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Review
. 2020 Nov 18;9(11):1146.
doi: 10.3390/antiox9111146.

Systematic Review and Meta-Analysis of the Blood Glutathione Redox State in Chronic Obstructive Pulmonary Disease

Salvatore Sotgia  1 , Panagiotis Paliogiannis  2 , Elisabetta Sotgiu  1 , Sabrina Mellino  1 , Elisabetta Zinellu  3 , Alessandro G Fois  2   3 , Pietro Pirina  2   3 , Ciriaco Carru  1   4 , Arduino A Mangoni  5 , Angelo Zinellu  1
Affiliations
Review

Systematic Review and Meta-Analysis of the Blood Glutathione Redox State in Chronic Obstructive Pulmonary Disease

Salvatore Sotgia et al. Antioxidants (Basel). .

Abstract

The aim of this systematic review and meta-analysis was to assess the blood concentrations of the total and reduced forms of the low-molecular-weight antioxidant thiol glutathione (GSH) in chronic obstructive pulmonary disease (COPD) patients in comparison to healthy individuals. A literature search was conducted in the PubMed and Web of Science databases from inception until June 2020. In the 18 studies identified (involving a total of 974 COPD patients and 631 healthy controls), the pooled reduced GSH concentrations were significantly lower in patients with COPD than controls (SMD = -3.04, 95% CI = -4.42 to -1.67; p < 0.001). By contrast, the pooled total GSH concentrations were significantly higher in patients with COPD than controls (SMD = 0.42, 95% CI = 0.11 to 0.73; p = 0.009). Our meta-analysis showed that the blood concentrations of reduced GSH, even in the presence of higher total GSH concentrations, were significantly lower in patients with COPD when compared to healthy controls. This suggests that an impaired antioxidant defense system plays an important role in the pathogenesis of COPD.

Keywords: chronic obstructive pulmonary disease (COPD); glutathione; oxidative stress.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
Forest plot of studies examining blood reduced GSH and COPD.
Figure 3
Figure 3
Sensitivity analysis of the association between blood reduced GSH and COPD. The influence of individual studies on the overall standardized mean difference (SMD) is shown. The middle vertical axis indicates the overall SMD, and the two vertical axes indicate the 95% confidence intervals (CI). Hollow circles represent the pooled SMD when the remaining study was omitted from the meta-analysis. Two ends of each broken line represent 95% CIs.
Figure 4
Figure 4
Funnel plot of studies investigating healthy controls and patients with COPD.
Figure 5
Figure 5
Funnel plot of studies investigating healthy controls and patients with COPD after trimming and filling. Dummy studies and genuine studies are represented by enclosed circles and free circles, respectively.
Figure 6
Figure 6
Meta-regression analysis of malondialdehyde serum concentration and SMD.
Figure 7
Figure 7
Forest plot of studies examining blood reduced GSH and COPD according to assay method used to detect GSH.
Figure 8
Figure 8
Forest plot of studies examining blood total GSH and COPD.
Figure 9
Figure 9
Sensitivity analysis of the association between blood total GSH and COPD. The influence of individual studies on the overall standardized mean difference (SMD) is shown. The middle vertical axis indicates the overall SMD, and the two vertical axes indicate the 95% confidence intervals (CI). Hollow circles represent the pooled SMD when the remaining study was omitted from the meta-analysis. Two ends of each broken line represent 95% CIs.
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