Endothelial dysfunction in patients with chronic obstructive pulmonary disease: some aspects of medicamental treatment (a literature review)
DOI:
https://doi.org/10.14739/2310-1210.2021.1.224944Keywords:
chronic obstructive pulmonary disease, endothelial dysfunction, drug treatmentAbstract
The aim of the study was to analyze the professional literature concerning general principles of medicamental correction for endothelial dysfunction and their peculiarities in patients with chronic obstructive pulmonary disease.
The development of chronic obstructive pulmonary disease (COPD) is based on certain trigger factors and pathogenetic processes (chronic inflammation of low intensity, oxidative stress, endothelial dysfunction). These factors are common for a number of other pathological processes, promoting the development of systemic extrapulmonary effects and comorbid conditions. Endothelial dysfunction is of particular interest because it causes, first of all, cardiovascular system pathology. Therefore, modern treatment of COPD, in addition to the drugs approved by clinical protocols, must be supplemented by methods of endothelial dysfunction correction in the long-term management for patients beyond the exacerbation period, which at the same time have no negative effect on the disease course.
At present, medicines of various pharmacological groups with a positive effect on the endothelial function are known. Among them are those ones that replenish the deficiency of endothelial relaxing factors or have a direct effect on endothelial receptors; stimulate endothelial nitric oxide synthase activation; prevent endothelial dysfunction caused by mediator influences; regulate the blood coagulation system; provide protection from endothelial cell membrane damage or affect various pathogenetic links of the disease (inflammatory process, immune disorders, dysbiosis, etc.), that indirectly reduces endothelial dysfunction.
Conclusions. The key role of endothelial dysfunction in the formation of comorbid pathology in COPD, first of all lesions of cardiovascular system, determines the necessity for complex treatment of these patient groups with additional correction of endothelial dysfunction, especially in long-term management programs beyond the exacerbation period. Given the multifactorial mechanisms of endothelial dysfunction development, the treatment choice for its correction should be personalized taking into account all the disease peculiarities and the comorbid pathology spectrum.
References
Global Initiative for Chronic Obstructive Lung Disease. (2020). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (2020 Report). https://goldcopd.org/wp-content/uploads/2019/12/GOLD-2020-FINAL-ver1.2-03Dec19_WMV.pdf
Vanfleteren, L. E. (2015). Does COPD stand for "COmorbidity with Pulmonary Disease"? European Respiratory Journal, 45(1), 14-17. https://doi.org/10.1183/09031936.00148014
Kochetova, E. V. (2017). Otsenka komorbidnosti u bol'nykh khronicheskoi obstruktivnoi bolezn'yu legkikh [Assessment of comorbidity in those suffering from chronic obstructive pulmonary disease]. Tuberkulez i bolezni legkikh, 95(4), 11-14. https://doi.org/10.21292/2075-1230-2017-95-4-11-14 [in Russian].
Kovalenko, V. M., & Bortkevych, O. P. (2019). Komorbidnist: vyznachennia, mozhlyvi napriamky diahnostyky ta likuvannia [Comorbidity: definition, possible ways to diagnostics and treatment]. Ukrainskyi revmatolohichnyi zhurnal, (3), 33-43. [in Ukrainian].
Lemko, O. I., & Vantyukh, N. V. (2017). Endotelialna dysfunktsiia ta yii mistse v patohenezi khronichnoho obstruktyvnoho zakhvoriuvannia lehen (Chastyna І) [Endothelial dysfunction and its role in the pathogenesis of chronic obstructive pulmonary disease (Chapter I)]. Ukrainskyi terapevtychnyi zhurnal, (2), 91-97. [in Ukrainian].
Yusupalieva, M. M. (2016). Struktura komorbidnoi patolohii u khvorykh iz khronichnym obstruktyvnym zakhvoriuvanniam lehen na etapi sanatorno-kurortnoho likuvannia [Structure of co-morbid pathology in patients with chronic obstructive pulmonary disease at the stage of sanatorium-resort treatment]. Tuberkuloz, lehenevi khvoroby, VIL-infektsiia, (1), 112-116. [in Ukrainian].
