The role of hydrogen sulfide in the progression of chronic obstructive pulmonary disease in patients with non-alcoholic steatohepatitis.

Introduction: The steady increase in the incidence of comorbidity of chronic obstructive pulmonary disease and non-alcoholic steatohepatitis against the background of obesity in people of working age in Ukraine and in the world stipulates the need of investigation of the mechanisms of interconnection and the search for new factors of the pathogenesis of progression of this comorbid pathology. Attention to the role of hydrogen sulfide in the development of fibrosis has only been recently paid. The aim: To establish the role of hydrogen sulfide in the mechanisms of progression of chronic obstructive pulmonary disease and non-alcoholic steatohepatitis against the background of obesity.

Material And Methods: Materials and methods: 100 patients with chronic obstructive pulmonary disease have been examined, including 49 with non-alcoholic steatohepatitis and obesity of the 1st stage: group 1 – 28 patients with chronic obstructive pulmonary disease (2B GOLD); group 2 – 23 patients with chronic obstructive pulmonary disease (3C, D); group 3 – 25 patients with chronic obstructive pulmonary disease (2B) with non-alcoholic steatohepatitis; group 4 – 24 patients with chronic obstructive pulmonary disease (3C, D) and non-alcoholic steatohepatitis. The average age of patients was (47.3±3.1) years. There were 20 apparently healthy persons of the corresponding age and sex in the control group.

Results: The received data confirm that patients with chronic obstructive pulmonary disease secondary to non-alcoholic steatohepatitis, which developed against the background of obesity, suffer from a significant increase in the synthesis of collagen and glycoproteins, accompanied by an ineffective resorption of newly formed collagen due to insufficient activation of collagenolysis and proteolysis, a significant imbalance in the connective tissue metabolism system, which leads to progressive fibrosis of the lungs and liver and disturbances of their functions. This was caused by the disorder of H2S homeostasis, confirmed by the data of correlation analysis.

Conclusions: Patients with chronic obstructive pulmonary disease and non-alcoholic steatohepatitis, which developed against the background of obesity, are characterized by a significant increase in the synthesis of collagen and glycoproteins, which was accompanied by an ineffective resorption of newly formed collagen against the background of substantial activation of proteinase inhibitors (α2-MG), accompanied by the hyperproduction of nitrogen monoxide, endothelin-1, hyperlipidemia, deficiency of hydrogen sulfide liberation.