COPD: balancing oxidants and antioxidants

• Published in: International journal of chronic obstructive pulmonary disease 2015-01, Vol.10 (Issue 1), p.261-276
• Main Authors: Fischer, Bernard M, Voynow, Judith A, Ghio, Andrew J
• Format: Article
• Language: English
• Subjects: Airway management; Animals; Antioxidants; Antioxidants - metabolism; Antioxidants - therapeutic use; Care and treatment; Chronic obstructive pulmonary disease; Cigarettes; Development and progression; Disease susceptibility; Environmental aspects; Epigenesis, Genetic; Free radicals; Gases; Gene expression; Gene Expression Regulation; Gene-Environment Interaction; Health aspects; Humans; Inflammation; Lavage; Lipid peroxidation; Lipids; Lung - metabolism; Lung - physiopathology; Lung diseases, Obstructive; Lungs; Mucins - genetics; Mucins - metabolism; Neutrophils; Nitrogen dioxide; Oxidants - metabolism; Oxidation; Oxidative stress; Oxidative Stress - drug effects; Proteins; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - etiology; Pulmonary Disease, Chronic Obstructive - genetics; Pulmonary Disease, Chronic Obstructive - metabolism; Pulmonary Disease, Chronic Obstructive - physiopathology; Review; Risk Factors; Smoking; Smoking - adverse effects; Smoking - metabolism; Tobacco smoke; Vitamin E
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S42414

Chronic obstructive pulmonary disease (COPD) is one of the most common chronic illnesses in the world. The disease encompasses emphysema, chronic bronchitis, and small airway obstruction and can be caused by environmental exposures, primarily cigarette smoking. Since only a small subset of smokers develop COPD, it is believed that host factors interact with the environment to increase the propensity to develop disease. The major pathogenic factors causing disease include infection and inflammation, protease and antiprotease imbalance, and oxidative stress overwhelming antioxidant defenses. In this review, we will discuss the major environmental and host sources for oxidative stress; discuss how oxidative stress regulates chronic bronchitis; review the latest information on genetic predisposition to COPD, specifically focusing on oxidant/antioxidant imbalance; and review future antioxidant therapeutic options for COPD. The complexity of COPD will necessitate a multi-target therapeutic approach. It is likely that antioxidant supplementation and dietary antioxidants will have a place in these future combination therapies.