Еndothelial dysfunction in patients with chronic obstructive pulmonary disease: feasibility of non-medicamental treatment (literature review and personal experience)
DOI:
https://doi.org/10.14739/2310-1210.2021.5.222384Keywords:
chronic obstructive pulmonary disease, endothelial dysfunction, haloaerosoltherapyAbstract
The aim of the work was to study the feasibility of the use of non-medicamental factors for the correction of endothelial dysfunction in patients with chronic obstructive pulmonary disease.
Results. Chronic obstructive pulmonary disease (COPD) is considered as a systemic disease, one of the pathogenetic components of which is endothelial dysfunction (ED), which contributes to the development of comorbid cardiovascular pathology. At the same time, the basic treatment of patients with COPD includes drugs that may adversely influence it, and some medicines for the cardiac pathology treatment can increase the bronchial obstruction. Therefore, a question of non-medicamental methods of ED correction is actual, especially beyond the acute period of the disease. Methods of hardware physiotherapy, including ozone therapy, singlet oxygen therapy and its combination with magnetic therapy, low-intensity laser radiation, ultrasound therapy, a combination of laser therapy with balneotherapy, are widely employed. These methods have antioxidant, bronchodilating and anti-inflammatory effects, promote improvement of hemodynamics, as well as rheological properties of blood and microcirculation. Interval hypoxic therapy is also used, because in response to the hypoxic stimulation, the mechanisms of the respiratory system regulation, gas exchange and blood circulation are activated.
It is also promising to use haloaerosoltherapy (HAT), which due to the increase of bronchs drainage function and sanitizing effect leads to the inhibition of local inflammation, improves ventilation and gas exchange, and reduces the intensity of oxidative stress, which promotes decrease of systemic inflammation and ED, associated with it. Particularly, this effect is manifested by lowering of edothelin-1 level and the expression of adhesion molecules by lymphocytes (CD54+).
Conclusions. The analysis shows that the inclusion of methods with non-medicamental influence on the endothelium can significantly increase the effectiveness of complex treatment of patients with COPD, without increasing the medicinal load on the organism, which helps to avoid undesirable side effects. The use of HAT in the rehabilitation treatment of COPD patients contributes not only to decreasing the activity of local and systemic inflammatory processes, but also is accompanied by a certain correction of ED. However, specific recommendations for the use of certain non-medicamental effects in the complex rehabilitation treatment of patients with COPD, taking into account the presence of ED, have not been developed.
References
Wouters, E., & Franssen, F. M. (2019). Chronic Obstructive Pulmonary Disease: Shifting the Paradigm to the Vasculature. American Journal of Respiratory and Critical Care Medicine, 199(3), 258-259. https://doi.org/10.1164/rccm.201808-1542ED
Global Initiative for Chronic Obstructive Lung Disease. (2020). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2020 REPORT. GOLD COPD. https://goldcopd.org/gold-reports/
Karoli, N. A., & Rebrov, A. P. (2019). Markery disfunktsii endoteliya u bol'nykh khronicheskoi obstruktivnoi bolezn'yu legkikh i ishemicheskoi bolezn'yu serdtsa [Endothelial dysfunction in patients with chronic obstructive pulmonary disease in combination with coronary heart disease]. Terapevticheskii arkhiv, 91(3), 22-26. https://doi.org/10.26442/00403660.2019.03.000061 [in Russian].
Ni, L., & Dong, C. (2018). Roles of Myeloid and Lymphoid Cells in the Pathogenesis of Chronic Obstructive Pulmonary Disease. Frontiers in Immunology, 9, Article 1431. https://doi.org/10.3389/fimmu.2018.01431
Szucs, B., Szucs, C., Petrekanits, M., & Varga, J. T. (2019). Molecular Characteristics and Treatment of Endothelial Dysfunction in Patients with COPD: A Review Article. International Journal of Molecular Sciences, 20(18), Article 4329. https://doi.org/10.3390/ijms20184329
Lemko, O. I., & Vantyukh, N. V. (2017). Endotelialna dysfunktsiia ta yii mistse v patohenezi khronichnoho obstruktyvnoho zakhvoriuvannia lehen (Chastyna I). [Endothelial dysfunction and its role in the pathogenesis of chronic obstructive pulmonary disease (Chapter I)]. Ukrainskyi terapevtychnyi zhurnal, (2), 91-97. [in Ukrainian].
