title: N-acetylcysteine advancement of surfactant therapy in experimental meconium aspiration syndrome: possible mechanisms.
abstract: Meconium aspiration syndrome (MAS) is meconium-induced respiratory failure of newborns associated with activation of inflammatory and oxidative pathways. For severe MAS, exogenous surfactant treatment is used which improves respiratory functions but does not treat the inflammation. Oxidative process can lead to later surfactant inactivation; hence, surfactant combination with antioxidative agent may enhance the therapeutic effect. Young New Zealand rabbits were instilled by meconium suspension and treated by surfactant alone, N-acetylcysteine (NAC) alone or by their combination and oxygen-ventilated for 5 h. Blood samples were taken before and 30 min after meconium application and 30 min, 1, 3 and 5 h after the treatment for evaluating of oxidative damage, total leukocyte count, leukocyte differential count and respiratory parameters. Leukocyte differential was assessed also in bronchoalveolar lavage fluid. NAC alone had only mild therapeutic effect on MAS. However, the combination of NAC and surfactant facilitated rapid onset of therapeutic effect in respiratory parameters (oxygenation index, PaO(2)/FiO(2)) compared to surfactant alone and was the only treatment which prevented neutrophil migration into the lungs, oxidative damage and lung edema. Moreover, NAC suppressed IL-8 and IL-beta formation and thus seems to be favorable agent for improving surfactant therapy in MAS.
authors: Department of Physiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovak Republic. jana.kopincova@jfmed.uniba.sk.
authors: J
authors: J
authors: Kopincová
authors: D
authors: D
authors: Mokrá
authors: P
authors: P
authors: Mikolka
authors: M
authors: M
authors: Kolomazník
authors: A
authors: A
authors: Čalkovská
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D000831:Animals, Newborn; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology; D054441:Cell Migration Assays, Leukocyte; D016207:Cytokines / Q000378:metabolism; D004353:Drug Evaluation, Preclinical; D004359:Drug Therapy, Combination; D004487:Edema / Q000517:prevention & control; D005100:Expectorants / Q000494:pharmacology / Q000627:therapeutic use*; D007958:Leukocyte Count; D008168:Lung / Q000187:drug effects / Q000378:metabolism; D008471:Meconium Aspiration Syndrome / Q000276:immunology / Q000378:metabolism / Q000517:prevention & control*; D010865:Pilot Projects; D011663:Pulmonary Surfactants / Q000494:pharmacology / Q000627:therapeutic use*; D011817:Rabbits; D011897:Random Allocation; D012129:Respiratory Function Tests; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D014443:Tyrosine / Q000031:analogs & derivatives / Q000378:metabolism
chemical_list: D016207:Cytokines; D005100:Expectorants; D011663:Pulmonary Surfactants; D017392:Thiobarbituric Acid Reactive Substances; C002744:3-nitrotyrosine; D014443:Tyrosine; D000111:Acetylcysteine