title: The effect of short-term, high-dose oral N-acetylcysteine treatment on oxidative stress markers in cystic fibrosis patients with chronic P. aeruginosa infection -- a pilot study.
abstract: BACKGROUND
  Patients with cystic fibrosis (CF) and chronic Pseudomonas aeruginosa lung infection have increased oxidative stress as a result of an imbalance between the production of reactive oxygen species caused by inflammation and their inactivation by the impaired antioxidant systems. Supplementation with anti-oxidants is potentially beneficial for CF patients.
  
  
  METHODS
  The effect of 4 weeks of oral N-acetylcysteine (NAC) treatment (2400 mg/day divided into two doses) on biochemical parameters of oxidative stress was investigated in an open-label, controlled, randomized trial on 21 patients; 11 patients in the NAC group and 10 in the control group. Biochemical parameters of oxidative burden and plasma levels of antioxidants were assessed at the end of the study and compared to the baseline values in the two groups.
  
  
  RESULTS
  A significant increase in the plasma levels of the antioxidant ascorbic acid (p=0.037) and a significant decrease in the levels of the oxidized form of ascorbic acid (dehydroascorbate) (p=0.004) compared to baseline were achieved after NAC treatment. No significant differences were observed in the control group. The parameters of oxidative burden did not change significantly compared to baseline in either of the groups. A better lung function was observed in the NAC treated group with a mean (SD) change compared to baseline of FEV1% predicted of 2.11 (4.6), while a decrease was observed in the control group (change -1.4 (4.6)), though not statistically significant.
  
  
  CONCLUSIONS
  Treatment with N-acetylcysteine 1200 mg×2/day for 30 days significantly decreased the level of oxidized vitamin C and increased the level of vitamin C (primary end-points) and a not statistically significant improvement of lung function was observed in this group of patients.
authors.affiliation: Copenhagen Cystic Fibrosis Center, University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Marianne
authors.initials: M
authors.lastname: Skov
authors.affiliation: Copenhagen Cystic Fibrosis Center, University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Tacjana
authors.initials: T
authors.lastname: Pressler
authors.affiliation: Department of Veterinary Disease Biology, Faculty of Health Science, University of Copenhagen, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Lykkesfeldt
authors.affiliation: Laboratory of Clinical Pharmacology, Bispebjerg/Frederiksberg Hospitals, Copenhagen, Denmark.
authors.forename: Henrik Enghusen
authors.initials: HE
authors.lastname: Poulsen
authors.affiliation: Department of Clinical Microbiology, University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Peter Østrup
authors.initials: PØ
authors.lastname: Jensen
authors.affiliation: Department of Clinical Microbiology, University Hospital Rigshospitalet, Copenhagen, Denmark; The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Hørsholm, Denmark.
authors.forename: Helle Krogh
authors.initials: HK
authors.lastname: Johansen
authors.affiliation: Copenhagen Cystic Fibrosis Center, University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Tavs
authors.initials: T
authors.lastname: Qvist
authors.affiliation: General practice, Nørre Farimagsgade 54, Copenhagen, Denmark.
authors.forename: Dorthe
authors.initials: D
authors.lastname: Kræmer
authors.affiliation: Department of Clinical Microbiology, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of International Health, Immunology and Microbiology, Costerton Biofilm Center, Faculty of Health Science, University of Copenhagen, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Høiby
authors.affiliation: Department of International Health, Immunology and Microbiology, Costerton Biofilm Center, Faculty of Health Science, University of Copenhagen, Denmark. Electronic address: ociofu@sund.ku.dk.
authors.forename: Oana
authors.initials: O
authors.lastname: Ciofu
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage*; D000284:Administration, Oral; D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage; D001205:Ascorbic Acid / Q000378:metabolism*; D002908:Chronic Disease; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000378:metabolism; D008168:Lung / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D011552:Pseudomonas Infections / Q000150:complications / Q000503:physiopathology; D017382:Reactive Oxygen Species / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; D017382:Reactive Oxygen Species; D001205:Ascorbic Acid; D000111:Acetylcysteine
keywords: Antioxidants; Ascorbic acid; N-acetylcysteine; Oxidative stress