Vaes, A. W., Spruit, M. A., Theunis, J., Goswami, N., Vanfleteren, L. E., Franssen, F., Wouters, E., & De Boever, P. (2017). Endothelial function in patients with chronic obstructive pulmonary disease: a systematic review of studies using flow mediated dilatation. Expert Review of Respiratory Medicine, 11(12), 1021-1031. https://doi.org/10.1080/17476348.2017.1389277
Ambrosino, P., Lupoli, R., Iervolino, S., De Felice, A., Pappone, N., Storino, A., & Di Minno, M. (2017). Clinical assessment of endothelial function in patients with chronic obstructive pulmonary disease: a systematic review with meta-analysis. Internal and Emergency Medicine, 12(6), 877-885. https://doi.org/10.1007/s11739-017-1690-0
Budnevskiy, A. V., Chernov, A. V., Isaeva, Ya. V., & Malysh, E. Yu. (2015). Klinicheskaya effektivnost' primeneniya kompleksnoi programmy legochnoi reabilitatsii u bol'nykh khronicheskoi obstruktivnoi bolezn'yu legkikh v sochetanii s metabolicheskim sindromom [Сlinical efficacy of pulmonary rehabilitation program in patients with chronic obstructive pulmonary disease and metabolic syndrome]. Pul'monologiya, 25(4), 447-455. https://doi.org/10.18093/0869-0189-2015-25-4-447-455 [in Russian].
Polverino, F., Celli, B. R., & Owen, C. A. (2018). COPD as an endothelial disorder: endothelial injury linking lesions in the lungs and other organs? (2017 Grover Conference Series). Pulmonary Circulation, 8(1), Article 2045894018758528. https://doi.org/10.1177/2045894018758528
Vatutin, N. T., & Smirnova, A. S. (2016). Komorbidnost' KhOBL i serdechno-sosudistoi patologii: osobennosti lecheniya [Treatment of comorbid chronic obstructive pulmonary disease and cardiovascular disease]. Pul'monologiya, 26(3), 364-371. https://doi.org/10.18093/0869-0189-2016-26-3-364-371 [in Russian].
Rodriguez-Miguelez, P., Gregg, J., Seigler, N., Bass, L., Thomas, J., Pollock, J. S., Sullivan, J. C., Dillard, T. A., & Harris, R. A. (2018). Acute tetrahydrobiopterin improves endothelial function in patients with COPD. Chest, 154(3), 597-606. https://doi.org/10.1016/j.chest.2018.04.028
Asanov, E. O., Dyba, I. A., Osmak, E. D., & Polyagushko, L. G. (2016). Ventilyatsiya legkikh i legochnyi gazoobmen u bol'nykh pozhilogo vozrasta s KhOZL: vliyanie gipoksicheskikh trenirovok [Ventilation and pulmonary gas exchange in olderly patients with COPD: influence of hypoxic training]. Ukrainskyi pulmonolohichnyi zhurnal, (3), 35-38. http://www.ifp.kiev.ua/doc/journals/upj/16/pdf16-3/35.pdf [in Russian].
Dimitrova, A., Izov, N., Maznev, I., Vasileva, D., & Nikolova, M. (2017). Physiotherapy in Patients with Chronic Obstructive Pulmonary Disease. Open Access Macedonian Journal of Medical Sciences, 5(6), 720-723. https://doi.org/10.3889/oamjms.2017.176
Sycheva, M. G. (2018). Fizicheskaya reabilitatsiya bol'nykh khronicheskimi respiratornymi zabolevaniyami: optimal'naya organizatsiya pri ogranichennykh resursakh [Physical rehabilitation of patients with chronic respiratory diseases: the optimal organization under limited resources]. Pul'monologiya, 28(1), 110-117. https://doi.org/10.18093/0869-0189-2018-28-1-110-117 [in Russian].
