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Cited by 179Chronic Obstructive Pulmonary Disease (COPD) ResearchAntioxidant Activity and Oxidative StressAsthma and respiratory diseases

Long-term administration of N-acetylcysteine decreases hydrogen peroxide exhalation in subjects with chronic obstructive pulmonary disease

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KASIELSKI, M, NOWAK, D·2001·Respiratory Medicine
DOI 10.1053/rmed.2001.1066
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Abstract

Patients with chronic obstructive pulmonary disease (COPD) exhale more hydrogen peroxide (H2O2) and lipid peroxidation products than healthy subjects. This may reflect oxidative stress in the airways that plays important role in the development and progression of COPD. N-acetylcysteine (NAC), a mucolytic drug, possesses antioxidant properties as it is a precursor of reduced glutathione that together with glutathione peroxidase may decompose H2O2 and lipid peroxides. We aimed to determine the effect of NAC, 600 mg effervescent tablets (Fluimucil), once a day for 12 months, and placebo on the concentration of H2O2 and thiobarbituric acid reactive substances (TBARs) in expired breath condensate and serum levels of two lipid peroxidation products (TBARs, lipid peroxides) in patients with COPD. The study was performed as a double-blind, double-dummy comparison between active drug and placebo in two parallel groups. Forty-four outpatients with stable COPD (22 in the NAC group and 22 in the placebo group) completed the study. Specimens of expired breath condensate and serum were collected at the randomization visit and then every 3 months over 1 year. The concentration of TBARs and H2O2 in expired breath condensate was measured spectrofluorimetrically by the thiobarbituric acid and homovanillic acid methods, respectively. Serum levels of lipid peroxides were determined spectrophotometrically after extraction with butanol and pyridine. Initially, H2O2 exhalation did not differ between the placebo and NAC groups up to 6 months of treatment. After this the significant differences were observed. After 9 and 12 months of treatment NAC group exhaled 2.3-fold (0.17+/-0.33 microM vs. 041+/-0.26 microM, P<0.04) [median 0.01 microM, quartile range (qr)=0.22 vs. median 0.15 microM, qr =0.43] and 2.6-fold (0.15+/-0.23 microM vs. 0.40+/-0.25 microN, P<0.05) median = 0.00 microM, qr = 0.23 vs. median = 0.36 microM, qr = 0.51] less H2O2 than placebo receivers, respectively. No significant effect of NAC administration on TBARs exhalation and serum levels of TBARs and lipid peroxides were noted over the whole treatment period. Also no significant associations between exhaled H2O2 and concentrations of lipid peroxidation products were noted in both treatment groups at any time-point. These results indicate that long-term oral administration of NAC attenuates H2O2 formation in the airways of COPD subjects and prove anti-oxidant action of drug. However, further studies are necessary to estimate the clinical significance of this finding.

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  • Supplementation with N-acetyl cysteine 600 mg every day for 12 months suppressed the concentration of hydrogen peroxide in exhaled breath condensate compared to the placebo group.

    “Similarly, supplementation with N-acetyl cysteine 600 mg every day for a period of 12 months suppressed the concentration of hydrogen peroxide in exhaled breath condensate compared to the placebo group (Kasielski and Nowak 2001).”

    From Reactive Oxygen Species, Toxicity, Oxidative Stress, and Antioxidants: Chronic Diseases and Aging (2023) · cites this paper as Kasielski and Nowak 2001

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Authors
KASIELSKI, M., & NOWAK, D.
Affiliations
Medical University of Lodz (PL)
ORCID
Venue
Respiratory Medicine
Publisher
Elsevier BV
Published
2001-06
Volume
95
Issue
6
Pages
448-456
ISSN
0954-6111 (ISSN-L)
DOI
10.1053/rmed.2001.1066
OpenAlex
W1978444750
Cited by
179
References
46
Citations by year
2026: 3 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 6 · 2020: 1 · 2019: 3 · 2018: 5 · 2017: 3 · 2016: 5 · 2015: 6 · 2014: 8 · 2013: 8 · 2012: 11
FWCI
9.67
Type
journal article
Language
en
Open access
Licence
Locations
  • Respiratory Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
Keywords
N-acetylcysteine, chronic obstructive pulmonary disease, lipid peroxidation, TBARS, oxidative stress, antioxidant therapy, long-term treatment, glutathione precursor, airway inflammation biomarkers, serum lipid peroxide, mucolytic agents, COPD exacerbations
MeSH terms
Acetylcysteine, Adult, Aged, Analysis of Variance, Breath Tests, Double-Blind Method, Female, Humans, Hydrogen Peroxide, Lung Diseases, Obstructive, Male, Middle Aged, Spectrometry, Fluorescence, Lipid Peroxidation, Free Radical Scavengers, Treatment Outcome, Thiobarbituric Acid Reactive Substances, Statistics, Nonparametric

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