The еndothelial dysfunction in smoker and ex-smoker patients with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is one of the leading health problems worldwide and continues to be a major cause of morbidity and mortality in developed countries. Vascular endothelial dysfunction is a characteristic pathological finding of COPD at different stages of the disease. As the most important risk factor of COPD, cigarette smoking may initiate vascular impairment through direct injury of endothelial cells or release of inflammatory mediators. Components of cigarette smoke stimulate adhesion molecule expression and leukocyte adhesion to endothelium cells. The purpose of this work is to find out the role of systemic endothelial dysfunction in patients with COPD.<br />
The plasma levels of sVCAM-1 were quantified by enzyme-linked immunosorbent assay (ELISA) in 34 age-matched (57±6.8 years): 1 - current smokers (n=13), 2 - ex-smoker (n=11) patients with COPD, and 3 - non-smoker patients with bronchial asthma (n=10). Also we analyzed such indices as FEV1 % predicted, FEV1/FVC, % predicted and reversibility of airflow obstruction, %. The level of sVCAM-1 was higher in smokers 19.2±4.8 ng/ml in comparing with ex-smokers 14.8±2.8 ng/ml and non-smokers with bronchial asthma 14.2±5.1 ng/ml, (p<0.05). The degree of FEV1, % predicted was lower in smoker patients with COPD (48.3±18.8 %) than in ex-smoker patients with COPD (66.2±20.4, p=0,02) and patients with bronchial asthma (73.6±5.4, p<0,001). The extent of FEV1/FVC, % predicted was higher in patients with bronchial asthma (79.5±11.9, p<0.001) in compared with smoker (55.8±14.9, p<0.001) and ex-smoker patients (63.09±9.9, p=0.003) with COPD. The reversibility of airflow obstruction was significant higher in patients with bronchial asthma (16.3±2.8 %) in comparing with smokers (5.2±3.8 %) and ex-smokers (7.1±4.2 %) patients with COPD (p<0.05). Also we found correlation between the age and level of sVCAM-1 was correlated (r=0.467, p<0.05). We can not reject hypothesis that there is reversibility of ED after smoking cessation because the level of sVCAM-1 is decreasing in ex-smoker patients with COPD. The mechanism of endothelial dysfunction in COPD is not fully understood and studying of it is necessary for developing new strategies for the pharmacological therapy of patients with COPD.

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