Merlo, C., Bernardi, E., Bellotti, F., Pomidori, L., & Cogo, A. (2020). Supervised exercise training improves endothelial function in COPD patients: a method to reduce cardiovascular risk? ERJ Open Research, 6(2), Article 00304-2019. https://doi.org/10.1183/23120541.00304-2019
Aldabayan, Y. S., Ridsdale, H. A., Alrajeh, A. M., Aldhahir, A. M., Lemson, A., Alqahtani, J. S., Brown, J. S., & Hurst, J. R. (2019). Pulmonary rehabilitation, physical activity and aortic stiffness in COPD. Respiratory Research, 20(1), Article 166. https://doi.org/10.1186/s12931-019-1135-6
Alyavi, A. L., Rahimova, D. A., & Sabirzhanova, Z. T. (2017). Rannyaya diagnostika i adekvatnoe lechenie bol'nykh s legochnym sertsem [Early diagnosis and adequate treatment of patients with cor pulmonale]. Ukrainskyi terapevtychnyi zhurnal, (1), 27-32. [in Russian].
Chukhraiev, N., Chukhraieva, E., Gun’ko, M., Kurik, L., Lomeiko, S., Marushko, Y., Samosyuk, N., Tkalina, A., Vladimirov, A., Unichenko, A., Zavorotnaya, R., & Zukow, W. (2018). Singlet-oxygen therapy (N. Chukhraiev, A. Vladimirov, W. Zukow, Eds.). Radom. https://doi.org/10.5281/zenodo.1161333
Barak, O. F., Mladinov, S., Hoiland, R. L., Tremblay, J. C., Thom, S. R., Yang, M., Mijacika, T., & Dujic, Z. (2017). Disturbed blood flow worsens endothelial dysfunction in moderate-severe chronic obstructive pulmonary disease. Scientific Reports, 7(1), Article 16929. https://doi.org/10.1038/s41598-017-17249-6
Nikitin, V. A., Vasil’eva, L. V., Karpukhina, E. P., & Popov, A. V. (2019). Otsenka effektivnosti lazerno-ul'trazvukovoi terapii v kompleksnom lecheniii khronicheskoi obstruktivnoi bolezni legkikh s soputstvuyushchei arterial'noi gipertenziei [Efficacy of laser and ultrasonic therapy in patients with chronic obstructive pulmonary disease and hypertension comorbidity]. Pul'monologiya, 29(1), 43-51. https://doi.org/10.18093/0869-0189-2019-29-1-43-51 [in Russian].
Mehani, S. (2017). Immunomodulatory effects of two different physical therapy modalities in patients with chronic obstructive pulmonary disease. Journal of Physical Therapy Science, 29(9), 1527-1533. https://doi.org/10.1589/jpts.29.1527
Sayed, M. A., El-Sherif, R. M., Mohamed, A. R., & El-Sherif, A. A. (2018). Low-level laser therapy in chronic obstructive lung disease. Egyptian Journal of Bronchology, 12(3), 317-322 https://doi.org/10.4103/ejb.ejb_110_17
Fiodorov, S. M. (2016). Suchasni pohliady na mahnitolazernu i fotomahnitnu terapiiu ta yikh zastosuvannia v nevrolohichnii praktytsi [The modern concept of magnetic-laser and photomagnetic therapy and its use in neurological practice]. Fotobiolohiia ta fotomedytsyna, 12(1-2), 38-50. [in Ukrainian].
Samosiuk, I., Chukhraeva, E., Samosiuk, N., & Zukow, W. (2012). Low-intensity physical factors in the treatment of and medical rehabilitation of patients with type 2 diabetes and their effects on lipid metabolism. Journal of Health Science, 2, 27-37. https://www.semanticscholar.org/paper/Low-intensity-physical-factors-in-the-treatment-of-Samosiuk-Chukhraeva/afd6cd5313cb3a4a4878c52e756b84034c436f47#paper-header
Pobedennaya, L. P., & Chumak, Yu. Yu. (2012). Mekhanizmy regulyatsii bronkhial'noi prokhodimosti u bol'nykh bronkhial'noi astmoi [Mechanisms of bronchial patency regulation in patients with bronchial asthma]. Ukrainskyi pulmonolohichnyi zhurnal, (2), 67-71. [in Russian].
Uyanaeva, A. I., Airapetova, N. S., Badalov, N. G., Tupitsina, Yu. Yu., L’vova, N. V., Nitchenko, O. V., Uyanaeva, M. A., & Ksenofontova, I. V. (2015). Fiziobal'neoterapiya v profilaktike pogodoobuslovlennykh obostrenii u bol'nykh s khronicheskoi obstruktivnoi bolezn'yu legkikh [The role of physiobalneotherapy in the prevention of weather-dependent exacerbations in the patients presenting with chronic obstructive pulmonary disease]. Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul'tury, 92(6), 17-22. https://doi.org/10.17116/kurort2015617-22 [in Russian].
