N-Acetylcysteine Improves Inflammatory Response in COPD Patients by Regulating Th17/Treg Balance through Hypoxia Inducible Factor-1 α Pathway

Biomed Res Int. 2021 Jun 29:2021:6372128. doi: 10.1155/2021/6372128. eCollection 2021.

Abstract

Introduction: This study was aimed to investigate the effects of N-acetylcysteine (NAC) on chronic obstructive pulmonary disease (COPD) and the change of Th17/Treg cytokine imbalance. Material and Methods. A total of 121 patients with stable COPD at the stage of C or D were consecutively enrolled and randomly divided into 2 groups. Patients in the treatment group received NAC granules (0.2 g × 10 bags, 0.4 g each time, 3 times/d) for half a year. The control group was treated with the same amount of placebo therapy. The peripheral blood of the patient was collected and the cytokine, T lymphocyte subsets were detected.

Results: We found the oral administration of NAC could regulate Th17/Treg balance to resist inflammation in COPD patients. Serum testing showed that the proportion of Treg in CD4+ T cells has increased and the Th17/Treg ratio has decreased during the NAC treatment. In vitro studies, we found that NAC regulated Th17/Treg balance through Hypoxia Inducible Factor-1α pathway.

Conclusions: Our result could provide new diagnosis and treatment for elderly patients with COPD from the perspective of immunity ideas.

Publication types

  • Randomized Controlled Trial
  • Retracted Publication

MeSH terms

  • Acetylcysteine / administration & dosage
  • Acetylcysteine / pharmacology*
  • Administration, Oral
  • Aged
  • Down-Regulation / drug effects
  • Female
  • Humans
  • Hypoxia-Inducible Factor 1, alpha Subunit / metabolism*
  • Inflammation / blood
  • Inflammation / complications
  • Inflammation / pathology*
  • Interleukin-10 / blood
  • Interleukin-17 / blood
  • Lymphocyte Count
  • Male
  • Pulmonary Disease, Chronic Obstructive / blood
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / immunology*
  • T-Lymphocytes, Regulatory / drug effects
  • T-Lymphocytes, Regulatory / immunology*
  • Th17 Cells / drug effects
  • Th17 Cells / immunology*
  • Up-Regulation / drug effects

Substances

  • HIF1A protein, human
  • Hypoxia-Inducible Factor 1, alpha Subunit
  • Interleukin-17
  • Interleukin-10
  • Acetylcysteine