N-acetylcysteine improves the clinical conditions of mustard gas-exposed patients with normal pulmonary function test.
Administration of N-acetylcysteine may be effective in diseases caused by oxidative-antioxidative imbalance. We aimed to determine the effect administration for 4 months of N-acetylcysteine (1200 mg daily) on sulfur mustard-induced bronchiolitis obliterans in patients with normal pulmonary function test. In a double-blind clinical trial, 144 patients with bronchiolitis obliterans due to sulfur mustard and bronchiolitis obliterans syndrome class 0, randomly entered to group 1 (n = 72, N-acetylcysteine) and group 2 (n = 72, placebo). The changes in dyspnoea, wake-up dyspnoea, cough and sputum were measured after 4 months using a 'delta value' (i.e. symptom score after 4 months--symptom score before the trial). Spirometric findings were measured at the beginning of the trial, 2 months later and 4 months later. Dyspnoea (delta value: -0.78 (0.61), P < 0.001), wake-up dyspnoea (delta value: -0.57 (0.64), P < 0.001), and cough (delta value: -0.86 (0.63), P < 0.001) improved after 4 months of N-acetylcysteine administration compared to the control group. N-acetylcysteine reduced sputum from 76.9% (n = 40) of cases before the trial to 9.6% (n = 5) of cases after the trial. Spirometric components were significantly improved in N-acetylcysteine group compared to the placebo group: FEV1 (P < 0.0001), FVC (P = 0.014) and FEV1/FVC (P = 0.003). A 4-month trial with 1200 mg oral N-acetylcysteine per day can be used for treating bronchitis, but is also effective in treating bronchiolitis. It also prevents sulfur mustard-induced oxidative stress, and can be used in the treatment of sulfur mustard-induced pulmonary disease.
Ghanei
Mostafa
M
Research Center of Chemical Injuries, Baqiyatallah University of Medical Sciences, Tehran, Iran. ghanei@excite.com
Shohrati
Majid
M
Jafari
Mehrdad
M
Ghaderi
Soleyman
S
Alaeddini
Farshid
F
Aslani
Jafar
J
D000111:Acetylcysteine / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000975:Antioxidants / Q000494:pharmacology / Q000627:therapeutic use*; D001989:Bronchiolitis Obliterans / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D002619:Chemical Warfare Agents / Q000633:toxicity*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009151:Mustard Gas / Q000633:toxicity*; D018384:Oxidative Stress / Q000187:drug effects; D012129:Respiratory Function Tests; D013147:Spirometry; D013183:Sputum / Q000187:drug effects; D013997:Time Factors; D014797:Vital Capacity / Q000187:drug effects
D000975:Antioxidants; D002619:Chemical Warfare Agents; D009151:Mustard Gas; D000111:Acetylcysteine