Lemko, O. I. (2011). Kliniko-patohenetychne obgruntuvannia pryntsypiv haloaerozolterapii ta imunoreabilitatsii u vidnovliuvalnomu likuvanni khvorykh na khronichne obstruktyvne zakhvoriuvannia lehen. (Avtoref. dis. … dokt. med. nauk). [Clinical-pathogenic substantiation of haloaerosoltherapy and immunorehabilitation principles in the rehabilitation of chronic obstructive pulmonary disease patients]. (Extended abstract of doctoral thesis). Yalta. [in Ukranian].
Gabor, M. L., & Lemko, O. I. (2010). Stan antyoksydantnoho zakhystu, protsesy perekysnoho okyslennia lipidiv ta tsytokinovyi status u khvorykh na khronichne obstruktyvne zakhvoriuvannia lehen [Antioxidant defense, lipids’ peroxidation and cytokin status at patients with chronic obstructive pulmonary disease]. Ukrainskyi medychnyi almanakh, 13(3), 40-42. [in Ukrainian].
Lemko, O. I., Reshetar, D. V., Vantiukh, N. V., & Kopynets, I. I. (2018). Haloaerozolterapiia pry khronichnomu obstruktyvnomu zakhvoriuvanni lehen: osoblyvosti likuvalnoho vplyvu [Haloaerosoltherapy in chronic obstructive pulmonary disease: the features of therapeutic effect]. Astma ta alerhiia, (2), 34-36. [in Ukrainian].
Lemko, O. I., & Vantiukh, N. V. (2010). Vplyv haloaerozolterapii na klitynnyi imunitet ta protsesy apoptozu limfotsytiv u khvorykh na khronichne obstruktyvne zakhvoriuvannia lehen [The influence of haloaerosoltherapy on cellular immunity and lymphocyte apoptosis in patients with chronic obstructive pulmonary disease]. Medychna reabilitatsiia, kurortolohiia, fizioterapiia, (3), 7-10. [in Ukrainian].
Bychkova, N. G., & Bychkova, S. A. (2015). Imunnyi status khvorykh na khronichne obstruktyvne zakhvoriuvannia lehen, poiednane iz khronichnoiu khvoroboiu nyrok ta metabolichnymy rozladamy [Immune status of patients with chronic obstructive pulmonary disease, accompanied with chronic kidney disease and metabolic disturbances]. Ukrainskyi zhurnal nefrolohii ta dializu, (1), 8-13. [in Ukrainian].
Lemko, O. I., & Vantyukh, N. V. (2017). Endotelialna dysfunktsiia ta yii mistse v patohenezi khronichnoho obstruktyvnoho zakhvoriuvannia lehen. Chastyna II [Endothelial dysfunction and its role in the patogenesis of chronic obstructive pulmonary disease. Сhapter IІ]. Ukrainskyi terapevtychnyi zhurnal, (3), 71-77. [in Ukranian].
Malyarska, N. V., & Kalinichenko, M. A. (2017). Endotelialna dysfunktsiia yak universalnyi predyktor rozvytku sertsevo-sudynnoi patolohii ta mozhlyvosti yii korektsii v praktytsi simeinoho likaria [Endothelial dysfunction as a universal predictor of cardiovascular disease and the possibility of its correction in the family doctor’s practice]. Liky Ukrainy, (1), 38-41. [in Ukrainian].
Tao, Z., Jin, W., Ao, M., Zhai, S., Xu, H., & Yu, L. (2019). Evaluation of the anti-inflammatory properties of the active constituents in Ginkgo biloba for the treatment of pulmonary diseases. Food & Function, 10(4), 2209-2220. https://doi.org/10.1039/c8fo02506a
Qiu, J., Guo, Y., Xu, X., Yue, H., & Yang, Y. (2020). Ginkgo leaf extract and dipyridamole injection for chronic cor pulmonale: a PRISMA-compliant meta-analysis of randomized controlled trials. Bioscience Reports, 40(3), Article BSR20200099. https://doi.org/10.1042/BSR20200099
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
