S, et al. Investigation of thiol-disulphide balance in patients with acute urticaria and chronic spontaneous urticaria. Cutan Ocul Toxicol. 2017;36(3):205-210.
• Referans 25. Özcan O, Erdal H, Çakırca G, et al. Oxidative stress and its impacts on intracellular lipids, proteins and DNA. J Clin Exp Invest. 2015;6(3):331-6.
• Referans 26. Topuz M, Kaplan M, Akkus O, et al. The prognostic importance of thiol/disulfide homeostasis in patients with acute pulmonary thromboembolism. Am J Emerg Med. 2016;34(12):2315-2319.
• Referans 27. Şener A, Çelik GK, Özhasenekler A, et al. Evaluation of dynamic thiol/disulfide homeostasis in adult patients with community-acquired pneumonia. Hong Kong J Em Med. 2018;26(6):343-350.