The association between oxidative stress and obstructive lung impairment in patients with COPD.

An oxidant/antioxidant imbalance is thought to play an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). We hypothesized that antioxidant capacity reflected by erythrocyte glutathione peroxidase (GPx), superoxide dismutase (SOD) and catalase (CAT) activities, and serum levels of the lipid peroxidation product malondialdehyde (MDA), may be related to the severity of obstructive lung impairment in patients with COPD. Erythrocyte GPx, SOD and CAT activities, and serum levels of MDA were measured in 79 consecutive patients with stable COPD. Pulmonary functional tests were assessed by body plethysmography. Moderate COPD (FEV1 50-80%) was present in 23, and severe COPD (FEV1 < 50%) in 56 patients. Erythrocyte GPx activity was significantly lower, and serum MDA levels were significantly higher in patients with severe COPD compared to patients with moderate COPD (GPx: 43.1+/-1.5 vs. 47.7+/-2.9 U/gHb, p<0.05, MDA: 2.4+/-0.1 vs. 2.1+/-0.1 nmol/ml, p<0.05). Linear regression analysis revealed a significant direct relationship between FEV1 and erythrocyte GPx activity (r = 0.234, p<0.05), and a significant inverse relationship between FEV1 and serum MDA levels (r = -0.239, p<0.05). However, no differences were observed in the erythrocyte SOD and CAT activities between the two groups of patients with different severity of COPD. Findings of the present study suggest that antioxidant capacity reflected by erythrocyte GPx activity and serum levels of the lipid peroxidation product MDA are linked to the severity of COPD.

Endobronchial actinomycosis presenting as haemoptysis.

Actinomycosis is an infrequent chronic progressive granulomatous and suppurative disease caused by Actinomyces israelii, a natural inhabitant of the gastrointestinal tract. We report a rare case of a 68-year-old man with primary endobronchial actinomycosis who presented in the emergency respiratory ward with massive hemoptysis and dyspnea. An urgent fiberoptic bronchoscopy revealed hypertrophic mucosa and a narrowed lingular bronchus with a pale extruding exophyt. Diffuse bleeding from the mucosa adjacent to the exophyt was present. Histopathologic evaluation revealed chronic inflammation with abscess formation and clusters of Actinomyces colonies. Therapy with clindamycin maintained for 7 weeks prevented recurrence of the disease. In the light of our case and the review of literature we conclude that early recognition of primary endobronchial actinomycosis associated with hemoptysis and proper antibiotic treatment are essential to prevent undesirable complications including unwarranted surgery (Fig. 2, Ref. 30). Full Text (Free, PDF) www.bmj.sk.