The respiratory system is continuously exposed to endogenous and exogenous
oxidants.
Chronic obstructive pulmonary disease (
COPD) is characterized by chronic
inflammation of the airways, leading to the destruction of lung parenchyma (
emphysema) and declining pulmonary function. It is increasingly obvious that
reactive oxygen species (ROS) and
reactive nitrogen species (RNS) contribute to the progression and amplification of the inflammatory responses related to this disease. First, we described the association between cigarette smoking, the most representative exogenous
oxidant, and
COPD and then presented the multiple pathophysiological aspects of ROS and antioxidative defense systems in the development and progression of
COPD. Second, the relationship between
nitric oxide system (endothelial) dysfunction and oxidative stress has been discussed. Third, we have provided data on the use of these
biomarkers in the pathogenetic mechanisms involved in
COPD and its progression and presented an overview of oxidative stress
biomarkers having clinical applications in respiratory medicine, including those in exhaled breath, as per recent observations. Finally, we explained the findings of recent clinical and experimental studies evaluating the efficacy of antioxidative interventions for
COPD. Future breakthroughs in antioxidative
therapy may provide a promising therapeutic strategy for the prevention and treatment of
COPD.