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Can Blood Biomarkers Be Used to Assess Oxidative Stress in COPD Patients After Pulmonary Rehabilitation
(Dove Medical Press Ltd, 2023) Beykumul, Aysegul; Ersoy, Yuksel; Gulbas, Gazi; Neselioglu, Salim
Purpose: To determine the level of oxidative stress in the body due to pulmonary rehabilitation (PR) with thiols and disulfide and to investigate their relationship with indirect markers such as creatine kinase (CK), creatine kinase - MB (CK-MB), and lactate dehydrogenase (LDH), which show cell destruction.Patients and Methods: Patients with chronic obstructive pulmonary disease (COPD) are included in inpatient and outpatient care. They were evaluated before and after for PR, and an exercise program was prescribed. In addition, native thiol (NT), total thiol (TT), disulfide (DS), LDH, CK, and CK-MB values were tested.Results: The mean age of 21 patients was 63 +/- 7.31 years. Eleven of them were outpatients and 10 of them were inpatients. Most of the patients were male (M/F=20/1, 95.2/4.8%). There was a significant difference in pulmonary function tests (PFT), St. George Respiratory Questionnaire (SGRQ), and 1 repetition maximum (1RM) before and after the treatment (p<0.001). There was a correlation between PFT and 1RM upper extremity. While there was no significant difference between thiols and disulfide, according to GOLD scores, there was a significant difference in patients with level 3-MMRC. No correlation was found between LDH, CK, CKMB, and thiols, DS. Delta CK was found to be associated with Delta DS, and Delta CK-MB with Delta NT, and Delta TT.Conclusion: PR contributes to the antioxidant process by improving respiration and reducing oxidative stress. The decrease in LDH, CK with PR, increase in CK-MB, and correlation of CK with thiols and DS gave a different interpretation. In this case, it should be considered that oxidative stress may also be increased in people with high CK values.
Can the ADO Index Be Used as a Predictor of Mortality from COVID-19 in Patients with COPD?
(Dove Medical Press Ltd, 2024) Yazar, Esra Ertan; Gunluoglu, Gulsah; Yigitbas, Burcu Arpinar; Calikoglu, Mukadder; Gulbas, Gazi; Sarioglu, Nurhan; Bozkus, Fulsen
Background: Several studies have shown that the risk of mortality due to COVID-19 is high in patients with COPD. However, evidence on factors predicting mortality is limited. Research Question: Are there any useful markers to predict mortality in COVID-19 patients with COPD?. Study Design and Methods: A total of 689 patients were included in this study from the COPET study, a national multicenter observational study investigating COPD phenotypes consisting of patients who were followed up with a spirometry-confirmed COPD diagnosis. Patients were also retrospectively examined in terms of COVID-19 and their outcomes. Results: Among the study patients, 105 were diagnosed with PCR-positive COVID-19, and 19 of them died. Body mass index (p= 0.01) and ADO (age, dyspnoea, airflow obstruction) index (p= 0.01) were higher, whereas predicted FEV1 (p< 0.001) and eosinophil count (p= 0.003) were lower in patients who died of COVID-19. Each 0.755 unit increase in the ADO index increased the risk of death by 2.12 times, and each 0.007 unit increase in the eosinophil count decreased the risk of death by 1.007 times. The optimum cut-off ADO score of 3.5 was diagnostic with 94% sensitivity and 40% specificity in predicting mortality. Interpretation: Our study suggested that the ADO index recorded in the stable period in patients with COPD makes a modest contribution to the prediction of mortality due to COVID-19. Further studies are needed to validate the use of the ADO index in estimating mortality in both COVID-19 and other viral respiratory infections in patients with COPD.
Capacity of Carbon Monoxide Diffusion
(Aves, 2011) Gulbas, Gazi; Gunen, Hakan
Carbon monoxide diffusion test provides important information in diagnosis and follow-up of parenchymal and vascular pulmonary diseases, if well-standardized and evaluated correctly. This review is prepared to contribute to the correct application and evaluation of this test.
