The oxidative-antioxidative status in patients with bronchial asthma in inhaled and systemic glucocorticoid therapy

Aim. To study the oxidative-antioxidative status in patients with bronchial asthma (BA) and its changes in response to treatment with account for the method of glucocorticoid therapy (GT). Material and methods. A total of 40 patients with moderate bronchial asthma (BA) of mixed type were randomized into 2 groups by the method of GT. The patients of Group 1 received oral prednisolone for 20 days, beginning with a dose of 20 mg/day, those of Group 2 also inhaled benacort (400 ng twice a day) for 20 days. Admission and discharge measurements were made of overall plasma oxidative activity (OOA) and concentration of thiobarbiturate-reactive products (TBRP); overall antioxidant activity (ОАОA), the activity of superoxidedismutase (SOD), catalase and glutathione peroxidase (GP) in the red cells. The control group consisted of 20 healthy subjects. Results. In acute active BA, plasma OOA and TBRP levels were high (p < 0.001) while antioxidant defense in the red cells was suppressed: OAOA by 22% (p < 0.05), SOD activity by 41% (p < 0.001), catalase activity by 15% (p < 0.05) and GP by 44% (p < 0.01). GT in Group 1 resulted in clinical improvement associated with low production of free radicals, suppression of intracellular antioxidant defense, in Group 2 clinical improvement was not associated with changes in the oxidative-antioxidative status of BA patients.
Conclusion. BA patients have a marked imbalance between production of active oxygen forms and activity of intracellular antioxidant enzymes. This evidences for low adaptive and defense processes leading to the oxidative stress which is one of the leading links in BA pathogenesis. Oral GT reduced extracellular oxidative status, inhibited activity of intracellular antioxidative enzymes. Inhalation GT had no negative systemic action on antioxidant enzymes.

bronchial asthma, glucocorticoids, antioxidants