Mechanisms Of Local And Systemic Inflammation In Chronic Obstructive Pulmonary Disease With Comorbid Hypertension And Obesity

Abstract Today chronic obstructive pulmonary disease COPD is considered not only as a disease with changes in the bronchial tree and lungs but also as a systemic inflammatory syndrome with systemic effects and the presence of comorbidities. The objectives of this study were to evaluate the lipid peroxidation antioxidant system and proteolysis intensity in the blood and exhaled breath condensate EBC as well as local balance between pro- and anti-inflammatory cytokines in COPD patients with hypertension and obesity. The study included 25 healthy subjects and 50 patients with COPD without hypertension and with comorbid hypertension and obesity 36 patients. General tripsin-like proteinase TLP activity was determined by Kunits method neutral proteolytic activity of citrate blood plasma and EBC by azoalbumin azocasein and azocol lysis. Superoxyddismutase SOD and catalase Ct activity malone dialdehyde MDA level HS-group content in the blood and EBC were also examined. The concentration of cytokines TNF26945 IL-126946 TGF- 269461 IFN 26947 were marked with ELISA method. Patients with COPD and comorbid hypertension and obesity showed more elevation of TNF26945 IL-126946 TGF- 269461 in EBC local and systemic higher MDA index decrease of Ct and SOD activity in EBC and increased Ct activity in blood activation of neutral proteolytic systems and acid TLP reduced collagenolysis intensity. The course of COPD with hypertension and obesity was characterized by more intensification of inflammatory process on the level of the bronchial tree and with more systemic inflammatory response.