Pokazatelji oksidativnog stresa i inflamacije kod pacijenata sa hroničnom opstruktivnom bolešću pluća i komorbiditetom
Indicators of oxidative stress and inflammation in chronic obstructive pulmonary disease patients with co-morbidity
Doktorand
Stanojković, Ivana D.Mentor
Spasić, SlavicaČlanovi komisije
Kotur-Stevuljević, JelenaMilenković, Branislava
Spasić, Slavica
Metapodaci
Prikaz svih podataka o disertacijiSažetak
Hronična opstruktivna bolest pluća (HOBP) je hronična inflamatorna bolest koja zahvata gornje i
donje disajne puteve, parenhim pluća i plućnu vaskulaturu. Procenjuje se da u našoj zemlji od
hronične opstruktivne bolesti boluje izmeĎu 400 000 i 600 000 ljudi. U svetu je više od 600
miliona obolelih od ove bolesti, sa blizu 3 miliona smrtnih slučajeva godišnje, čineći je petim
uzročnikom smrtnosti u ljudskoj populaciji. Procenjuje se da će u budućnosti broj obolelih rasti i
do 2020. godine biti treći uzročnik smrtnosti.
Ranijih godina je definicaja hronične opstruktivne bolesti pluća bila bazirana na plućnoj
patologiji, tj. na progresivnoj opstrukciji disajnih puteva. Smatralo se da je promenjeni
inflamatorni odgovor pluća na inhalirane toksične partikule i gasove iz duvanskog dima,
aerozagaĎenja i ostalih zagaĎivača glavni mehanizam u patogenezi ove bolesti. MeĎutim,
poslednja istraživanja ukazuju na složen mehanizam nastanka i razvoja ove bolesti, koji pored
pojačane inflama...cije uključuje i izražen oksidativni stres i pojačanu proteolizu ekstracelularnog
matriksa (ECM), a kao posledica disbalansa proteaza/antiproteaza sistema.
Hroničnu opstruktivnu bolest pluća karakterišu i stanja egzacerbacije bolesti. Egzacerbacija
HOBP definiše se pogoršanjem respiratornih simptoma u odnosu na predhodne dnevne
varijacije, koje zahtevaju promenu u tretmanu lekovima. Učestalost ovog stanja odreĎuje težinu i
ishod HOBP.
Bitna karakteristika HOBP je i veliki broj komorbiteta, nastalih u najvećem broju slučajevima
kao posledica delovanja upravo pojačane inflamacije, oksidativnog stresa i proteolize ECM.
MeĎu ovim bolestima najzastupljenije su bolesti kardiovaskularnog sistema, osteoporoza,
disfunkcija skeletnih mišića, depresija...
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease involving the
upper and lower airways, lung parenchyma and lungs vasculature. It is estimated that in our
country 400 000 to 600 000 people with chronic obstructive pulmonary disease. There are more
than 600 million COPD patients worldwide, and with close to 3 million lethal cases per year,
COPD is the fifth cause of mortality in human population. It is estimated that the number of
these patients will rise in future, and by 2010 the disease will become the third cause of
mortality.
In previous years the definition of chronic obstructive pulmonary disease was based on
pulmonary pathology, i.e. progressive obstruction of airways. It was considered that an altered
inflammatory pulmonary response to the inhaled toxic particles and gases from tobacco smoke,
air pollution and other pollutants was the main mechanism of the pathogenesis of this disease.
However, the latest investigations have shown a comp...lex mechanism of occurrence and
development of this disease, which besides an increased inflammation also includes an increased
oxidative stress and intensified proteolysis of the extracellular matrix (ECM), as a consequence
of disbalance of the protease/antiprotease system.
Chronic obstructive pulmonary disease is also characterized by the states of exacerbation of
disease. Exacerbation of COPD is defined as deterioration of respiratory symptoms in relation to
the previous daily variations, requiring a change in medical treatment. The frequency of this state
determines the severity and outcome of the COPD.
An essential characteristic of COPD is also a large number of comorbidity, in majority of cases
occurred as a consequence of an increased inflammation, oxidative stress and proteolysis of
ECM. The most frequent among these diseases are cardiovascular system disease, osteoporosis,
dysfunction of skeletal muscles, depression...