Antioxidant therapies in COPD.
Oxidative stress is an important feature in the pathogenesis of COPD. Targeting oxidative stress with antioxidants or boosting the endogenous levels of antioxidants is likely to be beneficial in the treatment of COPD. Antioxidant agents such as thiol molecules (glutathione and mucolytic drugs, such as N-acetyl-L-cysteine and N-acystelyn), dietary polyphenols (curcumin, resveratrol, green tea, catechins/quercetin), erdosteine, and carbocysteine lysine salt, all have been reported to control nuclear factor-kappaB (NF-kappaB) activation, regulation of glutathione biosynthesis genes, chromatin remodeling, and hence inflammatory gene expression. Specific spin traps such as alpha-phenyl-N-tert-butyl nitrone, a catalytic antioxidant (ECSOD mimetic), porphyrins (AEOL 10150 and AEOL 10113), and a superoxide dismutase mimetic M40419 have also been reported to inhibit cigarette smoke-induced inflammatory responses in vivo. Since a variety of oxidants, free radicals, and aldehydes are implicated in the pathogenesis of COPD, it is possible that therapeutic administration of multiple antioxidants will be effective in the treatment of COPD. Various approaches to enhance lung antioxidant capacity and clinical trials of antioxidant compounds in COPD are discussed.
Department of Environmental Medicine, Lung Biology and Disease Program, University of Rochester Medical Center, 601 Elmwood Ave, Box 850, Rochester, NY 14642, USA. irfan_rahman@urmc.rochester.edu
Irfan
I
Rahman
D000447:Aldehydes / Q000009:adverse effects; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D019587:Dietary Supplements; D005541:Forced Expiratory Volume; D005609:Free Radicals; D006801:Humans; D015227:Lipid Peroxidation; D008168:Lung / Q000503:physiopathology; D015201:Meta-Analysis as Topic; D016877:Oxidants / Q000009:adverse effects; D018384:Oxidative Stress; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D012129:Respiratory Function Tests; D012906:Smoke / Q000009:adverse effects; D012907:Smoking / Q000009:adverse effects; D019097:Spin Trapping; D013997:Time Factors; D016896:Treatment Outcome; D014815:Vitamins / Q000008:administration & dosage / Q000627:therapeutic use*
D000447:Aldehydes; D000975:Antioxidants; D005609:Free Radicals; D016877:Oxidants; D012906:Smoke; D014815:Vitamins