Title
Effect of high-dose N-acetylcysteine on airway geometry, inflammation, and oxidative stress in COPD patientsEffect of high-dose N-acetylcysteine on airway geometry, inflammation, and oxidative stress in COPD patients
Author
Faculty/Department
Faculty of Sciences. Physics
Faculty of Medicine and Health Sciences
Research group
Biophysics and Biomedical Physics
Condensed Matter Theory
Antwerp Surgical Training, Anatomy and Research Centre (ASTARC)
Laboratory Experimental Medicine and Pediatrics (LEMP)
Publication type
article
Publication
Subject
Human medicine
Source (journal)
International journal of chronic obstructive pulmonary disease
Volume/pages
8(2013), p. 569-579
ISSN
1176-9106
ISI
000327537300001
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Background: Previous studies have demonstrated the potential beneficial effect of N-acetylcysteine (NAC) in chronic obstructive pulmonary disease (COPD). However, the required dose and responder phenotype remain unclear. The current study investigated the effect of high-dose NAC on airway geometry, inflammation, and oxidative stress in COPD patients. Novel functional respiratory imaging methods combining multislice computed tomography images and computer-based flow simulations were used with high sensitivity for detecting changes induced by the therapy. Methods: Twelve patients with Global Initiative for Chronic Obstructive Lung Disease stage II COPD were randomized to receive NAC 1800 mg or placebo daily for 3 months and were then crossed over to the alternative treatment for a further 3 months. Results: Significant correlations were found between image-based resistance values and glutathione levels after treatment with NAC (P = 0.011) and glutathione peroxidase at baseline (P = 0.036). Image-based resistance values appeared to be a good predictor for glutathione peroxidase levels after NAC (P = 0.02), changes in glutathione peroxidase levels (P = 0.035), and reduction in lobar functional residual capacity levels (P = 0.00084). In the limited set of responders to NAC therapy, the changes in airway resistance were in the same order as changes induced by budesonide/formoterol. Conclusion: A combination of glutathione, glutathione peroxidase, and imaging parameters could potentially be used to phenotype COPD patients who would benefit from addition of NAC to their current therapy. The findings of this small pilot study need to be confirmed in a larger pivotal trial.
Full text (open access)
https://repository.uantwerpen.be/docman/irua/e0c2ab/6286.pdf
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