Priming of beta-2 agonist and antimuscarinic induced physiological responses
induced by 1200mg/day NAC in moderate to severe COPD patients: A pilot study.
Author(s): Sinojia R(1), Shaikh M(1), Kodgule R(1), Bhosale S(1), Madas S(1), Vaidya A(2),
Salvi S(1), Brashier B(3).
Affiliation(s): Author information:
(1)Chest Research Foundation, Department of Pulmonary Research, Pune, Maharashtra,
India.
(2)Cipla Ltd., Mumbai, India.
(3)Chest Research Foundation, Department of Pulmonary Research, Pune, Maharashtra,
India. Electronic address: bbrashier@crfindia.com.
Publication date & source: 2014, Respir Physiol Neurobiol. , 191:52-9
This study evaluated antioxidant modulations of lung physiological-responses to
beta-2-agonist and antimuscarinic bronchodilators with 1200mg/day
n-acetyl-cysteine (NAC) in a placebo-controlled, randomised, double-blind,
parallel-group study, in moderate-very severe COPD patients.METHODS: 15 COPD
patients received NAC treatment, while 9 COPD patients received placebo
treatment, for 15 days. Pre-and-post salbutamol and ipratopium-bromide
lung-physiology responses were measured using body-plethysmography,
impulse-oscillometry (IOS) and spirometry before-and-after study treatments.
RESULTS: Compared to pre-treatment, the NAC-treatment significantly enhanced the
potential of ipratopium-bromide to reduce functional-residual-capacity (FRC) by
nearly 3-folds (mean% FRC-response: pre-NAC: -5.51%±10.42% versus post-NAC:
-17.89%±12.94%, p=0.02; mean-absolute FRC-response: pre-NAC: -300ml±450ml versus
post-NAC: -770ml±550ml, p=0.02), which was superior to placebo-treatment. The
increase in total-lung-capacity response to ipratopium-bromide, although
insignificant, was superior with post-NAC treatment versus post-placebo treatment
(p=0.049). The salbutamol-response remained unaltered with either treatment.
CONCLUSION: The treatment with 1200mg/day NAC has potential to enhance the
bronchodilator ability of antimuscarinic-agents but not beta-2-agonist. However,
its clinical application has to be established in large sample-size studies for
longer-duration.
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