Коморбідні стани при хронічному обструктивному захворюванні легень: вивчені та дискусійні питання
Частина 1
DOI:
https://doi.org/10.30978/UTJ2021-1-85Ключові слова:
хронічне обструктивне захворювання легень, коморбідністьАнотація
Нині хронічне обструктивне захворювання легень розглядають як мультифакторне захворювання із системними позалегеневими проявами і високим рівнем коморбідності. Диференціація понять «поліморбідність» та «коморбідність» для хворих з цією патологією є вельми важливою. В основі коморбідних станів лежать спільні тригерні чинники і/або патогенетичні механізми, а їх розвиток зіставний у часі з основним захворюванням. Це зумовлює необхідність відповідного інтегрованого ведення таких пацієнтів. Наявність у пацієнта захворювань, не пов’язаних з основним патологічним процесом спільними причинними чинниками і/або патогенетичними механізмами, слід розцінювати як супутні, які є основою поліморбідності. Узагальнено дані вітчизняної та зарубіжної наукової літератури щодо механізмів розвитку можливої коморбідної патології у цього контингенту хворих. Наведено дані щодо провідної ролі оксидантного стресу та системного запалення низької інтенсивності у формуванні коморбідності при хронічному обструктивному захворюванні легень, висвітлено механізми їх впливу, взаємозв’язок і дискусійні питання, а також сучасні дані про генетичні та молекулярні механізми розвитку цих патологічних процесів. Особливу увагу приділено метаболічним порушенням, які розвиваються внаслідок оксидантного стресу та системного запалення. Зокрема показано, що системне запалення призводить до розвитку інсулінорезистентності, цукрового діабету та інших метаболічних розладів. Наведено дані щодо доцільності виділення метаболічних профілів або фенотипів, а також патогенетичне значення ендотоксикозу. Наслідком оксидантного стресу та системного запалення є також ендотеліальна дисфункція і пов’язані з нею захворювання серцево‑судинної системи. Наведено дані щодо особливостей проявів деяких з них у цього контингенту хворих.
Посилання
Bychkova NG, Bychkova SA. Immune status of patients with chronic obstructive pulmonary disease, accompanied with chronic kidney disease and metabolic distrurbances. Ukr.J.of Nephrology and Dialysis [in Ukrainian]. 2015;1 (45): 8-13.
Bilko VV, Kaidashev IP. The Il-33/St2 system regulates inflammation in bronchopulmonary diseases. Ukr.Pulmonol. J [in Ukrainian]. 2020; 1 : 59-64. DOI: 10.31215/2306-4927-2020-107-1-59-64
Burmak YuG, Treumova SI, Petrov EE, et al. Peculiarities of some structural-functional indicators of ventricles in patients with chronic obstructive lung disease in conditions of comorbidity with arterial hypertension. Achievements of Clinical and Experimental Medicine [in Ukrainian]. 2018; 2(34):258-260. DOI:10.11603/1811-2471.2018.v0.i2.8937
Vatutin NT, Smirnova AS. Treatment of comorbid chronic obstructive pulmonary disease and cardiovascular disease. Russian Pulmonology [in Russian]. 2016; 26(3):364-371. DOI: https:. doi.org/10.18093/0869-0189-2016-26-3-364-371
Vertkyn AL, Skotnykov AS, Tykhonovskaia EIu. Comorbidity in COPD: Role of Chronic Systemic Inflammation. «RМJ» [in Russian].2014; 11 : 811-821.URL:https:. www.rmj.ru/articles/aktualnaya_problema/Komorbidnosty_pri_HOBL_roly_hronicheskogo_sistemnogo_vospaleniya/?print_page = Y
Gabor ML, Lemko OI. Antioxidant defence, processes of lipid peroxidation and cytokine status at patients with chronic obstructive pulmonary disease. Ukr.Medical Almanaс [in Ukrainian]. 2010; 13(3):40-42.
