Department of Biomedical Sciences, School of Medicine, University of Sassari, 07100 Sassari, Italy.
Department of Clinical and Experimental Medicine, School of Medicine, University of Sassari, 07100 Sassari, Italy.
Molecules. 2021 Mar 12;26(6):1572. doi: 10.3390/molecules26061572.
This study aimed to review and critically appraise the current methodological issues undermining the suitability of the measurement of serum/plasma glutathione, both in the total and reduced form, as a measure of systemic oxidative stress in chronic obstructive pulmonary disease (COPD). Fourteen relevant articles published between 2001 and 2020, in 2003 subjects, 1111 COPD patients, and 892 controls, were reviewed. Nine studies, in 902 COPD patients and 660 controls, measured glutathione (GSH) in the reduced form (rGSH), while the remaining five, in 209 COPD patients and 232 controls, measured total GSH (tGSH). In the control group, tGSH ranged between 5.7 and 7.5 µmol/L, whilst in COPD patients, it ranged between 4.5 and 7.4 µmol/L. The mean tGSH was 6.6 ± 0.9 µmol/L in controls and 5.9 ± 1.4 µmol/L in patients. The concentrations of rGSH in the control group showed a wide range, between 0.47 and 415 µmol/L, and a mean value of 71.9 ± 143.1 µmol/L. Similarly, the concentrations of rGSH in COPD patients ranged between 0.49 and 279 µmol/L, with a mean value of 49.9 ± 95.9 µmol/L. Pooled tGSH concentrations were not significantly different between patients and controls (standard mean difference (SMD) = -1.92, 95% CI -1582 to 0.0219; = 0.057). Depending on whether the mean concentrations of rGSH in controls were within the accepted normal range of 0.5-5.0 µmol/L, pooled rGSH concentrations showed either a significant (SMD = -3.8, 95% CI -2.266 to -0.709; < 0.0001) or nonsignificant (SMD = -0.712, 95% CI -0.627 to 0.293; = 0.48) difference. These results illustrate the existing and largely unaddressed methodological issues in the interpretation of the serum/plasma concentrations of tGSH and rGSH in COPD.
本研究旨在综述和批判性评价目前存在的方法学问题，这些问题削弱了血清/血浆谷胱甘肽（无论是还原型还是总形式）作为慢性阻塞性肺疾病（COPD）系统氧化应激指标的适用性。我们共查阅了 2001 年至 2020 年间发表的 14 篇相关文献，涉及 2003 名受试者、1111 名 COPD 患者和 892 名对照者。其中 9 项研究（涉及 902 名 COPD 患者和 660 名对照者）检测了还原型谷胱甘肽（rGSH），而其余 5 项研究（涉及 209 名 COPD 患者和 232 名对照者）检测了总谷胱甘肽（tGSH）。在对照组中，tGSH 范围为 5.7 至 7.5µmol/L，而在 COPD 患者中，tGSH 范围为 4.5 至 7.4µmol/L。对照组的平均 tGSH 为 6.6 ± 0.9µmol/L，患者组为 5.9 ± 1.4µmol/L。对照组 rGSH 浓度范围很宽，为 0.47 至 415µmol/L，平均浓度为 71.9 ± 143.1µmol/L。同样，COPD 患者的 rGSH 浓度范围为 0.49 至 279µmol/L，平均浓度为 49.9 ± 95.9µmol/L。患者与对照组的 tGSH 浓度的汇总差异无统计学意义（标准均数差（SMD）=-1.92，95%CI-1582 至 0.0219； = 0.057）。根据对照组 rGSH 平均浓度是否在 0.5-5.0µmol/L 的可接受正常范围内，汇总 rGSH 浓度显示出显著（SMD=-3.8，95%CI-2.266 至-0.709； < 0.0001）或无显著（SMD=-0.712，95%CI-0.627 至 0.293； = 0.48）差异。这些结果说明了目前在 COPD 患者中解释血清/血浆 tGSH 和 rGSH 浓度时存在且尚未解决的方法学问题。
