Mikropartikulum és L-arginin útvonal kutatások stabil és exacerbált COPD betegekben

Abstract

Besides dr. Attila Kovács and dr. Viktor Vörös, dr. László Kovács inspired me to conduct research during my work in the Student Researchers' Society at university. I encountered patients' subjective complaints face-to-face for the first time during the treatment of chronic patients in his family physician's practice. My interest in chronic obstructive pulmonary disease was aroused by dr. Zoltán Balikó, who encouraged me to investigate COPD patients in the first years of my residency training. There has been many changes both in the management of COPD and in understanding the background of the disease in the 12 years that elapsed since then, but there are still many open issues remaining. In addition to the increase in the prevalence of COPD, the increase in the patient population and its ever more important role in the increasingly aging population, I have also witnessed individual human destinies and disease progressions in my professional career. Especially as the head of the Special Respiratory Care Unit of the Division of Pulmonology, I came in contact with the most severely ill COPD patients on a daily basis. Late dr. Tamás Magyarlaki encouraged me to investigate microparticles in this patient population and dr. Gitta Tőkés-Füzesi aided me in its practical implementation, while dr. Tihamér Molnár opened up my mind to the importance of NO pathways in diseases associated with chronic hypoxemia and inflammation. Therefore, with my research results I aim to contribute to the earliest possible screening of these patients, early recognition of their acute exacerbations, commencement of adequate therapy, and a better understanding of the patomechanisms of the disease. Nowadays, COPD is a leading cause of morbidity and mortality in developed countries. At a global level, COPD currently ranks between 4th and 6th places in the causes of death and is expected to be the third leading cause of death by 2020. This is caused by an increase in the environmental impacts damaging the respiratory system (mainly smoking), the aging population and improvement in the therapeutic outcomes in other major patient groups (e.g. cardiovascular patients). COPD constitutes a major social and economic burden due to its high prevalence and its chronic and progressive course. In the European Union, direct costs of respiratory diseases amount to 6 % of total healthcare costs, 56 % of which is allocated to the management of COPD. In the meantime, current pharmacotherapeutical options have a low efficacy on the progression of the disease, therefore prevention plays a major role in this patient population. Thus, in addition to markers used so far in clinical practice, it is important to determine new biomarkers, which aid in the assessment of factors involved in disease progression, in the early screening of patients at risk and in the follow-up of the individual course of the disease and the efficacy of the therapy.