Haysak MO, Lemko IS,Jakovenko NA,et al. Substantiation for non-invasive balneologic detoxication at chronic pathology of digestive organs. Bukovinian Medical Herald [in Ukrainian]. 2015; 19(1)(73): 30-33.
Gashynova KYu. Chronic obstructive pulmonary disease: prognosis and treatment optimization in accordance withlocal lesion and systemic manifestations.- The manuscript [in Ukrainian].Kyiv.2017 : 37 p.
Gerych PR. Сlinic-functional features of motion of cardio-respiratory pathology for patients with the chronic obstructive pulmonary disease. Bulletin of Problems of Bіology and Medicine [in Ukrainian]. 2017; 1(139)(4):121-127.
Digtiar NI, Gerasimenko ND, Savchenko LV, Racine MS. Low-grade systemic inflammation as a general framework of chronic obstructive pulmonary disease and comorbid conditions. Ukr.Pulmonol. J [in Russian]. 2016; 3 : 64-68.
Dziublyk OYa, Gumenyuk NI, Mhitaryan LS et al. Qualitative composition of blood lipoproteids in patients with inflammation of lower respiratory tract as a risk factor of atherosclerosis Ukr. Pulmonol. J [in Ukrainian]. 2017; 3 : 21-24.
Dychka LV, Lemko IS, Holubka OP, et al. Role of natural underground waters in the early prophylactics of metabolic disturbances.Collectionof scientific worksof staff membersof NMAPE [in Ukrainian].2016; 25 : 502-508.
Zhuravlyova ІV, Pylov DI. The value of the tumor necrosis factor-α and vaspin ratio in the development of insulin resistance.Problems of Endocrine Pathology.2019; 3 : 113-120.DOI: 10.21856/j-PEP.2019.3.15
Ivchuk VV, Kovalchuk TA. Оxidant and antioxidant system in chronic obstructive pulmonary disease occupational etiology. Medical and Cinical Chemistry [in Ukrainian]. 2019; 21(2): 61-67. DOI 10.11603/mcch.2410-681X.2019.v.i2.10295
Kovalenko VM, Bortkevych OP. Comorbidity: definition, possible ways to diagnostics and treatment. Ukr.J. of Rheumatology [in Ukrainian]. 2019;3(77):33-43.
Kolesnikova ОM, Krakhmalova OO. Influence of the tobacco smoking factor in the comorbid course of chronic obstructive pulmonary disease and ischemic heart disease. Ukr.Therapeutical J [in Russian].2018; 2 : 27-33. DOI:https:. doi.org/10.30978/UTJ2018-2-27
Krakhmalova OO, Samokhina LM, Kharchenko YuE. The antioxidant activity in patients with chronic obstructive pulmonary disease and ischemic heart disease. Ukr.Therapeutical J [in Russian]. 2018; 3-4 : 62-72. DOI:https:. doi.org/10.30978/UTJ2018-3-4-62
Krakhmalova OO, Tokarieva AY. Molecular-genetic aspects of copd: current view on the problem and prospects for the future. Ukr.Pulmonol. J [in Ukrainian]. 2019; 4 : 61-66.DOI: 10.31215/2306-4927-2019-106-4-61-66
Lemko IS,Jakovenko NA, Holubka OP et al.Investigation of the metabolic intoxication and peculiarities of its clinical-biochemical manifestation at chronic pathology of digestive organs. Laboratory Diagnostics [in Ukrainian].2013; 4(66): 11-16.
Lemko OI. Some aspects of etiology, pathogenesis and duration of the chronic obstructive pulmonary disease (Рart I). Scientific bulletinof Uzhhorod University: series Medicine [in Ukrainian]. 2012; 1(43): 180-189.
Lemko OI. Some aspects of etiology, pathogenesis and duration of the chronic obstructive pulmonary disease (Рart ІI). Scientific bulletinof Uzhhorod University: series Medicine [in Ukrainian]. 2013; 1(46): 197-207.