Carotid intima-media thickness in chronic obstructive pulmonary disease and survival: A multicenter prospective study
(Wiley, 2019) Gulbas, Gazi; Turan, Onur; Sarioglu, Nurhan; Diken, Ozlem Ercen; Ogan, Nalan; Kadioglu, Esra Ekbic; Kurtipek, Ercan
Introduction Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovascular morbidity and mortality. Carotid intima-media thickness (CIMT) is a noninvasive method assessing atherosclerosis. Objective It was aimed to determine relationship and survival between COPD and CIMT. Methods CIMT was measured using Doppler ultrasound (USG) in 668 stable COPD patients at 24 centers. Patients were followed-up for 2 years. Results There were 610 patients who completed the study. There were 200 patients CIMT with <0.78 mm (group 1), and 410 with CIMT >= 0.78 mm (group 2). There was a significant difference at the parameters of age, gender, smoking load, biomass exposure, GOLD groups and degree of airway obstruction (FEV1) between groups 1 and 2. Our results revealed positive correlations between mean CIMT and age, smoking load (pack-years), biomass exposure (years), exacerbation rate (last year), duration of hypertension (years) and cholesterol level; negative correlations between CIMT and FEV1 (P < 0.05). According to logistic regression model, compared with group A, risk of CIMT increase was 2.2-fold in group B, 9.7-fold in group C and 4.4-fold in group D (P < 0.05). Risk of CIMT increase was also related with cholesterol level (P < 0.05). Compared with infrequent exacerbation, it was 2.8-fold in the patients with frequent exacerbation (P < 0.05). The mean survival time was slightly higher in group 1, but not significant (23.9 vs 21.8 months) (P > 0.05). Conclusion This study is the first regarding CIMT with combined GOLD assessment groups. It has revealed important findings supporting the increase in atherosclerosis risk in COPD patients. We recommend Doppler USG of the carotid artery in COPD patients at severe stages.
Chronic obstructive pulmonary disease phenotypes in Turkey: the COPET study-a national, multicenter cross-sectional observational study
(Tubitak Scientific & Technological Research Council Turkey, 2022) Yazar, Esra Ertan; Yigitbas, Burcu Arpinar; Ozturk, Can; Calikoglu, Mukadder; Gulbas, Gazi; Turan, Muzaffer Onur; Sahin, Hulya
Background/aim: While mortality rates decrease in many chronic diseases, it continues to increase in COPD. This situation has led to the need to develop new approaches such as phenotypes in the management of COPD. We aimed to investigate the distribution, characteristics and treatment preference of COPD phenotypes in Turkey. Materials and methods: The study was designed as a national, multicenter, observational and cross-sectional. A total of 1141 stable COPD patients were included in the analysis. Results: The phenotype distribution was as follows: 55.7% nonexacerbators (NON-AE), 25.6% frequent exacerbators without chronic bronchitis (AE NON-CB), 13.9% frequent exacerbators with chronic bronchitis (AE-CB), and 4.8% with asthma and COPD overlap (ACO). The FEV 1 values were significantly higher in the ACO and NON- AE than in the AE-CB and AE NON-CB (p < 0.001). The symptom scores, ADO (age, dyspnoea and FEV 1) index and the rates of exacerbations were significantly higher in the AE-CB and AE NON-CB phenotypes than in the ACO and NON-AE phenotypes (p < 0.001). Treatment preference in patients with COPD was statistically different among the phenotypes (p < 0.001). Subgroup analysis was performed in terms of emphysema, chronic bronchitis and ACO phenotypes of 1107 patients who had thoracic computed tomography. A total of 202 patients had more than one phenotypic trait, and 149 patients showed no features of a specific phenotype. Conclusion: Most of the phenotype models have tried to classify the patient into a certain phenotype so far. However, we observed that some of the patients with COPD had two or more phenotypes together. Therefore, rather than determining which phenotype the patients are classified in, searching for the phenotypic traits of each patient may enable more effective and individualized treatment.
