Paraoxonase-1 in stable chronic obstructive pulmonary disease: a systematic review and meta-analysis

Elisabetta Zinellu, Angelo Zinellu, Maria C. Pau, Alessandro G. Fois, Sabrina Mellino, Arduino A. Mangoni, Ciriaco Carru, Pietro Pirina

Research output: Contribution to journalReview articlepeer-review


INTRODUCTION: Oxidative stress plays a critical pathophysiological role in chronic obstructive pulmonary diseas (COPD). An impairment in antioxidant defense systems, which include the enzyme paraoxonase1 (PON-1), have bee reported in COPD patients. This systematic review and meta-analysis investigated the association between serum PON and COPD.

EVIDENCE ACQUISITION: A systematic search was performed using the following terms and their combination “paraoxonase-1” or “PON-1” and “chronic obstructive pulmonary disease” or “COPD” in PubMed, Web of Science Scopus, and Google Scholar, from inception to October 2021. Standardized mean differences (SMDs) of serum PONconcentrations between stable COPD patients and non-COPD subjects were calculated. 

EVIDENCE SYNTHESIS: Thirteen studies were included in the meta-analysis. Pooled results showed that serum PONconcentrations were significantly lower in patients with COPD (SMD=-1.12, 95% CI: -1.72 to -0.53; P<0.001). 

CONCLUSIONS: The observed reduction of PON-1 concentrations in COPD patients supports the presence of an impaired antioxidant defense system in this group. 

Original languageEnglish
Pages (from-to)138-145
Number of pages8
JournalMinerva Respiratory Medicine
Issue number3
Early online date2 Aug 2022
Publication statusPublished - Sept 2022


  • Oxidative stress
  • Pulmonary disease, chronic obstructive
  • Systematic review


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