Lemko OI, Vantyukh NV. Endothelial dysfunction and its role in the pathogenesis of chronic obstructive pulmonary disease (Chapter I).Ukr.Therapeutical J [in Ukrainian].2017; 2 : 91-97.
Lemko OI, Vantyukh NV. Endothelial dysfunction and its role in the pathogenesis of chronic obstructive pulmonary disease (Chapter ІI).Ukr.Therapeutical J [in Ukrainian].2017; 3 : 71-77.
Lemko OI, Reshetar DV. Peculiarities of the cytokine status and inflammatory activity in patients with chronic obstructive pulmonary disease. Asthma and allergy [in Ukrainian].2012; 3 : 12-17.
Leonova EI, Adasheva TV, Zadionchenko VS. at al Clinical and functional status of patients with chronic obstructive pulmonary disease and atrial fibrillation. Russian Pulmonology [in Russian]. 2017; 27(6): 760-766. DOI: 10.18093/0869-0189-2017-27-6-760-766
Maksiv КhYa, Marushchak MI. Comborbidity of chronic obstructive lung disease with arterial hypertension: the state of the antioxidant defense system. Bulletin of Medical and Biological Research [in Ukrainian].2019;1 : 35-40. DOI 10.11603/bmbr.2706-6290.2019.1.10517
Mostovoy YM, Slepchenko NS, Dmytriiev KD, Sidorov AA. Chronic obstructive pulmonary disease and the heart: achievments and current questions. Ukr.Pulmonol. J [in Ukrainian]. 2018; 4 : 56-61.DOI:10.31215/2306-4927-2018-102-4-56-61
Nemtsova VD. Influence of hypothyroidism on the level of 8-hydroxy-2’-deoxyguanosine as a biomarker of oxidative damage in comorbid conditions. Ukr.Therapeutical J [in Ukrainian]. 2018; 3-4 : 56-61.
Pertseva TO, Konopkina LI, Yakovlieva VH. Prediction of violations of primary and secondary hemostasis in patients with chronic obstructive pulmonary disease. Asthma and Allergy [in Ukrainian].2018; 3 : 7-12.
Rasin MS, Kajdashev IP. The role of nuclear transcription factors in modern syntropy internal pathology (review) [in Russian].2014; 1(99):17-21.
Semidotska ZD, Chernyakova IA, Pionova OM, Tryfonova NS. Modern Aspects of Chronic Obstructive Pulmonary Disease. The East Europe J. of Internal and Family Medecine [in Ukrainian].2016; 2 : 4-12. DOI: 10.15407/internalmed2016.02.001.
Sova SG. Diseases of civilization: liver and polymorphic metabolic continuum. Ukr.Therapeutical J [in Ukrainian].2018; 2 : 91-103. DOI: http://doi.org/10.30978/UTJ2018-2-91
Titova ON, Kuzubova NA, Zolotnitskaya VP et al A role of endothelial dysfunction for development of microcirculation and cardiopulmonary blood flow abnormalities in patients with COPD and different alphaantitrypsin phenotypes. Russian Pulmonology [in Russian]. 2017; 27(1): 29-36.DOI: 10.18093/0869-0189-2017-27-1-29-36
Treumova SI, Petrov YeYe, Burmak YuG, Ivanyts’ka T. A. Chronic obstructive pulmonary disease and ischemic heart disease: the problems of comorbidity (literature review). Bulletin of Problems of Bіology and Medicine [in Ukrainian]. 2017; 3(141) (4): 66-70. DOI 10.29254/2077-4214-2017-4–3-141-66-72
Fadieienko GD, Nesen AO. Comorbidity and integration role of therapy of internal disease. Ukr.Therapeutical J [in Ukrainian].2015;2 : 7-15.