Diagnostic and treatment outcomes of patients with pulmonary tuberculosis in the first year of COVID-19 pandemic
(Who Eastern Mediterranean Regional Office, 2022) Yakupogullari, Yusuf; Ermis, Hilal; Kazgan, Zeynep; Otlu, Baris; Bayindir, Yasar; Gulbas, Gazi; Tanriverdi, Elif
Background: The COVID-19 pandemic has put a significant strain on human life and health care systems, however, little is known about its impact on tuberculosis (TB) patients. Aims: To assess the impact of COVID-19 pandemic on pulmonary tuberculosis (PTB) diagnosis, treatment and patient outcomes, using the WHO definitions. Methods: A cross-sectional study was conducted in Malatya region, Turkey (population 800 000). Data on regional PTB test numbers, case notification rates and PTB patients' clinical characteristics and treatment outcomes were collected. Data from the first pandemic year (2020) were compared to data from the previous 3 years (2017-2019). The attitudes and experiences of patients were analysed. Results: Despite a non-significant 22% decrease in annual PTB case notifications (P = 0.317), the number of TB tests performed (P = 0.001) and PTB patients evaluated (P = 0.001) decreased significantly during the pandemic year compared with the previous 3 years. The proportion of patients with high (3/4+) sputum acid-fast bacilli grades (P = 0.001), TB relapse (P = 0.022) and treatment failure (P = 0.018) increased significantly. The median 64.5-day treatment delay detected in 2017-2019 increased significantly to 113.5 days in 2020 (P = 0.001), due primarily to patients' reluctance to visit a health care facility. Conclusion: In addition to the problems with case detection, this study shows notable deterioration in several indicators related to the severity, contagiousness and poor outcomes of TB, which had already been suppressed for decades.
DO disease stages affect oxidative stress in stable COPD?
(Cell Press, 2024) Yalcinsoy, Murat; Beykumul, Aysegul; Gulbas, Gazi; Arslan, Ahmet Kadir; Neselioglu, Salim
Background: Detection of oxidative stress level may lead us to understand the pathogenesis of COPD better and to search for new treatments. Oxidative stress levels have also been shown to be elevated in stable COPD patients. We aimed to investigate whether the stage of COPD affects the severity of inflammation-induced oxidative stress in patients with stable COPD. Methods: Between June 2019 and March 2020, all consecutive patients admitted to COPD-specific outpatient clinics were included. Patients were classified A, B, and E according to the GOLD guideline. Results: The median age of 98 patients (Male: 92 (93.9 %)) was 65 (min-max: 49-86). A statistically significant difference was found between the groups in FEV1, FVC, and FEV1/FVC (p < 0.001). age, and thiols (r = -0.168, p = 0.049; r = -0.184, p = 0.035) and DS (r = -0.209, p = 0.019) were found to be negatively correlated at a low level. When adjusted for age, oxidative stress parameters were similar between stages. Conclusion: No difference between stages and oxidative stress parameters according to GOLD classification in stable COPD patients. Our results may be a guide for not using anti-inflammatory therapy except for attacks.
