Publication:

Effects of administration of oral n-acetylcysteine on oxidative stress in chronic obstructive pulmonary disease patients in rural population

Background Chronic obstructive pulmonary disease (COPD) is a common pulmonary disease and the fourth leading cause of death globally. Oxidative stress is an important attribute in the pathogenesis of COPD.  Targeting oxidative stress would be a logical therapeutic approach for COPD and glutathione precursors like N-acetylcysteine (NAC) have shown therapeutic promise in the treatment of this chronic pathology. This study attempts to determine the dose related effects of NAC on the oxidative stress, its safety and efficacy in COPD patients.

Methods A randomized, double blind, placebo controlled, parallel group, single centred study, and was carried out in rural set-up. Sixty eight diagnosed cases of COPD according to GOLD criteria (global initiative for chronic obstructive lung disease), were recruited in the study, following approval from the ethics committee. The patients were randomized to three treatment arms (placebo, NAC 600 mg once a day (OD) and NAC 600 mg bis a day (BID). The patients were monitored for incidence and severity of adverse effects as a measure of safety. Efficacy of NAC was determined based on symptom improvement, pulmonary function, oxygen saturation and serum malondialdehyde (MDA) concentration.

Results Results indicate a significant improvement in the efficacy parameters in the group that received higher dose of NAC. NAC was well tolerated by all the study subjects. Addition of NAC to the standard treatment of COPD exhibits beneficial effects in disease exacerbations, symptom improvement and a decline in oxidative stress parameters, reinforcing the antioxidant, anti-inflammatory and mucolytic properties of NAC.

Conclusions This approach opens possibilities for a novel therapeutic approach in COPD.