Zaporožskij Medicinskij Žurnal (Aug 2013)
Dynamics of systemic inflammation and oxidative stress biomarkers in patients with combined course of chronic obstructive pulmonary disease and arterial hypertension during treatment with tiotriazoline
Abstract
Introduction. Despite the considerable efforts of researchers to develop effective methods of chronic obstructive pulmonary disease (COPD) and arterial hypertension (AH) treatment, both diseases continue to occupy a prominent place among the causes of morbidity and mortality both in Ukraine and in the world. It is well known that systemic inflammation and oxidative stress play an important role in pathogenesis of COPD and AH. The problem of finding treatment that would have both anti-inflammatory and antioxidant action is an urgent problem of treating patients with the above mentioned diseases. From literary data we know about using of phosphodiesterase-4 inhibitors, statins, chemokine and selectin receptor antagonists, and others for these purposes. However, these studies are rather contradictory. At the same time, tiotriazoline, according to clinical researches, also have both anti-inflammatory and antioxidant properties. Objective. To study the influence of tiotriazoline on biomarkers of systemic inflammation and oxidative stress in patients with combined course of COPD and arterial hypertension. Materials and methods. A total of 43 patients with combined course of COPD and AH were examined. The patients were divided in 2 groups. The first group was formed by patients who received only basic treatment (n=21). The second group was formed by patients who received basic treatment and tiotriazoline (n=22). Control group was formed from healthy persons of the same age and sex (n=20).The treatment period was 1 month. ELISA method was used to determine serum concentrations of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). Immunoturbidimetric method was used to measure C-reactive protein. As oxidative stress markers, the levels of oxidative protein modification, spontaneous and iron induced aldehydephenylhydrazone’s (APH), ketondinitrophenylhydrazone’s (KPH) were measured. Diastolic function of right (RV) and left ventricle (LV), endothelium dependent vasodilatation (EDVD), were also measured. Results. The patients with combined course of COPD and AH have increased levels of IL-6, TNF-α, spontaneous and iron induced levels of APH and KPH, while comparing with control subjects. After treatment, it was revealed that those patients who additionally received tiotriazoline have significant two fold decrease in levels of IL-6 (p<0,01), TNF-α for -44,8% (p<0,01) and C-reactive protein for -17,3% (p<0,05). Also, the levels of iron induced APH and KPH were decreased for -36,5% (p<0,01) and -47,3% (p<0,01) in the tiotriazoline group. In those patients, who received only basic treatment, the significant decrease in the levels of inflammatory and oxidative stress biomarkers was not revealed. Additional treatment with tiotriazoline also show positive influence on increasing of the LV E’/A’ ratio in +27,1% (p<0,05), RV E’/A’ ratio in +44,6% (p<0,01) and EDVD in +44,6% (p<0,01). Conclusion. The patients with combined course of COPD and AH have increased levels of inflammatory cytokines and oxidative stress biomarkers. The adding of tiotriazoline to the basic treatment decrease levels of inflammatory cytokines IL-6 and TNF-α. Additional treatment with tiotriazoline improves antioxidant properties of serum, by decreasing levels of iron induced APH and KPH.
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