The Effects of Allopurinol on Glutathione Sulfhydryl (GSH) Serum Level, Six Minute Walking Test, and CAT Score of COPD Patients

Samuel Samuel, Suradi Suradi, Yusup Subagio Sutanto


Background: Stress oxidative in COPD impairs striated muscle thus worsening COPD symptoms. Allopurinol as antioxidant reduces stress oxidative so it can improve exercise capacity and clinical symptoms. The aims of this study were to analyze the effects of allopurinol on GSH serum level, six minute walking test (6MWT), and COPD assessment test (CAT) score of COPD patients.
Methods: This study was a pre and post test clinical trial held in pulmonology outpatient clinic in Dr. Moewardi General Hospital Surakarta from January to February 2018 using purposive sampling. The COPD group C and D patients were cathegorized as intervention group which received allopurinol 300 mg/day for 4 weeks and control group which did not receive allopurinol. Glutathione sulfhydryl serum level, 6MWT, and CAT score were measured at baseline and after 4 weeks in both groups.
Results: A total of 37 stable COPD group C and D patients were included in this study. The intervention group showed decreased GSH level (52.58±38.39) µg/ml and CAT score (10.37±4.46) which were statistically significant compared to control group (P<0,005). The intervention group also showed significant increased of 6MWT (P=0.005) while control group showed no significant increased (P=0.109) however the 6MWT differences in both groups were not significant with P=0.057.
Conclusion: Allopurinol decreased GSH serum level, increased 6MWT, and decreased CAT score of stable COPD group C and D patients. (J Respir Indo. 2019; 39(3):169-79)


COPD, allopurinol, GSH, CAT

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Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. Capetown: Global Initiative for Chronic Obstructive Lung Disease Inc; 2017. p. 1-123.

Senior RM, Pierce RA, Atkinson J. Chronic obstructive pulmonary disease: epidemiology, pathophysiology, pathogenesis, and α1-antitrypsin deficiency. In: Grippi MA, Elias JA, Fishman JA, Kotloff RM, Pack AI, Senior R, editors. Fishman’s pulmonary diseases and disorders. 5th ed. New York: McGraw-Hill Education; 2015. p. 613-45.

Amin M, Yunus F, Antariksa B, Djajalaksana S, Wiyono W, editors. PPOK Diagnosis Dan Penatalaksanaan. 1st ed. Jakarta: Penerbit Universitas Indonesia; 2016. p. 1-111.

Barnes PJ. New anti-inflammatory targets for chronic obstructive pulmonary disease. Nat Rev Drug Discov. 2013;12(7):543-59.

Rahman I. Pharmacological antioxidant strategies as therapeutic interventions for COPD. Biochim Biophys Acta. 2012;1822(5):714-28.

Pirabbasi E, Cheragi M. Antioxidant supplementation among COPD: is it necessary? Pakistan J Nutr. 2012;11(5):501-6.

Kirkham PA, Barnes PJ. Oxidative stress in COPD. Chest. 2013;144(1):266-73.

Pouwels SD, Heijink IH, Hacken NHT. DAMPs activating innate and adaptive immune responses in COPD. 2013;10:1-12.

Heunks LMA, Dekhuijzen PNR. Respiratory muscle function and free radicals: from cell to COPD. Thorax. 2000;55(8):704-16.

Ryan MJ, Jackson JR, Hao Y, Leonard SS, Alway SE. Inhibition of xanthine oxidase reduces oxidative stress and improves skeletal muscle function in response to electrically stimulated isometric contractions in aged mice. Free Radic Biol Med. 2011;51(1):38-52.

Macnee W, Vestbo J, Agusti A. COPD: pathogenesis and natural history. In: Broaddus VC, Mason RJ, Ernst JD, King TE, Lazarus RC, Murray JF, et al, editors. Murray & Nadel’s textbook of respiratory medicine. 6th ed. Philadelpia: Elsevier Saunders; 2016. p. 751-89.

Ichinose M, Sugiura H, Yamagata S, Koarai A, Tomaki M, et al. Xanthine oxidase inhibition reduces reactive nitrogen species production in COPD airways. Eur Respir J. 2003;22(3):457-61.

Raharjo A. Pengaruh latihan harmonika pada kapasitas inspirasi, gejala sesak napas, kapasitas latihan, dan kualitas hidup penderita PPOK. [Thesis]. Departement of Pulmonology and Respiratory Medicine Medical Faculty: Sebelas Maret University; 2017.

Widyastuti K. Pengaruh exercise berjalan berbasis pedometer dan standar terhadap aktivitas fisik, gejala sesak napas, kapasitas exercise, dan kualitas hidup penderita PPOK stabil. [Thesis]. Departement of Pulmonology and Respiratory Medicine Medical Faculty: Sebelas Maret University; 2017.

Mustadi W. Pengaruh pemberian L-Carnitine terhadap kadar asam laktat, 6MWT, % VEP1, dan skor CAT penderita PPOK stabil. [Thesis]. Departement of Pulmonology and Respiratory Medicine Medical Faculty: Sebelas Maret University; 2016.

Morris D, Khurasany M, Nguyen T, Kim J, Guilford F, Mehta R, et al. Glutathione and infection. Biochim Biophys Acta - Gen Subj. 2013;1830(5):3329-49.

Rochester CL, Vogiatzis I, Holland AE, Lareau SC, Marciniuk DD, Spruit M. An official American Thoracic Society/European Respiratory Society policy statement: enhancing implementation, use, and delivery of pulmonary rehabilitation. Am J Respir Crit Care Med.2015;192:1373-86.

Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, et al. An official European respiratory society/American thoracic society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1428-46.

Enright P. The Six-Minute Walk Test. Respir Care. 2003;48:783-5.

Karloh M, Mayer AF, Maurici R, Pizzichini MMM, Jones PW, Pizzichini E. The COPD assessment test: what do we know so far? a systematic review and meta-analysis about clinical outcomes prediction and classification of patients into gold stages. Chest. 2016;149(2):413-25.

Puspitasari Y. Peran erdosteine pada derajat obstruksi dan skor COPD assessment test (CAT) penderita PPOK stabil. [Thesis]. Departement of Pulmonology and Respiratory Medicine Medical Faculty: Sebelas Maret University; 2015.

Smid DE, Franssen FME, Houben-Wilke S, Vanfleteren LEGW, Janssen DJA, Wouters EFM, et al. Responsiveness and MCID estimates for CAT, CCQ, and HADS in patients with COPD undergoing pulmonary rehabilitation: a prospective analysis. J Am Med Dir Assoc. 2017;18(1):53-8.



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