Effects of varenicline on lung tissue in the animal model
(Soc Brasileira Pneumologia Tisiologia, 2020) Ermis, Hilal; Parlakpinar, Hakan; Elbe, Hulya; Vardi, Nigar; Polat, Alaaddin; Gulbas, Gazi
[Abstract Not Available]
The evaluation of sensory gating with P50 paradigm in chronic obstructive pulmonary disease
(European Respiratory Soc Journals Ltd, 2012) Kamisli, Ozden; Ermis, Hilal; Kamisli, Suat; Gulbas, Gazi; Ozcan, Cemal
[Abstract Not Available]
Factors associated with noninvasive ventilation response in the first day of therapy in patients with hypercapnic respiratory failure
(Wolters Kluwer Medknow Publications, 2012) Gursel, Gul; Aydogdu, Muge; Tasyurek, Secil; Gulbas, Gazi; Ozkaya, Sevket; Nazik, Sakine; Demir, Ayse
Background and Aim: Noninvasive ventilation (NIV) decreases mechanical ventilation indication in the early period of acute hypercapnic respiratory failure (AHcRF) and factors for success have been studied well. But, less is known about the factors influencing the NIV response in the subacute period. This study was aimed to determine the factors influencing the reduction of PaCO 2 levels within first 24 hours of therapy. Methods: NIV response was defined as reduction of PaCO 2 level below 50 mmHg within first 24 hours. Patients with AHcRF, treated with NIV, were divided into 2 groups according to this criterion; group 1 as the nonresponsive, group 2 as the responsive. The differences in NIV methods and characteristics of the two groups were evaluated and compared in this retrospective study. Results: A total of 100 patients were included in the study; 66 of them in group 1 and 34 in group 2. No significant differences were identified between the length of NIV application and intensive care unit (ICU) stay, intubation and mortality rates, across the groups. Ninety-one percent of the patients in group 2 had received all night long NIV therapy; this was just 74 in group 1 (P=0.036). Results of multivariate analysis showed that while nocturnal application was significantly associated with better response, prior home ventilation and requirement of higher pressure support (PS) levels significantly and independently associated with poorer response to NIV therapy. Conclusion: In patients with AHcRF, all night long use of NIV may accelerate healing by improving PaCO 2 reduction within the first 24 hours. A rapid response in PaCO 2 levels should not be expected in patients requiring higher PS levels and using prior home ventilation.
A Heart Transplant Recipient Lost Due to Pneumocystis jiroveci Pneumonia Under Trimethoprim-Sulfamethoxazole Prophylaxis: Case Report
(Baskent Univ, 2010) Celik, Tuncay; Gedik, Ender; Kayabas, Uner; Bayindir, Yasar; Gulbas, Gazi; Firat, Ahmet Kemal; Togal, Turkan
Infections in solid-organ transplant recipients are the most important causes of morbidity and mortality. A primary goal in organ transplant is the prevention or effective treatment of infection, which is the most-common life-threatening complication of long-term immunosuppressive therapy. A 21-year-old woman who underwent heart transplant 3 years previous owing to dilated cardiomyopathy was referred to our hospital with symptoms of high fever and cough. The patient's history revealed that she had received a trimethoprim-sulfamethoxazole double-strength tablet each day for prophylactic purposes. On chest radiograph, pneumonia was detected, and in broncho-alveolar lavage sample, Pneumocystis jiroveci cysts were found. After diagnosing P. jiroveci pneumonia, trimethoprim-sulfamethoxazole was initiated at 20 mg/kg/d including intravenous trimethoprim in divided dosages every 6 hours. On the sixth day of therapy, she died in intensive care unit. In solid-organ transplant recipients, although antipneumocystis prophylaxis is recommended within the first 6 to 12 months after transplant, lifelong prophylaxis is also used in several settings. In addition, the physician should keep in mind that P. jiroveci pneumonia may develop in solid organ recipients, despite trimethoprim-sulfamethoxazole prophylaxis.
Investigation of neuromuscular transmission in patients with chronic obstructive pulmonary disease: A preliminary report
(European Respiratory Soc Journals Ltd, 2012) Kaplan, Yuksel; Gulbas, Gazi; Ermis, Hilal; Kamisli, Ozden; Kamisli, Suat; Ozcan, Cemal
[Abstract Not Available]
A Life-threatening Complication of Deep Venous Thrombosis; Phlegmesia Cerulea Dolens
(Emergency Medicine Physicians Assoc Turkey, 2013) Kaya, Mer; Yucel, Neslihan; Gulbas, Gazi; Ermis, Hilal; Kutlu, Ramazan
Phlegmasia cerulea dolens is a rare condition caused by complete venous occlusion and often results in tissue necrosis, limb amputation, or death. In this study, a 51 year old female presenting at our emergency department with leg edema, leg pain and cyanosis and was diagnosed with phlegmesia cerulea dolens, which is a life-threatening complication of deep venous thrombosis. Prompt diagnosis and treatment initiation are important to prevent pulmonary emboli, gangrene, amputation, and, ultimately, death.
