REVIEW  CHRONIC OBSTRUCTIVE PULMONARY DISEASE Free access

Minerva Medica 2022 June;113(3):370-404

DOI: 10.23736/S0026-4806.22.07972-1

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Role of oxidative stress in the pathogenesis of COPD

Francesco NUCERA ¹ ✉, Sharon MUMBY ², Keshav R. PAUDEL ³, Vivek DHARWAL ³, Antonino DI STEFANO ⁴, Vincenzo CASOLARO ⁵, Philip M. HANSBRO ³, Ian M. ADCOCK ², Gaetano CARAMORI ¹

¹ Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), University of Messina, Messina, Italy, 2 Section of Airways Diseases, Faculty of Medicine, Imperial College London, National Heart and Lung Institute, London, UK; ³ Center for Inflammation, Centenary Institute and University of Technology Sydney, School of Life Sciences, Faculty of Science, Sydney, Australia, 4 Division of Pneumology, Laboratory of Cardiorespiratory System Citoimmunopathology, Istituti Clinici Scientifici Maugeri IRCCS, Veruno, Novara, Italy; ⁵ Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy

Chronic inhalation of cigarette smoke is a prominent cause of chronic obstructive pulmonary disease (COPD) and provides an important source of exogenous oxidants. In addition, several inflammatory and structural cells are a source of endogenous oxidants in the lower airways of COPD patients, even in former smokers. This suggests that oxidants play a key role in the pathogenesis of COPD. This oxidative stress is counterbalanced by the protective effects of the various endogenous antioxidant defenses of the lower airways. A large amount of data from animal models and patients with COPD have shown that both the stable phase of the disease, and during exacerbations, have increased oxidative stress in the lower airways compared with age-matched smokers with normal lung function. Thus, counteracting the increased oxidative stress may produce clinical benefits in COPD patients. Smoking cessation is currently the most effective treatment of COPD patients and reduces oxidative stress in the lower airways. In addition, many drugs used to treat COPD have some antioxidant effects, however, it is still unclear if their clinical efficacy is related to pharmacological modulation of the oxidant/antioxidant balance. Several new antioxidant compounds are in development for the treatment of COPD.

KEY WORDS: Oxidative stress; Pulmonary disease, chronic obstructive; Antioxidants