Evaluation of oxidative stress and effectiveness of low-dose glucocorticoid therapy on exacerbation of chronic obstructive pulmonary disease.

Background. Chronic obstructive pulmonary disease (COPD) and its exacerbation are considered to be related to oxidative stress. We determined the levels of reactive oxygen metabolites (ROM) and a biological antioxidant potential (BAP) in blood before and after the exacerbation. Methods. For these determinations, the Free Radical Analytical System 4 was used. Twenty-one male patients were divided into two groups. Results. Group A patients (n = 11, for whom the disease was end-stage) showed high ROM levels and low BAP levels. Meanwhile, Group B patients (n = 10, for whom the disease was not end-stage but the exacerbation was repeated) exhibited variable ROM levels corresponding to the symptoms. Before the exacerbation, ROM levels increased. After administering high-dose glucocorticoids, the exacerbation disappeared and ROM levels decreased to the baseline. To suppress the relapse, the Group B patients were medicated with low-dose glucocorticoids by inhalation and systemic administration. Then, ROM levels did not increase or the relapse did not occur. BAP levels continued to be low, and were restored after a stable state was obtained. Conclusion. Overproduction of ROM may precede exacerbation of COPD, and the low-dose glucocorticoid therapy may be effective to suppress its overproduction and to preserve COPD in a stable state.