From the Department of General Thoracic Surgery and Lung Transplantation; University of Health Sciences, Ankara, Turkey.
Exp Clin Transplant. 2023 Jun;21(6):526-533. doi: 10.6002/ect.2022.0003. Epub 2022 Jul 22.
Oxidative stress developing due to oxidant/antioxidant imbalance plays a crucial role in the etiopathogenesis of chronic progressive lung diseases.The condition is typically more severe in lung transplant candidates with end-stage lung disease. Here, we investigated dynamic thiol-disulfide homeostasis as a marker for oxidative stress in lung transplant candidates.
The study included 40 patients with end-stage lung disease with indications for lung transplant (candidate group) and 40 healthy controls. Patient demographic data, laboratory results, and thiol-disulfide homeostasis values were recorded. We categorized patients according to their primary diseases and noted clinical measurements of forced expiratory volume in 1 second, forced vital capacity, 6-minute walk test, systolic pulmonary artery pressure, and lung allocation scores.Thiol-disulfide homeostasis parameters were compared before and after transplant.
Demographic characteristics were similar in the candidate and control groups. In the candidate group, native thiol and total thiol levels (antioxidant parameters of thiol-disulfide homeostasis) were significantly lower, whereas disulfide-to-native thiol and disulfide-to-total thiol ratios (oxidant parameters of thiol-disulfide homeostasis) were significantly higher. We observed no significant differences between the disease subgroups in terms of thioldisulfide homeostasis parameters. Moderately significant correlations were shown between the antioxidant markers ofthiol-disulfide homeostasis and the clinical measurements, including the lung allocation scores. Our multiple regression analyses showed that native thiol and total thiol were significant predictive factors to estimate the lung allocation score. During the study period, 6 patients (15%)received lung transplant. There were significant differences in antioxidant parameters ofthiol-disulfide homeostasis in the pre- versus posttransplant periods.
In patients with end-stage lung disease, the dynamic thiol-disulfide homeostasis status is altered in favor of oxidants. Thus, thiol-disulfide homeostasis parameters can be used to detect oxidative stress and estimate lung allocation scores in these patients. Lung transplant may have positive effects on oxidative stress.
由于氧化剂/抗氧化剂失衡导致的氧化应激在慢性进行性肺部疾病的发病机制中起着关键作用。在患有终末期肺部疾病的肺移植候选者中，这种情况通常更为严重。在这里，我们研究了作为肺移植候选者氧化应激标志物的动态硫醇-二硫键动态平衡。
该研究纳入了 40 名有肺移植适应证的终末期肺病患者（候选组）和 40 名健康对照者。记录患者的人口统计学数据、实验室结果和硫醇-二硫键动态平衡值。我们根据主要疾病对患者进行分类，并记录用力呼气量 1 秒、用力肺活量、6 分钟步行试验、收缩压肺动脉压和肺分配评分的临床测量值。比较移植前后硫醇-二硫键动态平衡参数。
候选组和对照组的人口统计学特征相似。在候选组中，天然硫醇和总硫醇水平（硫醇-二硫键动态平衡的抗氧化参数）显著降低，而二硫键与天然硫醇和二硫键与总硫醇的比值（硫醇-二硫键动态平衡的氧化参数）显著升高。我们没有观察到疾病亚组之间硫醇-二硫键动态平衡参数有显著差异。硫醇-二硫键动态平衡的抗氧化标志物与临床测量值（包括肺分配评分）之间存在中度显著相关性。我们的多元回归分析显示，天然硫醇和总硫醇是估计肺分配评分的显著预测因素。在研究期间，有 6 名患者（15%）接受了肺移植。移植前后硫醇-二硫键动态平衡的抗氧化参数有显著差异。
在终末期肺病患者中，动态硫醇-二硫键动态平衡状态有利于氧化剂。因此，硫醇-二硫键动态平衡参数可用于检测这些患者的氧化应激并估计肺分配评分。肺移植可能对氧化应激有积极影响。