Feshchenko YI. Urgent Challenges of modern pulmonology. Ukr.Pulmonol. J [in Ukrainian]. 2018; 3 : 5-12. DOI: 10.31215/2306-4927-2018-101-3-5-12
Chernyshov VA. Obesity, diabetes mellitus and oncopathology: epidemiological and pathogenetic aspects. Ukr.Therapeutical J [in Russian]. 2018;3-4 : 86-95. DOI: http://doi.org/10.30978/UTJ2018-3-4-86
Yusupalieva ММ. Structure of co-morbid pathology in patients with chronic obstructive pulmonary disease at the stage of sanatorium-resort treatment. Tuberculosis, Lung Diseases, HIV Infection [in Ukrainian]. 2016;1(24):112-116.
Yakovleva OA, Masloiid TN, Scherbenuk NV, Klekot AA. The pathogenetic partners of the comorbidity of chronic obstructive pulmonary disease and cardiac pathology.Ukr.Therapeutical J [in Russian].2015;1 : 74-79.
Yatsyshyn RI, Kaminskyi VYa, Chernyuk NV, Gerych PR. Evolution of bronchial asthma phenotypes: from Th2-types to «omics»-technologies. Klinichna immunolohiia. Alerholohiia.Infektolohiia [in Ukrainian]. 2018;special issue1 : 12-18.
Adil M, Khan RA, Ghosh P et al. Piogitazone and risk of bladder cancer in type 2 diabetes mellitus patients: a systematic review and meta-analysis of observational studies using real world data. Clin Epidem Health. 2018;6:61-68. doi: https://doi.org/10.1016/j.cegh.2017.08.002.
Agca R, Heslinga SC, Rollefstad S et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint dicorders: 2015/2016 update. An of Rheumatic diseases. 2016;76(1):17-28. doi: www.dx.doi.org/10.1136/annrheumdis-2016-209775.
Agusti A, Carverley PM, Celli B et al. Characterisation of COPD heterogeneity in the ECLIPSE cohort. Respir Res. 2010;11:122.
Akash MS.H., Rehman K, Chen S. Role of inflammatory mechanisms in pathogenesis of type 2 diabetes mellitus. J Cell Biochem. 2013;114(3):525-531. doi: 10.1002/jcb.24402.
Ambrosino P, Lupoli R, Cafaro G et al. Subclinical carotid atherosclerosis in patients with chronic obstructive pulmonary disease: a meta-analysis of literature studies. Ann Med. 2017;49(6):513-524. doi: 10.1080/07853890.2017.1311022.
Antus B, Kardos Z. Oxidative stress in COPD: molecular background and clinical monitoring. Current Medicinal Chemistry. 2015;22(5):627-650. doi: 10.2174/092986732205150112104411.
Bathri R, Bose P, Gujar VS et al. The role of ROS in COPD progression and therapeutic strategies. Reactive Oxygen Species. 2017;4(10):237-250. doi: http://dx.doi.org/10.20455/ros.2017.837.
Bruno CM, Valenti M. Acid-Base Disorders in patients with chronic obstructive pulmonary disease: a pathophysiological review. Journal of Biomedicine and Biotechnology. 2012;2012. ID 915150. doi: 10.1155/2012/9151.
Caram LM, Ferrari R, Naves CR et al. Risk factors for cardiovascular disease in patients with COPD: mild-to-moderate COPD versus severe-to-very severe COPD. J Bras Pneumol. 2016;42(3):179-184. doi: doi.org/10.1590/S1806-37562015000000121.
Chen W, Thomas J, Sadatsafavi M, FitzGerald JM. Risc of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. The Lancet Respir Med. 2015;N 3 (8):631-639. doi: 10.1016/S2213-2600 (15)00241-6.
Choudhury G, MacNee W. Role of inflammation and oxidative stress in the pathology of ageing in COPD: potential therapeutic interventions. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2017;14(1):122-135. doi: 10.1080/15412555.2016.1214948.