Raherison, C., Ouaalaya, E. H., Bernady, A., Casteigt, J., Nocent-Eijnani, C., Falque, L., Le Guillou, F., Nguyen, L., Ozier, A., & Molimard, M. (2018). Comorbidities and COPD severity in a clinic-based cohort. BMC Pulmonary Medicine, 18(1), Article 117. https://doi.org/10.1186/s12890-018-0684-7
Burmak, Yu. G., Treumova, S. I., Petrov, E. E., Ivanytskaya, T. A., & Ivanytsky, I. V. (2018). Osoblyvosti deiakykh strukturno-funktsionalnykh pokaznykiv shlunochkiv u khvorykh na khronichne obstruktyvne zakhvoriuvannia lehen v umovakh komorbidnosti z hipertonichnoiu khvoroboiu [Peculiarities of some structural-functional indicators of ventriclesin patients with chronic obstructive lung disease in conditions of comorbidity with arterial hypertension]. Zdobutky klinichnoi i eksperymentalnoi medytsyny, (2), 258-260. https://doi.org/10.11603/1811-2471.2018.v0.i2.8937 [in Ukrainian].
Mannino, D. M., Higuchi, K., Yu, T.-Ch., Zhou, X., Li, Y., Tian, H., & Suh, K. (2015). Economic Burden of COPD in the Presence of Comorbidities. Chest, 148(1), 138-150. https://doi.org/10.1378/chest.14-2434
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), 1-18. https://doi.org/10.1177/2045894018758528
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 pathogenesis of chronic obstructive pulmonary disease. Сhapter IІ]. Ukrainskyi terapevtychnyi zhurnal, (3), 71-77. [in Ukrainian].
Ollila, A., Vikatmaa, L., Virolainen, J., Nisula, S., Lakkisto, P., Vikatmaa, P., Tikkanen, I., Venermo, M., & Pettilä, V. (2019). The association of endothelial injury and systemic inflammation with perioperative myocardial infarction. Annals of Clinical Biochemistry, 56(6), 674-683. https://doi.org/10.1177/0004563219873357
Smakotina, S. A., Berns, S. A., & Gerasimova, E. B. (2017). Lipidsnizhayushchie i pleiotropnye effekty atorvastatina u patsientov s khronicheskoi obstruktivnoi bolezn'yu legkikh [Lipid-lowering and pleiotropic effects of atorvastatin in patients with chronic obstructive pulmonary disease]. Fundamental'naya i klinicheskaya meditsina, 2(2), 33-42. https://doi.org/10.23946/2500-0764-2017-2-2-33-42 [in Russian].
Savchenko, L. V., & Kaidashev, I. P. (2018). Individual approach to the treatment of obese COPD patients can reduce anthropometric indicators, the level of systemic inflammation and improve the quality of life. Wiadomosci Lekarskie, 71(3, Pt. 1), 451-459.
Vukic Dugac, A., Ruzic, A., Samarzija, M., Badovinac, S., Kehler, T., & Jakopovic, M. (2014). Persistent endothelial dysfunction turns the frequent exacerbator COPD from respiratory disorder into a progressive pulmonary and systemic vascular disease. Medical Hipotheses, 84(2), 155-158. https://doi.org/10.1016/j.mehy.2014.11.017
Nikitin, V. A., Vasil’eva, L. V., Karpukhina, E. P., & Popov, A. V. (2019). Otsenka effektivnosti lazerno-ul'trazvukovoi terapii v kompleksnom lechenii 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].
Huertas, A., Guignabert, C., Barberà, J. A., Bärtsch, P., Bhattacharya, J., Bhattacharya, S., Bonsignore, M. R., Dewachter, L., Dinh-Xuan, A. T., Dorfmüller, P., Gladwin, M. T., Humbert, M., Kotsimbos, T., Vassilakopoulos, T., Sanchez, O., Savale, L., Testa, U., & Wilkins, M. R. (2018). Pulmonary vascular endothelium: the orchestra conductor in respiratory diseases. European Respiratory Journal, 51(4), Article 1700745. https://doi.org/10.1183/13993003.00745-2017
Zolotnitskaya, V. P., Kuzubova, N. A., Titova, O. N., Surkova, E. A, & Shumilov, A. A. (2017). Vozmozhnosti korrektsii kapillyarnogo krovoobrashcheniya v legkikh u patsientov s khronicheskoi obstruktivnoi bolezn'yu legkikh s sochetannoi patologiei [An opportunity to improve pulmonary capillary circulation in patients with chronic obstructive pulmonary disease and comorbidity]. Pul'monologiya, 27(6), 767-775. https://doi.org/10.18093/0869-0189-2017-27-6-767-775 [in Russian].