Neuromuscular transmission in hypoxemic patients with chronic obstructive pulmonary disease
(Elsevier, 2013) Gulbas, Gazi; Kaplan, Yuksel; Kamisli, Ozden; Ermis, Hilal; Kamisli, Suat; Ozcan, Cemal
Many studies have focused on the systemic effects of chronic obstructive pulmonary disease (COPD), but none has examined neuromuscular junction transmission (NMT). We evaluated NMT dysfunction using single-fiber electromyography (SFEMG) in patients with COPD. Twenty patients with COPD and 20 age-matched healthy controls were included in the study. All patients and controls underwent SFEMG. Abnormal NMT was found in seven of 20 patients (35%), but in none of the control subjects. The COPD patients were subgrouped according to the presence of hypoxemia. The patients with normoxemia were classified as Group 1, and the patients with hypoxemia were classified as Group 2. Abnormal NMT was found in six patients in Group 2 and in one in Group 1. While there was significant difference in terms of abnormal NMT between Group 2 and the controls, there was none between Group 1 and the controls. Our results show that NMT abnormalities can be present in hypoxemic patients with COPD. (C) 2013 Elsevier B.V. All rights reserved.
Prevalence of COPD: First epidemiological study of a large region in Turkey
(Elsevier, 2008) Gunen, Hakan; Hacievliyagil, Suleyman Savas; Yetkin, Ozkan; Gulbas, Gazi; Mutlu, Levent Cem; Pehlivan, Erkan
Background: Although chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and morbidity worldwide, epidemiological data oil COPD is very limited. This study was designed to obtain some baseline data on COPD in the Malatya region of Turkey. Methods: Sixty clusters from urban and rural regions were randomly selected. Ten and seven consecutive households were included in the study from each urban and rural cluster, respectively. A validated questionnaire on the epidemiology of COPD was completed for each participant over 18 by a Pulmonary physician. Each subject underwent standard spirometric measurement and early bronchodilation testing. Results: A total of 1160 participants completed the study (93%). Some 6.9% of the participants were found to have COPD (F/M = 1/4). While the prevalence of COPD was 18.1 % in current smokers over 40 years of age, the prevalence was 4.5% among younger smokers. Some 25.5% of the women and 57.2% of the men were current smokers. Biomass exposure, as a sole reason for COPD, was significantly common among female patients living in rural areas (54.5%). In the development of COPD, the relative risk ratio of cigarette smoke was found to be 3.4 and 3.3 times higher than biomass exposure and occupational exposure, respectively. Conclusions: Smoking rate and COPD prevalence were found to be unexpectedly high in the region, and biomass exposure is still an important cause of COPD, particularly among females living in rural areas. We think that national policies against smoking and biomass exposure should be implemented immediately. (C) 2009 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Prevalence of malnutrition in COPD and its relationship with the parameters related to disease severity
(Dove Medical Press Ltd, 2018) Mete, Burak; Pehlivan, Erkan; Gulbas, Gazi; Gunen, Hakan
Objective: The aim of the study was to determine the nutritional status and anthropometric values in a group of patients with COPD and to examine the relationship between these factors and disease severity. Methods: A total of 105 COPD patients were included in this cross-sectional study. The patients underwent spirometric exmination. Mini nutritional assessment form was applied, and the anthropometric values of the patients were measured by bioelectrical impedance method. Nutrient registration forms were given using a 3-day, 24-hour recall method to assess the nutrient uptake. COPD severity was determined using the Global Initiative for Chronic Obstructive Lung Disease criteria, and the correlations between nutritional status and disease severity parameters were measured. Results: The prevalence of malnutrition in our patients with COPD was found to be 17%. Spirometric parameters were found to be significantly lower in patients with low body mass index (BMI) and malnutrition. As the modified Medical Research Council dyspnea scale score increased, the frequency of malnutrition increased (P=0.002). Positive significant correlation was found between spirometric variables and muscle mass and fat external tissue volume of the patients. Patients receiving higher protein content in diet showed a better muscle mass amount (P<0.001). Conclusion: Our study results confirmed that malnutrition is an important and frequently encountered problem in COPD patients, and spirometric values of the patients with malnourishment and with low BMI are significantly lower. We think that nutritional status should be evaluated in every COPD patient, and nutritional intake should be tailored individually.
