The effect of endobronchial coil treatment (EBCT) on hemorheological parameters and oxidative stress: a pilot study

Yıl 2025, Cilt: 18 Sayı: 2, 5 - 5

Erhan Ugurlu , Emine Kılıç Toprak , Nazlı Çetin , Özgen Kılıç Erkek , Nilüfer Yiğit , Hilmiye Pakyürek , Göksel Altınışık Ergur , Z. Melek Küçükatay

https://doi.org/10.31362/patd.1528960

Öz

Objective: Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable, curable disease characterized by persistent airflow limitation, respiratory symptoms due to airway and/or alveolar abnormalities caused by severe exposure to harmful particles, gases. During the endobronchial coil treatment (EBCT) process, the volume of the lung parenchyma is reduced by shrinking the elastic recoil. Although there are studies showing worsening of hemorheological parameters in COPD exacerbations, no study investigated whether hemorheological parameters are improved after coil. The aim of this study was to assess the effects of coil therapy on erythrocyte deformability, whole blood viscosity (WBV) measured at autologous, standard (40%) hematocrit and plasma viscosity (PV) in COPD patients.
Material and methods: Venous blood samples were taken once from the healthy control group (n=17) and before and 1 month after the treatment from the COPD patients who had been indicated for coil according to GOLD guidelines (n=20). To assess erythrocyte deformability, shear-dependent erythrocyte elongation was measured at 0.3-3.0 Pa by an ektacytometer (LORCA), while WBV, PV were measured using a rotational viscometer.
Results: Erythrocyte deformability measured at shear stresses between 0.3-5.33 Pa were found to be higher following treatment compared to pre-coil values. EBCT did not have a statistically significant effect on WBV measured at autologous, 40% hematocrit, PV and oxidative stress indices.
Conclusion: Increased erythrocyte deformability determined following EBCT at the shear stresses observed at the pulmonary level is a favourable finding, showing that the procedure may positively affect the hemodynamics of COPD patients as well as causing clinical improvement.

Anahtar Kelimeler

Chronic obstructive pulmonary disease, endobronchial coil therapy, erythrocyte deformability, hemorheology, oxidative stress

Endobronşiyal koil tedavisinin (EBCT) hemoreolojik parametreler ve oksidatif stres üzerine etkisi: pilot çalışma

Öz

Amaç: Kronik Obstrüktif Akciğer Hastalığı (KOAH), zararlı partiküllere, gazlara şiddetli maruziyetin neden olduğu hava yolu ve/veya alveolar anormalliklere bağlı kalıcı hava akımı kısıtlılığı, solunum semptomları ile karakterize yaygın, önlenebilir, tedavi edilebilir bir hastalıktır. Endobronşiyal koil tedavisi (EBCT) işlemi sırasında elastik geri tepme küçültülerek akciğer parankiminin hacmi azaltılır. KOAH alevlenmelerinde hemoreolojik parametrelerin kötüleştiğini gösteren çalışmalar olmasına rağmen, koil sonrası hemoreolojik parametrelerin iyileşip iyileşmediğini araştıran bir çalışma yoktur. Bu çalışmanın amacı, KOAH hastalarında koil tedavisinin eritrosit deformabilitesi, otolog, standart (%40) hematokritte ölçülen tam kan viskozitesi (WBV) ve plazma viskozitesi (PV) üzerindeki etkilerini değerlendirmektir.
Gereç ve yöntem: Sağlıklı kontrol grubundan (n=17) ve GOLD yönergelerine göre coil için endikasyon konulmuş olan KOAH hastalarından (n=20) tedaviden önce ve 1 ay sonra venöz kan örnekleri alındı. Eritrosit deformabilitesini değerlendirmek için, kaymaya bağlı eritrosit uzaması 0,3-3,0 Pa'da bir ektasitometre (LORCA) ile ölçülürken, WBV, PV rotasyonel bir viskozimetre kullanılarak ölçüldü.
Bulgular: Eritrosit deformabilitesi 0,3-5,33 Pa arasındaki kayma streslerinde ölçülmüş ve tedavi sonrasında coil öncesi değerlere kıyasla daha yüksek bulunmuştur. EBCT'nin otolog, %40 hematokrit, PV ve oksidatif stres indekslerinde ölçülen WBV üzerinde istatistiksel olarak anlamlı bir etkisi olmamıştır.
Sonuç: EBCT sonrasında pulmoner düzeyde gözlenen kayma gerilimlerinde belirlenen artmış eritrosit deformabilitesi, işlemin KOAH hastalarının hemodinamiğini olumlu yönde etkileyebileceğini ve klinik iyileşmeye neden olabileceğini gösteren olumlu bir bulgudur.

Anahtar Kelimeler

Kronik obstrüktif akciğer hastalığı, endobronşiyal koil tedavisi, eritrosit deformabilitesi, hemoreoloji, oksidatif stress

Kaynakça

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