The effect of different treatment modalities on oxidative stress in COPD

Adv Ther. 2008 Jul;25(7):710-7. doi: 10.1007/s12325-008-0064-4.

Abstract

Introduction: Oxidant/antioxidant interactions are known to be important processes in the pathogenesis of chronic obstructive pulmonary disease (COPD). We aimed to evaluate the effects of corticosteroids (CS), and N-acetylcysteine (NAC) on plasma oxidant/antioxidant levels in patients with COPD.

Methods: This study utilised a single-blind, randomised, placebo-controlled, parallel-group methodology. We enrolled 58 patients with stable COPD and 30 healthy controls with similar demographic profiles. The patients with COPD were randomly divided into three treatment groups. Group 1 received basal treatment (regular ipratropium bromide and beta-2 agonist as needed), placebo CS and placebo NAC. In addition to basal treatment, group 2 received oral CS (methylprednisolone 40 mg/day) and placebo NAC. Group 3 received basal treatment plus NAC (600 mg/day) and placebo CS. Each group received treatment for 15 days. We measured plasma malondialdehyde (MDA) and superoxide dismutase (SOD) at the start and the end of study.

Results: Post-treatment plasma MDA levels were significantly lowered only in group 2 (P=0.004). No significant differences were found with respect to erythrocyte SOD levels.

Conclusion: This study demonstrates that oral CS, by aiding the oxidant/antioxidant system, may offer a new therapeutic option in COPD treatment.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcysteine / pharmacology*
  • Acetylcysteine / therapeutic use
  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Drug Therapy, Combination
  • Female
  • Free Radical Scavengers / pharmacology*
  • Free Radical Scavengers / therapeutic use
  • Glucocorticoids / pharmacology*
  • Glucocorticoids / therapeutic use
  • Humans
  • Ipratropium / therapeutic use
  • Male
  • Malondialdehyde / blood
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Oxidative Stress / drug effects*
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / metabolism
  • Respiratory Function Tests
  • Superoxide Dismutase / blood

Substances

  • Adrenergic beta-Antagonists
  • Free Radical Scavengers
  • Glucocorticoids
  • Malondialdehyde
  • Superoxide Dismutase
  • Ipratropium
  • Acetylcysteine
  • Methylprednisolone