Prognostic role of simplified Pulmonary Embolism Severity Index and the European Society of Cardiology Prognostic Model in short- and long-term risk stratification in pulmonary embolism
(Professional Medical Publications, 2014) Kilic, Talat; Gunen, Hakan; Gulbas, Gazi; Hacievliyagil, Suleyman Savas; Ozer, Ali
Objectives: Hemodynamic status, cardiac enzymes, and imaging-based risk stratification are frequently used to evaluate a pulmonary embolism (PE). This study investigated the prognostic role of a simplified Pulmonary Embolism Severity Index (sPESI) score and the European Society of Cardiology (ESC) model. Methods: The study included 50 patients from the emergency and pulmonology department of,one medical center between October 2005 and June 2006. The ability of the sPESI and ESC model to predict short-term (in-hospital) and long-term (6-month and 6-year) overall mortality was assessed, in addition to the accurancy of the sPESI and ESC model in predicting short-term adverse events, such as cardiopulmonary resuscitation, or major bleeding. Results: Of the 50 patients, the in-hospital and 6-year mortality rates were 14% and 46%, respectively. Fifteen (30%) of these experienced adverse events during hospitalization. Importantly, patients classified as low-risk according to the sPESI had no short-term adverse events as opposed to 4.8 % in the ESC low-risk group. They also had no in-hospital, 6-month, or 6-year mortality compared to 4.8%, %14.3, and %23.8, respectively, in the ESC low-risk group. Conclusions: The sPESI predicted short-term and long-term survival. The exclusion of short-term adverse events does not appear to require imaging and laboratory testing.
Prognostic role of the simplified pulmonary embolism severity index and shock index in pulmonary embolism
(Medycyna Praktyczna, 2014) Kilic, Talat; Ermis, Hilal; Gulbas, Gazi; Kaya, Omar; Aytemur, Zeynep A.; Inceoglu, Feyza; Hacievliyagil, Suleyman S.
INTRODUCTION The stratification of acute pulmonary embolism (PE) using the simplified pulmonary embolism severity index (sPESI) and shock index (SI) does not require any prognostic tools such as biomarkers or echocardiography. OBJECTIVES We compared the ability of the sPESI and SI to predict 30-day and 3-year mortality following PE. PATIENTS AND METHODS Prognostic models based on the sPESI and SI were used to predict the overall 30-day (short-term) and 3-year (long-term) mortality in a cohort of 194 patients with confirmed PE. RESULTS Overall, the mortality rate in this cohort was 9.2% in the first month and 29.9% at 3 years. The sPESI categorized fewer patients as low risk (41.7%; 81 of 194 patients) when compared with the SI lower than 1 (74.7%; 145 of 194 patients). Importantly, patients classified as low risk in the sPESI had no 30-day mortality compared with 2.1% of patients (3 of 145) classified as low-risk based on the SI. The 3-year mortality rate in low-risk patients according to the sPESI was lower than that in low-risk patients identified based on the SI (4.9% vs. 20.7%; P < 0.0001). While a multivariate Cox analysis showed that both the SI and sPESI were independent prognostic variables for 3-year mortality, it showed that only the SI was an independent prognostic variable for 30-day mortality. CONCLUSIONS Both prognostic models allow to stratify the risk of short-and long-term mortality in patients with PE, but the sPESI was better than SI at classifying low-risk patients.
