The effect of different treatment modalities on oxidative stress in COPD.
BACKGROUND
Oxidant/antioxidant interactions are known to be important processes in the pathogenesis of chronic obstructive pulmonary disease (COPD). We aimed to evaluate the effects of corticosteroids (CS), and N-acetylcysteine (NAC) on plasma oxidant/antioxidant levels in patients with COPD.


METHODS
This study utilised a single-blind, randomised, placebo-controlled, parallel-group methodology. We enrolled 58 patients with stable COPD and 30 healthy controls with similar demographic profiles. The patients with COPD were randomly divided into three treatment groups. Group 1 received basal treatment (regular ipratropium bromide and beta-2 agonist as needed), placebo CS and placebo NAC. In addition to basal treatment, group 2 received oral CS (methylprednisolone 40 mg/day) and placebo NAC. Group 3 received basal treatment plus NAC (600 mg/day) and placebo CS. Each group received treatment for 15 days. We measured plasma malondialdehyde (MDA) and superoxide dismutase (SOD) at the start and the end of study.


RESULTS
Post-treatment plasma MDA levels were significantly lowered only in group 2 (P=0.004). No significant differences were found with respect to erythrocyte SOD levels.


CONCLUSIONS
This study demonstrates that oral CS, by aiding the oxidant/antioxidant system, may offer a new therapeutic option in COPD treatment.
Kuleci
Sedat
S
Cukurova University, School of Medicine, Department of Chest Diseases, Adana, Turkey.
Hanta
Ismail
I
Kocabas
Ali
A
Canacankatan
Necmiye
N
D000111:Acetylcysteine / Q000494:pharmacology* / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D004359:Drug Therapy, Combination; D005260:Female; D016166:Free Radical Scavengers / Q000494:pharmacology* / Q000627:therapeutic use; D005938:Glucocorticoids / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D009241:Ipratropium / Q000627:therapeutic use; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000378:metabolism; D012129:Respiratory Function Tests; D013482:Superoxide Dismutase / Q000097:blood
D000319:Adrenergic beta-Antagonists; D016166:Free Radical Scavengers; D005938:Glucocorticoids; D008315:Malondialdehyde; D013482:Superoxide Dismutase; D009241:Ipratropium; D000111:Acetylcysteine; D008775:Methylprednisolone