Chronic obstructive pulmonary disease (COPD) is a major and rapidly increasing health problem
associated with a chronic inflammatory response, predominantly in small airways and lung parenchyma. Oxidative
stress induced by reactive oxygen and nitrogen species (ROS and RNS) plays a central role in the
pathophysiology of COPD. There is evidence that several molecules formed during oxidative processes may
have the potential to serve as biomarkers of oxidative stress in the airways of patients with COPD. Among these molecules
carbon monoxide, ethane and pentane can be measured in the exhaled air, while 8-isoprostane, malondialdehyde, 4-
hydroxyhexenal, 4-hyroxynonenal, acrolein, hydrogen peroxide, nitrogen oxides and 3-nitrotyrosine can be detected in
exhaled breath condensate and/or sputum supernatant. In this review the molecular background of these processes including
the formation of ROS and RNS, the biosynthesis of essential ω-3 and ω-6 polyunsaturated fatty acids as building
blocks of lipids in the cellular membranes and their enzymatic and non-enzymatic metabolism to eicosanoids and related
compounds have been summarized. Moreover, the formation of oxidative stress markers studied most commonly in the
context of COPD has been briefly discussed. The associations between biomarkers and clinical variables have also been
highlighted in an attempt to illustrate the potential clinical applicability of these biomarker measurements.
Keywords: Chronic obstructive pulmonary disease, eicosanoids, isofurans, isoprostanes, lipid peroxidation, oxidative stress,
polyunsaturated fatty acids, reactive oxygen and nitrogen species.
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