Rabe, K. F., Hurst, J. R., & Suissa, S. (2018). Cardiovascular disease and COPD: dangerous liaisons? European Respiratory Review, 27(149), Article 180057. https://doi.org/10.1183/16000617.0057-2018
Nogovitsyna, A. S., Nikitin, A. V., Lykina, I. V., Grethetsenko, M. N., & Kolcheva, A. N. (2013). Otsenka effektivnosti primeneniya atorvastatina i metformina na osnovanii dinamiki markerov sistemnogo vospaleniya u bol'nykh KhOBL s aterosklerozom na fone metabolicheskogo sindroma (kratkoe soobshchenie) [Evaluation of the effectiveness of the atorvastatin and the metformin according to the dynamics of the markers of systemic inflammation in COPD patients with atherosclerosis on the background of metabolic syndrome]. Vestnik novykh meditsinskikh tekhnologii, (1). [in Russian].
Ignatova, G. L., Blinova, E. V., Bel'sner, M. S., & Grebneva, I. V. (2016). Opyt primeneniya selektivnogo ingibitora fosfodiesterazy-4 roflumilasta (Daksas) u patsientov s khronicheskoi obstruktivnoi bolezn'yu legkikh i metabolicheskim sindromom [An experience of therapy of patients with chronic obstructive pulmonary disease and metabolic syndrome with selective phosphodiesterase64 inhibitor roflumilast]. Pul'monologiya, 26(3), 323-327. https://doi.org/10.18093/0869-0189-2016-26-3-323-327 [in Russian].
Mescheryakova, N. N., Belevskiy, A. S., & Chernyak, A. V. (2014). Osnovnye printsipy reabilitatsii dlya bol'nykh s khronicheskoi obstruktivnoi bolezn'yu legkikh [Basic principles of rehabilitation in patients with chronic obstructive pulmonary disease]. Meditsinskiy sovet, (16), 61-64. https://doi.org/10.21518/2079-701X-2014-16-61-64 [in Russian].
Vivodtzev, I., Minet, C., Wuyam, B., Borel, J. C., Vottero, G., Monneret, D., Baguet, J. P., Lévy, P., & Pépin, J. L. (2010). Significant Improvement in Arterial Stiffness After Endurance Training in Patients With COPD. Chest, 137(3), 585-592. https://doi.org/10.1378/chest.09-1437
Filatova, Yu. I., Perfil'eva, M. V., & Chernov, A. V. (2014). Osobennosti kliniki i terapii khronicheskoi obstruktivnoi bolezni legkikh na fone metabolicheskogo sindroma [Features of the clinic and treatment of chronic obstructive pulmonary disease with metabolic syndrome]. Molodoi uchenyi, (7), 220-222. https://moluch.ru/archive/66/11112/ [in Russian].
Vatutin, N. T., & Smirnova, A. S. (2016). Komorbidnost' khronicheskoi obstruktivnoi bolezni legkikh 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].