Divo MJ, Casanova C, Marin JM et al. COPD comorbidities network. Eur Respir J. 2015;46(3):640-650. doi: 10.1183/09031936.00171614.
Dove RE, Leong-Smoth P, Roos-Engstrand E et al. Cigarette smoke — induced induction of antioxidant enzyme activities in airway leukocytes is absent in active smokers with COPD. Eur Clin Respir J. 2015;2:1-11. doi: 10.3402/ecrj.v2.27837.
Drake L.Y, Kita H. IL-33:Biological properties, function and roles in airway disease. Immunol Rev. 2017;278(1):173-184. doi: 10.1111/imr.12552.
Dursunoglu N, Dursunoglu D, Yidiz AI et al. Severity of coronary atherosclerosis in patients with COPD. Clin RespirJ. 2017;11(6):751-756. doi: 0.1111/crj.12412.
Echave-Sustaeta JM, Comeche Casanova L, Cosio BG et al. Comorbidity in chronic obstructive pulmonary disease. Related to disease severity?. Int J Cron Obstruct Pulmon Dis. 2014;9:1307-1314.
Ferri C. Strategies for reducing the risk of cardiovascular disease in patients with chronic obstructive pulmonary disease. High Blood Press Cardiovasc Prev. 2015;22(2):103-111. doi: 10.1007/s40292-015-0078-3.
Glass CK, Saijo K. Nuclear receptor transrepression pathways that regulate inflammation in macrophages and T cells. Nat Rev Immunol. 2010;N 10 (5):365-376. doi: 10.1038/nri2748.
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020. Update 2020. URL: https://goldcopd.org/wp-content/uploads/2019/11/GOLD-2020-REPORT-ver1.0wms.pdf.
Han MK, Quibrera PM, Carretta EE et al. Frequency of exacerbations in patients with chronic obstructive pulmonary disease: an analysis of the SPIROMICS cohort. The Lancet Respir Med. 2017;5(8):619-626. doi: https://doi.org/0.1016/S2213-2600 (17)30207-2.
Hitchings AW, Archer JR, Srivastava SA, Baker EH. Safety of metformin in patients with chronic obstructive pulmonary disease and type 2 diabetes mellitus. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2015;12:126-131. doi: 10.3109/15412555.2014.898052.
Imai Y, Dobrian AD, Weaver JR et al. Interaction between cytokines and inflammatory cells in islet dysfunction, insulin resistance and vascular disease. Diabetes Obes Metab. 2013;Suppl 3:117-129. doi: 10.1111/dom.12161.
Lamonaca P, Prinzi G, Kisialiou A et al. Metabolic disorder in chronic obstructive pulmonary disease (COPD) patients: towards a personalized approach using marine drug derivatives. MDPI. 2017;15(3):81-106. doi: 10.3390/md15030081.
Li J, Agarwal SK, Alonso A et al. Airflow obstruction, lung function, and incidence of atrial fibrillation the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2014;129(9):971-980. doi: 10.1161/CIRCULATIONAHA.113.004050.
Liao K.-M., Chen Ch. Yu. Incidence and risk factors of atrial fibrillation in Asian COPD patients. J Chron Obstruct Pulmon Dis. 2017;12:2523-2530. doi: 10.2147/COPD.S143691.
Liew FY, Girard JP, Turnquist HR. Interleukin-33 in health and disease. Nature Reviews Immunology. 2016;16:676-689. doi: 10.1038/nri.2016.95.
MacDonald MI, Shafuddin E, King PT et al. Cardiac dysfunction during exacerbations of chronic obstructive pulmonary disease. Lancet Respir Med. 2016;4(2):138-148. doi: 10.1016/S2213-2600 (15)00509-3.
Mannino DM, Higuchi K, Yu TC et al. Economic burden of COPD in the Presence of Comorbiditiens. Chest. 2015;148(1):138-150. doi: 10.1378/chest.14-2434.
