Research Article Heterogeneity of Systemic Oxidative Stress Profiles in COPD: A Potential Role of Gender Jonathan Maury, 1,2,3 Farés Gouzi, 1,2,4 Philippe De Rigal, 3 Nelly Heraud, 3 Joël Pincemail, 5 Nicolas Molinari, 1,2,4 Pascal Pomiès, 1,2 Dalila Laoudj-Chenivesse, 1,2,4 Jacques Mercier, 1,2,4 Christian Préfaut, 2,3 and Maurice Hayot 1,2,4 1 PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295 Montpellier Cedex 5, France 2 University of Montpellier, 34295 Montpellier, France 3 Clinique du Soule “La Solane”, Fontalvie Group, 66340 Oss´ eja, France 4 Department of Clinical Physiology, CHRU Montpellier, 34295 Montpellier, France 5 Department of Cardiovascular Surgery and CREDEC, University of Li` ege, CHU Sart Tilman, 4000 Li` ege, Belgium Correspondence should be addressed to Jonathan Maury; jonathan.maury@5-sante.fr Received 21 January 2015; Accepted 26 May 2015 Academic Editor: Swaran J. S. Flora Copyright © 2015 Jonathan Maury et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Oxidative stress (OS) plays a key role in the muscle impairment and exercise capacity of COPD patients. However, the literature reveals that systemic OS markers show great heterogeneity, which may hinder the prescription of efective antioxidant supplementation. his study therefore aimed to identify OS markers imbalance of COPD patients, relative to validated normal reference values, and to investigate the possibility of systemic OS proiles. We measured systemic enzymatic/nonenzymatic antioxidant and lipid peroxidation (LP) levels in 54 stable COPD patients referred for a rehabilitation program. he main systemic antioxidant deicits in these patients concerned vitamins and trace elements. Fully 89% of the COPD patients showed a systemic antioxidant imbalance which may have caused the elevated systemic LP levels in 69% of them. Interestingly, two patient proiles (clusters 3 and 4) had a more elevated increase in LP combined with increased copper and/or decreased vitamin C, GSH, and GPx. Further analysis revealed that the systemic LP level was higher in COPD women and associated with exercise capacity. Our present data therefore support future supplementations with antioxidant vitamins and trace elements to improve exercise capacity, but COPD patients will probably show diferent positive responses. 1. Introduction Chronic obstructive pulmonary disease (COPD) is a complex disease usually characterized by progressive airlow limi- tation that is not fully reversible and signiicant extrapul- monary efects that may further contribute to disease severity in individual patients [1]. One of the main systemic efects is a decrease in muscle mass linked to muscle dysfunction, which contribute to the decline in exercise capacity and a worsened prognosis [2, 3]. Although many factors are implicated in the respiratory and muscle pathophysiology of COPD, oxidative stress (OS) appears to play a key role [4, 5]. he COPD literature usually describes an increase in prooxidants, macromolecular damage (lipid and protein oxidation), and DNA oxidation [6–8], which correspond to deleterious OS as deined by Jones [9]. To limit cell damage, a complex antioxidant system may directly scavenge ROS and/or inhibit lipid peroxide reactions [10–13], but previous studies have shown a decrease in many enzymatic and nonenzymatic antioxidants in COPD patients [6, 7, 14–16]. However, the literature also suggests that systemic OS markers show great heterogeneity, particularly in the systemic antioxidant levels. For example, for a given parameter, sys- temic antioxidant levels in diferent groups of COPD patients were either lower than [6, 7, 14] or equal to [5] the levels in healthy subjects. he discrepancies among studies may be due to the diferences in centers and the low number of COPD patients included in the investigations. he literature has also described great heterogeneity from one COPD patient to another suggesting diferent systemic OS marker proiles, Hindawi Publishing Corporation Oxidative Medicine and Cellular Longevity Volume 2015, Article ID 201843, 11 pages http://dx.doi.org/10.1155/2015/201843