Study Of Malondialdehyde As An Indicator Of Oxidative Stress And Its Modulation By N-Acetylcysteine In Chronic Obstructive Pulmonary Disease
48-51
Correspondence
Anita B Kale
Deptt. Of Biochemistry, Jawaharlal Nehru Medical College, Sawangi (M), Wardha, Maharashtra.
Ph: 09850620123.
Email: anitachalak@rediffmail.com
Background & objectives: Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease characterized by systemic and local inflammation and oxidative stress. In view of the lack of therapy that might inhibit the progress of the disease, there is an urgent need for a successful therapeutic approach. This study aims to evaluate the effects of administration of oral N-acetylcysteine (NAC) on the oxidative stress and respiratory symptoms and also to check the safety of oral NAC.
Methods: This randomized, double blind study was conducted in sixty-eight adult patients diagnosed as having COPD. All patients received standard treatment for COPD and were divided into three groups. Group I received placebo, Group II and Group III received NAC 600 mg once daily (OD) and twice daily (BID) dose respectively for two months. Efficacy parameters included assessment of serum malondialdehyde (MDA) and respiratory symptoms. Adverse drug reactions were monitored as a safety measure.
Results: Mean serum MDA levels showed significant fall in group-II (p=0.001) and group-III (P=0.023) as compared to group-I (P=0.147) and improvement in respiratory symptoms was noticeable in group-III followed by group-II from day 0 to day 60. Nausea and stomatitis were the most common adverse drug reactions experienced by the patients in all the three groups.
Interpretation & conclusions: Maximum decline in oxidative stress was with OD dose followed by BID dose which indicates that antioxidants above a certain limit may not be much beneficial. Improvement in symptoms was seen maximum with BID dose followed by OD dose. This was due to mucolytic and immunomodulating properties of NAC besides its antioxidant role. Minor adverse drug reactions confirm the safety of NAC with both the doses. This confers a new facet in management of COPD and an attempt to impede the disease progression.