Maricić L, Vceva A, Visević R et al.Assessment of endothelial dysfunction by measuring von Willebrand factor and exhaled nitric oxide in patients with chronic obstructive pulmonary disease. Coll Antropol. 2013;37(4):1153-1160.
Miłkowska-Dymanowska J, Białas AJ, Zalewska-Janowska A et al. Underrecognized comorbidities of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2015;10:1331-1341. doi: 10.2147/COPD.S82420.
Miravittles M, Price D, Rabe KF et al. Comorbidities of patients in tiotropium clinical trials: comparison with observational studies of patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2015;10:549-564. doi: 10.2147/COPD.S71913.
Naviaux RK. Metabolic features and regulation of the healing cycle-A new model for chronic disease pathogenesis and treatment. Mitochondrion. 2019;46:278-297. doi: 10.1016/j.mito.2018.08.001.
Nazara Otero CA, Baloira Villar A. The continuum of COPD and cardiovascular risk: A global scenario of desease. Clin Ibvestig Arterioscler. 2015;27(3):144-147. doi: 10.1016/j.arteri.2014.09.003.
Papaioannou AI. MaziotiA., KiropoulosT. et al. Systemic and airway inflammation and the presence of emphysema in patients with COPD. Respir Med. 2010;104(2):275-282. doi: 10.1016/j.rmed.2009.09.016.
Papaioannou O, Karampitsakos T, Barbayianni I et al. Metabolic disorders in chronic lung diseases. Front Med. 2018;4. Article 246. doi: https://doi.org/10.3389/fmed.2017.00246.
Pawluk H, Pawluk R, Robaczewska J et al. Biomarkers of antioxidant status and lipid peroxidation in elderly patients with hypertension. Redox Report. 2017;22(6):542-546. doi: 10.1080/13510002.2017.1372072.
Raherison Ch., Ouaalaya El H, Bernady A et al. Comorbidities and COPD severity in a clinic-based cohort. BMC Pulmonary Medicine. 2018;18:117-127. doi: 10.1186/s12890-018-0684.
Sabit R, Thomas P, Shale DJ et al. The effects of hypoxia on markers of coagulation and systemic inflammation in patients with COPD. Chest. 2010;138:47-51. doi: 10.1378/chest.09-2764.
Singh SK, Verma S, Kumar MK et al. Evaluation of oxidative stress and antioxidant status in chronic obstructive pulmonary diseases. Dixit Scandinavian Journal of Immunology. 2017;85(2):130-137. doi: 10.1111/sji.12498.
Uhlig K, Leff B, Kent D et al. A frame work for crafting clinical practice guidelines that are relevant to the care and management of people with multimorbidity. J Gen Intern Med. 2014;29(4):670-679. doi: 10.1007/s11606-013-2659-y.
Vanfleteren LE, Spruit MA, Groenen M et al. Clusters of comorbidities based on validated objective measurements and systemic inflammation in patients with chronic obstructive pulmonary disease. Am J Respir. Crit Care. Med. 2013;187(7):728-735. doi: 10.1164/rccm.201209-1665OC.
Weiss CO, Varadhan R, Puhan MA et al. Multimorbidity and evidence generation. J Gen Intern Med. 2014;29(4):653-660. doi: 10.1007/s11606-013-2660-5.
Yin H, Yin S, Lin Q et al. Prevalence of comorbidities in chronic obstructive pulmonary disease patients: A meta-analysis. Medicine (Baltimore). 2017;96 (19). e6836. doi: http://dx.doi.org/10.1097/MD.0000000000006836.
Yo CH, Lee SH, Chang SS et al. Value of high-sensitivity C-reactive protein assays in predicting atrial fibrillation recurrence: a systematic review and meta-analysis. Br Med J Open. 2014;4(2). e004418. doi: 10.1136/bmjopen2013-004418.