Protective effect of dexpanthenol on bleomycin-induced pulmonary fibrosis in rats
(Springer, 2013) Ermis, Hilal; Parlakpinar, Hakan; Gulbas, Gazi; Vardi, Nigar; Polat, Alaadin; Cetin, Asli; Kilic, Talat
Despite extensive studies, there is no effective treatment currently available other than pirfenidone for idiopathic pulmonary fibrosis. A protective effect of pantothenic acid and its derivatives on cell damage produced by oxygen radicals has been reported, but it has not been tested in bleomycin (BLM)--induced pulmonary fibrosis in rats. Therefore, we aimed to investigate the preventive effect of dexpanthenol (Dxp) on pulmonary fibrosis. Thirty-two rats were assigned to four groups as follows: (1) control group, (2) dexpanthenol (Dxp) group; 500 mg/kg Dxp continued intraperitoneally for 14 days, (3) bleomycin (BLM) group; a single intratracheal injection of BLM (2.5 mg/kg body weight in 0.25-ml phosphate buffered saline), and (4) BLM + Dxp-treated group; 500 mg/kg Dxp was administered 1 h before the intratracheal BLM injection and continued for 14 days i.p. The histopathological grades of lung inflammation and collagen deposition, tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and myeloperoxidase (MPO) were measured. BLM provoked inflammation and collagen deposition (p < 0.0001), with a marked increase in myeloperoxidase (MPO) activity resembling increased inflammatory activity (p < 0.0001), which was prevented by Dxp (p < 0.0001, p = 0.02). BLM reduced tissue activities of SOD, GPx, and CAT compared to controls (p = 0.01, 0.03, 0.009). MDA was increased with BLM (p = 0.003). SOD (p = 0.001) and MDA (p = 0.016) levels were improved in group 4. The CAT levels in the BLM + Dxp group were close to those in the control group (p > 0.05). We showed that Dxp significantly prevents BLM-induced lung fibrosis in rats. Further studies are required to evaluate the role of Dxp in the treatment of lung fibrosis.
Relationship between serum ?-glutamyltransferase levels and acute exacerbation of chronic obstructive pulmonary disease
(Medycyna Praktyczna, 2013) Ermis, Hilal; Celik, Muhammet R.; Gulbas, Gazi; Tavli, Deniz; Aytemur, Zeynep A.
INTRODUCTION gamma-glutamyltransferase (GGT) is a plasma membrane enzyme, which is involved in antioxidant glutathione resynthesis. OBJECTIVES The aim of the study was to compare the serum levels of GGT (which is considered a novel marker of oxidative stress) between patients with stable chronic obstructive pulmonary disease (COPD) and those with acute exacerbation of COPD, and the relationship of GGT with inflammation. PATIENTS AND METHODS The study involved 132 patients with exacerbated COPD and normal function of the liver and biliary tract (mean age, 66.6 +/- 10.1 years; men, 88.6%) and 147 patients with stable COPD (mean age, 65.4 +/- 8.8 years; men, 87.1%). Serum GGT and C-reactive protein (CRP) levels were measured and compared between the groups. RESULTS Serum GGT levels in patients with exacerbated COPD were significantly higher than in those with stable COPD (30 U/l; interquartile range [IQR], 18.8 vs. 25 U/l; IQR, 16; P < 0.001]. Serum CRP levels were significantly higher in patients with exacerbated COPD compared with those with stable COPD (34 mg/l; IQR, 58.3 vs. 16 mg/l; IQR, 24.6; P < 0.001). A significant positive correlation was observed between GGT activity and CRP levels (r = 0.27, P = 0.002). The GGT level of 29 U/l was set as a cutoff value of acute exacerbation with the specificity of 70.1% and sensitivity of 62.8% (95% confidence interval, 0.6-0.71; area under the curve, 0.66; standard error, 0.032; P < 0.001). CONCLUSIONS Our study indicates that serum GGT levels as the marker of oxidative stress increase during exacerbated COPD and correlate with CRP levels. The measurement of GGT activity may be useful in the evaluation of exacerbated COPD.

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