title: The protective effects of ambroxol on radiation lung injury and influence on production of transforming growth factor beta1 and tumor necrosis factor alpha.
abstract: The aim of this article was to investigate the effect of ambroxol on radiation lung injury and the expression of transforming growth factor beta(1) (TGF-beta(1)), as well as tumor necrosis factor alpha (TNF-alpha) in plasma. Totally, 120 patients with locally advanced lung cancer in radiotherapy were randomized into treatment and control groups. Patients in the treatment group took ambroxol orally at a dosage of 90 mg, three times per day for 3 months from the beginning of radiotherapy. The expression of TGF-beta(1) and TNF-alpha in plasma was analyzed. The clinical symptoms and lung diffusing capacity were monitored using high resolving power computed tomography. The level of TGF-beta(1) in the control group was increased (11.8 +/- 5.5 ng/ml), whereas in ambroxol-treated patients, the increase was not significant (5.6 +/- 2.6 ng/ml, P < 0.001). Radiotherapy-induced elevation of TNF-alpha levels, seen in control patients, was also abolished after treatment with ambroxol (5.1 +/- 1.0 vs. 2.4 +/- 0.8 ng/ml, P < 0.001). In the treatment group, carbon monoxide diffusion capacity was not significantly decreased at 6, 12, and 18 months post-radiotherapy, compared with the control group (P < 0.05). Ambroxol decreased the expression of TGF-beta(1) and TNF-alpha, and minimized the diminishment of lung diffusion capacity after radiotherapy.
authors.affiliation: Jiangyin Hospital of Medical College, Southeast University, 214400, Jiangyin, Jiangsu Province, People's Republic of China. xiadeh@yahoo.com.cn
authors.forename: De-Hong
authors.initials: DH
authors.lastname: Xia
authors.forename: Lei
authors.initials: L
authors.lastname: Xi
authors.forename: Chen
authors.initials: C
authors.lastname: Xv
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Mao
authors.forename: Wei-Sheng
authors.initials: WS
authors.lastname: Shen
authors.forename: Zhong-Qin
authors.initials: ZQ
authors.lastname: Shu
authors.forename: Hong-Zhi
authors.initials: HZ
authors.lastname: Yang
authors.forename: Min
authors.initials: M
authors.lastname: Dai
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000551:Ambroxol / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002248:Carbon Monoxide / Q000378:metabolism; D005260:Female; D016166:Free Radical Scavengers / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011653:Pulmonary Diffusing Capacity / Q000187:drug effects / Q000528:radiation effects; D011658:Pulmonary Fibrosis / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D017564:Radiation Pneumonitis / Q000188:drug therapy / Q000378:metabolism / Q000517:prevention & control*; D020266:Radiotherapy, Conformal; D016037:Single-Blind Method; D053773:Transforming Growth Factor beta1 / Q000096:biosynthesis* / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000096:biosynthesis*
chemical_list: D000305:Adrenal Cortex Hormones; D016166:Free Radical Scavengers; D053773:Transforming Growth Factor beta1; D014409:Tumor Necrosis Factor-alpha; D000551:Ambroxol; D002248:Carbon Monoxide