The protective effects of ambroxol on radiation lung injury and influence on production of transforming growth factor beta1 and tumor necrosis factor alpha

Med Oncol. 2010 Sep;27(3):697-701. doi: 10.1007/s12032-009-9271-3. Epub 2009 Jul 28.

Abstract

The aim of this article was to investigate the effect of ambroxol on radiation lung injury and the expression of transforming growth factor beta(1) (TGF-beta(1)), as well as tumor necrosis factor alpha (TNF-alpha) in plasma. Totally, 120 patients with locally advanced lung cancer in radiotherapy were randomized into treatment and control groups. Patients in the treatment group took ambroxol orally at a dosage of 90 mg, three times per day for 3 months from the beginning of radiotherapy. The expression of TGF-beta(1) and TNF-alpha in plasma was analyzed. The clinical symptoms and lung diffusing capacity were monitored using high resolving power computed tomography. The level of TGF-beta(1) in the control group was increased (11.8 +/- 5.5 ng/ml), whereas in ambroxol-treated patients, the increase was not significant (5.6 +/- 2.6 ng/ml, P < 0.001). Radiotherapy-induced elevation of TNF-alpha levels, seen in control patients, was also abolished after treatment with ambroxol (5.1 +/- 1.0 vs. 2.4 +/- 0.8 ng/ml, P < 0.001). In the treatment group, carbon monoxide diffusion capacity was not significantly decreased at 6, 12, and 18 months post-radiotherapy, compared with the control group (P < 0.05). Ambroxol decreased the expression of TGF-beta(1) and TNF-alpha, and minimized the diminishment of lung diffusion capacity after radiotherapy.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Ambroxol / adverse effects
  • Ambroxol / pharmacology
  • Ambroxol / therapeutic use*
  • Carbon Monoxide / metabolism
  • Female
  • Free Radical Scavengers / adverse effects
  • Free Radical Scavengers / pharmacology
  • Free Radical Scavengers / therapeutic use*
  • Humans
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Pulmonary Diffusing Capacity / drug effects
  • Pulmonary Diffusing Capacity / radiation effects
  • Pulmonary Fibrosis / etiology
  • Pulmonary Fibrosis / metabolism
  • Pulmonary Fibrosis / prevention & control*
  • Radiation Pneumonitis / drug therapy
  • Radiation Pneumonitis / metabolism
  • Radiation Pneumonitis / prevention & control*
  • Radiotherapy, Conformal
  • Single-Blind Method
  • Transforming Growth Factor beta1 / biosynthesis*
  • Transforming Growth Factor beta1 / blood
  • Tumor Necrosis Factor-alpha / analysis
  • Tumor Necrosis Factor-alpha / biosynthesis*

Substances

  • Adrenal Cortex Hormones
  • Free Radical Scavengers
  • Transforming Growth Factor beta1
  • Tumor Necrosis Factor-alpha
  • Ambroxol
  • Carbon Monoxide