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.