Antiinflammatory effect of telmisartan on chronic obstructive pulmonary disease: 8-isoprostane concentration in exhaled breath condensate

Abstract

Aim. Chronic obstructive pulmonary disease (COPD) is a chronic, progressive, inflammatory disease. Oxidative stress and airway inflammation are its main pathophysiologic components. In this study, our aim was to investigate the effect of an angiotensin receptor blocker (ARB) telmisartan which also exerts antiinflammatory effects on inflammation and oxidative stress in COPD. Method. The study group consisted of 50 stable COPD patients including 25 telmisartan users. Exhaled breath condensate (EBC) samples of the cases were collected using an EBC collecting device (Ecoscreen, Jaeger, Germany). EBC samples were analyzed and 8-isoprostane levels were measured using an enzyme immunoassay method (Cayman Chemical Co. Michigan, USA). Results. Any intergroup difference as for mean age, distribution of gender and smoking were not found. In telmisartan users, and nonusers mean 8-isoprostane levels were 33.98 and 35.91 pg/mL, respectively with a statistically significant intergroup difference (p<0.001) Conclusion. We think that ARBs decrease oxidative stress and inflammation, and thus exert favourable effects on the pathophysiology and progression of COPD.Keywords: Chronic obstructive pulmonary disease, oxidative stress, 8-isoprostane, angiotensin receptor blocker, telmisartan Özet Amaç. Kronik obstrüktif akciğer hastalığı (KOAH) kronik, ilerleyici, inflamatuar bir hastalıktır. Oksidatif stres ve havayolu inflamasyonu hastalığın ana patofizyolojik etkenleridir. Bu çalışmada bir anjiyotensin reseptör blokeri (ARB) olan telmisartan'ın KOAH'daki antiinflamatuar etkisini araştırmayı amaçladık. Yöntem. Çalışmaya 25'i telmisartan kullanan 50 KOAH hastası alındı. Hastaların yoğunlaştırılmış soluk havası (EBC) örnekleri EBC toplama cihazı kullanılarak toplandı (Ecoscreen, Jaeger, Germany). EBC örnekleri analiz edildi ve enzim immunoassay metodu (Cayman Chemical Co. Michigan, USA) kullanılarak 8-izoprostan düzeyleri ölçüldü. Bulgular. Her iki grup arasında ortalama yaş, cinsiyet ve sigara kullanımı açısından fark yoktu. Telmisartan kullanan ve kullanmayan grupta 8-izoprostan düzeyleri sırasıyla 33,98 ve 35,91 pg/mL olarak ölçüldü, iki grup arasındaki fark istatistiksel olarak anlamlı bulundu (p<0,001). Sonuç. ARB'lerin oksidatif stres ve inflamasyonu azaltarak hastalığın patofizyolojisi ve ilerleyişine olumlu etkileri olabilir.Anahtar sözcükler: Kronik obstrüktif akciğer hastalığı, oksidatif stres, 8-izoprostan, anjiyotensin reseptör blokeri, telmisartan

The association of renin&ndash;angiotensin system blockades and pneumonia requiring admission in patients with COPD

“…Frequent exacerbation is a well-known COPD phenotype, regardless of baseline lung functional values. 10 , 42 Several mechanisms of exacerbation exist but remain poorly defined. An increased susceptibility to viral infection has been suggested to trigger more frequent exacerbation; bacterial infection and colonization may also be in play.…”

“… 9 , 12 – 14 Patients with histories of frequent exacerbation are most likely to be admitted to hospitals. 10 , 13 These patients need more systemic steroids, and it might make the patients more susceptible to pneumonia. Despite ambiguity in the temporal relationships between systemic steroid use and pneumonia, steroid use was closely associated with the prevalence of pneumonia in our study.…”

“… 9 , 15 , 16 Some RAS blockers have been used to make an effort to attenuate the chronic inflammation of COPD. 10 , 17 …”