In:
Respiratory Research, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
Abstract:
A persistent low inflammatory-oxidative status and the inadequacy of the antioxidant nuclear factor-E2-related factor 2 (Nrf2) have been implicated in chronic obstructive pulmonary disease (COPD) progression. Therefore this study was aimed to assess the association between lung function decline and oxidative-inflammatory markers and Nrf2 signaling pathway expression in peripheral blood mononuclear cells (PBMCs) over time. Methods 33 mild-moderate COPD outpatients (mean age 66.9 ± 6.9 years) were age-sex matched with 37 no-COPD subjects. A clinical evaluation, blood sampling tests and a spirometry were performed at baseline and after a mean follow-up of 49.7 ± 6.9 months. Results In COPD, compared to no-COPD, we found a faster lung function decline at follow-up. Although similar prevalence of smoking, hypertension, diabetes and dyslipidemia, systemic markers of inflammation (hs-CRP and white blood cells, WBCs) and oxidative stress (8-isoprostane) were significantly increased in COPD at follow-up, while the antioxidant glutathione (GSH) was significantly reduced. Moreover the expression of Nrf2 and of Nrf2-related genes heme oxygenase (HO)-1 and glutamate-cysteine ligase catalytic (GCLC) subunit in PBMCS were significantly down-regulated in COPD at follow-up, whereas no changes were observed in no-COPD. The percent variation (Δ) of FEV 1 detected after the follow-up in COPD patients was directly correlated with ΔNrf2 (r = 0.826 p 〈 0.001), ΔHO-1 (r = 0.820, p 〈 0.001) and ΔGCLC (r = 0.840, p 〈 0.001). Moreover ΔFEV 1 was also directly correlated with ΔGSH (r = 0.595, p 〈 0.01) and inversely correlated with Δ8-iso (r = − 0.587, p 〈 0.01) and with baseline smoking history (r = − 0.39, p 〈 0.03). No correlation was found between ΔFEV 1 , ΔCRP and ΔWBCs. By means of hierarchical stepwise multiple linear regression, taking into account other baseline key factors related to FEV 1 , ΔNrf2, ΔHO-1and ΔGCLC were found to be significant predictors of ΔFEV 1 , explaining 89.5% of its variance. Conclusions Although our results must be confirmed in larger trial they suggest that the down-regulation of Nrf2/ARE gene expression in PBMCs may be one of the determinants of FEV 1 decline and of COPD progression. Therefore the future possibility to counteract Nrf2 decline in COPD patients may help in reducing the negative effects of the oxidative stress-induced progression of the disease.
Type of Medium:
Online Resource
ISSN:
1465-993X
DOI:
10.1186/s12931-020-1292-7
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2020
detail.hit.zdb_id:
2041675-1
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