Wang, L., Jin, Y. Z., Zhao, Q. H., Jiang, R., Wu, W. H., Gong, S. G., He, J., Liu, J., & Jing, Z. C. (2017). Hemodinamic and gas exchange effects of inhalled iloprost in patients with COPD and pulmonary hypertension. International Journal of Chronic Obstructive Pulmonary Disease, 12, 3353-3360. https://doi.org/10.2147/COPD.S141798
Sitbon, O., & Vonk Noordegraaf, A. (2017). Epoprostenol and pulmonary arterial hypertension: 20 years of clinical experience. European Respiratory Review, 26(143), Article 160055. https://doi.org/10.1183/16000617.0055-2016
Boeck, L., Tamm, M., Grendelmeier, P., & Stolz, D. (2012). Acute Effects of Aerosolized Iloprost in COPD Related Pulmonary Hypertension - A Randomized Controlled Crossover Trial. PLOS ONE, 7(12), Article e52248. https://doi.org/10.1371/journal.pone.0052248
McLaughlin, V. V., Channik, R., Chin, K., Frey, A., Gaine, S., Ghofrani, A., Hoeper, M., Lang, I., Preiss, R., Rubin, L. J., Simonneau, G., Sitbon, O., Stefani, M., Tapson, V., & Galiè, N. (2015). Effect of selexipag on morbidity/mortality in pulmonary arterial hypertension: results of the GRIPHON study. Journal of the American College of Cardiology, 65(10), Article A1538. https://doi.org/10.1016/S0735-1097(15)61538-8
Ivanov, K. I. (2017). Stimulyatory rastvorimoi guanilattsiklazy i ingibitory fosfodiesterazy 5-go tipa v terapii nekotorykh form legochnoi gipertenzii [Soluble guanylate cyclase stimulators and phosphodiesterase-5 inhibitors in therapy of some groups of pulmonary hypertension]. Pul'monologiya, 27(6), 803-810. https://doi.org/10.18093/0869-0189-2017-27-6-803-810 [in Russian].
Shmalts, A. A., & Gorbachevskiy, S. V. (2016). Riotsiguat i sildenafil v lechenii legochnoi gipertenzii: skhodstva i razlichiya [Riociguat and sildenafil for pulmonary hypertension: similarity and difference]. Pul'monologiya, 26(1), 85-91. https://doi.org/10.18093/0869-0189-2016-26-1-85-91 [in Russian].
Pichl, A., Sommer, N., Bednorz, M., Seimetz, M., Hadzic, S., Kuhnert, S., Kraut, S., Roxlau, E. T., Kojonazarov, B., Wilhelm, J., Gredic, M., Gall, H., Tello, K., Richter, M. J., Pak, O., Petrovic, A., Hecker, M., Schermuly, R. T., Grimminger, F., Seeger, W., … Weissmann, N. (2019). Riociguat for treatment of pulmonary hypertension in COPD: a translational study. European Respiratory Journal, 53(6), Article 1802445. https://doi.org/10.1183/13993003.02445-2018
Hussain, N., Zuberi, F. F., Rehana, K., Ashraf, S., Jamal, A. N., Khawar, S., Mehmood, T., & Maheshwary, N. (2018). Efficacy of bosentan in the treatment of pulmonary hypertension; a prospective study focusing on safety and efficacy in patients with COPD. Journal of Lung, Pulmonary & Respiratory Research, 5(2), 67-72. https://doi.org/10.15406/jlprr.2018.05.00164
Martinez, F. J., Rabe, K. F., Calverley, P., Fabbri, L. M., Sethi S., Pizzichini E., McIvor, A., Anzueto, A., Alagappan, V., Siddiqui, S., Reisner, C., Zetterstrand, S., Roman, J., Purcayastha, D., Bagul, N., & Rennard, S. I. (2018). Determinants of Response to Roflumilast in Severe Chronic Obstructive Pulmonary Disease. Pooled Analysis of Two Randomized Trials. American Journal of Respiratory and Critical Care Medicine, 198(10), 1268-1278. https://doi.org/10.1164/rccm.201712-2493OC
Vasileiadis, I. E., Goudis, C. A., Giannkopoulou, P. T., & Liu, T. (2018). Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: A Promising Medication for Chronic Obstructive Pulmonary Disease? COPD: Journal of Chronic Obstructive Pulmonary Disease, 15(2) 148-156. https://doi.org/10.1080/15412555.2018.1432034
Curtis, K. J., Meyrick, V. M., Mehta, B., Haji, G. S., Li, K., Montgomery, H., Man, W. D.-C., Polkey, M. I., & Hopkinson, N. S. (2016). Angiotensin-Converting Enzyme Inhibition as an Adjunct to Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine, 194(11), 1349-1357. https://doi.org/10.1164/rccm.201601-0094OC
Podzolkov, V. I., Pisarev, M. V., & Zateyshchikova, D. A. (2018). Blokatory angiotenzinovykh retseptorov: ratsional'nyi vybor s uchetom vliyaniya na kardiovaskulyarnyi risk i soputstvuyushchie zabolevaniya [Angiotensin receptor blockers: rational prescription tailored to the cardiovascular risk and comorbidities]. Rossiiskii kardiologicheskii zhurnal, 23(11), 89-95. http://doi.org/10.15829/1560-4071-2018-11-89-95 [in Russian].
