Malondialdehyde level in chronic obstructive pulmonary disease exacerbations

Chronic obstructive pulmonary disease (COPD) exacerbations are associated with increased inflammation followed by oxidative stress (OS). Malondialdehyde (MDA) negatively correlation with PFT was demonstrated (Upasana J. et al. ERJ vol. 44 no. Suppl 58 P3958) In patients who survive their first COPD-related hospitalization up to 50% have been reported for re-admission within 6 months of discharge. Up to 84% of direct costs associated with COPD are due to inpatient hospitalizations. Aim: Relationships between exacerbation recoveries, and Malondialdehyde as an indicator of oxidative stress have been studied. Methods: The case-control study took place at P. Stradins Clinical hospital, Riga, Latvia. Spirometry data was obtained, also C-reactive protein, WBC counts, MDA serum level was measured in 19 COPD patients when at exacerbation (on admission), at 14 and 30 days post-exacerbation. Recurrent exacerbation was followed up during 60 days. Results: The MDA level was correlated with CRP levels and WBCcount (P=0.000; P=0.0001, respectively) during exacerbations. Those patients (n=12) who had recurrent exacerbations within 60 days had significantly higher levels of serum MDA at day 14 and 30, compared with those without recurrences (n=7): 3.48 mkM versus 1.75 mkM accordingly. No correlation between MDA level and spirometry data was revealed. Conclusions: Persistently heightened systemic inflammation followed by OS seems to support COPD exacerbation. A high serum MDA 14 day after may be used as a predictor of recurrent exacerbations within 60 days.