Bolieva, L. (2016). Endothelial dysfunction in patients with chronic obstructive pulmonary disease and concomitant arterial hypertension and its correction by telmisartan plus amlodipine fixed combination. European Respiratory Journal, 48, Article PA4617. https://doi.org/10.1183/13993003.congress-2016.PA4617
Mahmoud, K., Kassem, H. H., Baligh E., EIGamil, U., & Akf, Y. (2016). The effect of ivabradine on functional capacity in patients with chronic obstructive pulmonary disease. Clinical Medicine, 16(5), 419-422. https://doi.org/10.7861/clinmedicine.16-5-419
Caminiti, G., Zarzana, A., Selli, S., Motsella, V., Cardaci, V., & Volterrani, M. (2018). Effects of Ivabradine in Patients with COPD and Non-Paroxysmal Atrial Fibrillation: A Pilot Study. ES Pharmacology and Toxicology, 6(5), 343-348.
Nikitin, V. A., Gosteva, E. V., Pyshnograeva, L. V., & Vasil'eva, L. V. (2015). Kombinirovannaya terapiya bisoprololom i amlodipinom u bol'nykh khronicheskoi obstruktivnoi bolezn'yu legkikh s arterial'noi gipertenziei [Combination therapy with bisoprolol and amlodipine in patients with chronic obstructive pulmonary disease and hypertension]. Pul'monologiya, 25(4), 440-446. https://doi.org/10.18093/0869-0189-2015-25-4-440-446 [in Russian].
Baker, J. G., & Wilcox, R. G. (2017). β-Blockers, heart disease and COPD: current controversies and uncertainties. Thorax, 72(3), 271-276. https://doi.org/10.1136/thoraxjnl-2016-208412
Lipworth, B., Wedzicha, J., Devereux, G., Vestbo, J., & Dransfield, M. T. (2016). Beta-blockers in COPD: time for reappraisal. European Respiratory Journal, 48(3), 880-888. https://doi.org/10.1183/13993003.01847-2015
Krakhmalova, E. O., & Kharchenko, Yu. E. (2014). Priverzhennost' k terapii statinami u patsientov s KhOZL i IBS [Adherence to statin therapy among patients with COPD and CHD]. Zdorovia Ukrainy, (4. Kardiolohiia. Revmatolohiia. Kardiokhirurhiia), 34-35. [in Russian].
Wu, W.-T., & Chen, C.-Y. (2020). Protective Effect of Statins on Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease Patients: A Nationwide Retrospective, Matched Cohort Study. Scientific Reports, 10(1), Article 3104. https://doi.org/10.1038/s41598-020-59828-0
Lu, Y., Chang, R., Yao, J., Xu, X., Teng, Y., & Cheng, N. (2019). Effectiveness of long-term using statins in COPD - a network meta-analysis. Respiratory Research, 20(1), Article 17. https://doi.org/10.1186/s12931-019-0984-3
Rathor, V. P., Chugh, P., Ali, R., Bhatnagar, A., Haque, S. E., Bhatnagar, A., & Mittal, G. (2016). Formulation, preclinical and clinical evaluation of a new submicronic arginine respiratory fluid for treatment of chronic obstructive pulmonary disorder. Saudi Pharmaceutical Journal, 24(1), 49-56. https://doi.org/10.1016/j.jsps.2015.03.010
Voloshyna, L. O. (2016). Otsinka efektyvnosti zastosuvannia Larhininu aspartatu v kompleksnomu likuvanni khvorykh na osteoartroz z vysokym rivnem komorbidnosti ta kardiovaskuliarnoho ryzyku [The evaluation of efficacy of L-arginine aspartate in the complex treatment of patients with osteoarthritis with the high levels of comorbidity and cardiovascular risk]. Ukrainskyi terapevtychnyi zhurnal, (4), 63-70. [in Ukrainian].
Dron, L. A., & Kupnovytska, I. H. (2018). Polipshennia endotelialnoi funktsii ta funktsii zovnishnoho dykhannia u patsiientiv z komorbidnistiu (arterialna hipertenziia ta khronichne obstruktyvne zakhvoriuvannia lehen III stupenia) shliakhom zastosuvannia donatora azotu oksydu - L-arhininu [Improvement of endothelial function and external respiration in patients with comorbidity of hypertension and stage III chronic obstructive pulmonary disease, using nitric oxide donor - L-arginine]. Tuberkuloz, lehenevi khvoroby, VIL-infektsiia, (4), 66-72. https://doi.org/10.30978/TB2018-4-66 [in Ukrainian].
Vézina, F.-A., & Cantin, A. M. (2018). Antioxidants and Chronic Obstructive Pulmonary Disease. Chronic Obstructive Pulmonary Disease, 5(4), 277-288. https://doi.org/10.15326/jcopdf.5.4.2018.0133
Franssen, F. M., Alter, P., Bar, N., Benedikter, B. J., Iurato, S., Maier, D., Maxheim, M., Roessler, F. K., Spruit, M. A., Vogelmeier, C. F., Wouters, E. F., & Schmeck, B. (2019). Personalized medicine for patients with COPD: where are we? International Journal of Chronic Obstructive Pulmonary Disease, 14, 1465-1484. https://doi.org/10.2147/COPD.S175706
Stupnitska, G. Ya. (2014). Efektyvnist vykorystannia telmisartanu u khvorykh na khronichne obstruktyvne zakhvoriuvannia lehen iz suputnim metabolichnym syndromom [Efficiency of telmisartan in patients with chronic obstructive pulmonary disease accompanied with metabolic syndrome]. Ukrainskyi terapevtychnyi zhurnal, (2), 89-94. [in Ukrainian].
So, J. Y., Dhungana, S., Beros, J. J., & Criner, G. J. (2018). Statins in the treatment of COPD and asthma-where do we stand? Current Opinion in Pharmacology, 40, 26-33. https://doi.org/10.1016/j.coph.2018.01.001
Mroz, R. M., Lisowski, P., Tycinska, A., Bierla, J., Trzeciak, P. Z., Minarowski, L., Milewski, R., Lisowska, A., Boros, P., Sobkowicz, B., Duszewska, A. M., Chyczewska, E., Musial, W. J., & MacNee, W. (2015). Anti-inflammatory effects of atorvastatin treatment in chronic obstructive pulmonary disease. A controlled pilot study. Journal of Physiology and Pharmacology, 66(1), 111-128.
Fedeli, U., De Giorgi, A., Gennaro, N., Ferroni, E., Gallerani, M., Mikhailidis, D. P., Manfredini, R., & Fabbian, F. (2017). Lung and kidney: a dangerous liaison? A population-based cohort study in COPD patients in Italy. International Journal of Chronic Obstructive Pulmonary Disease, 12, 443-450. https://doi.org/10.2147/COPD.S119390
Bolotova, E. V., Yavlyanskaya, V. V., & Dudnikova, A. V. (2018). Kardiorenal'nye vzaimootnosheniya u bol'nykh khronicheskoi obstruktivnoi bolezn'oyu legkikh: rol' vitamina D [Cardiorenal relationships and a role of vitamin D in patients with chronic obstructive pulmonary disease]. Pul'monologiya, 28(5), 613-621. https://doi.org/10.18093/0869-0189-2018-28-5-613-621 [in Russian].
Kokturk, N., Baha, A., Oh, Y.-M., Young Ju, J., & Jones, P. W. (2018). Vitamin D deficiency: What does it mean for chronic obstructive pulmonary disease (COPD)? a compherensive review for pulmonologists. The Clinical Respiratory Journal, 12(2), 382-397. https://doi.org/10.1111/crj.12588
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)