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Erdosteine enhances airway response to salbutamol in patients with mild-to-moderate COPD
1 Lung Department, Orlandi General Hospital, Bussolengo, Verona,
Italy
* To whom correspondence should be addressed.
Background: Oxidative stress is presumed to impair
Methods: The objective was to assess the effect of antioxidant
interventions on short-term airway response to salbutamol in non-reversible
mild-to-moderate COPD patients. Thirty COPD patients (GOLD class 1–2),
current smoker ( Results: E and NAC caused significant drops in ROS blood levels
after four and ten days
(p < 0.001 and
p < 0.0001 vs. placebo). In contrast
to NAC, E lowered 8-isoprostane levels substantially for ten days
(p = 0.017 and
p = 0.0004 vs. placebo,
respectively). Only E restored significantly short-term reversibility in
COPD patients previously unresponsive to
Conclusions: This effect seems more related to the
peculiar protection against lipid peroxidation rather than to the
scavenging activity, which proves equal to that of NAC. E provides a sort
of indirect bronchodilation through 're-sensitisation' of
Key Words: antioxidants, b2-adrenoceptors, COPD (chronic obstructive pulmonary disease), mucolytics, lipid peroxidation, reversibility test
First published on September 3, 2008, doi:10.1177/1753465808096109 |
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-adenoceptor function and airway patency. Erdosteine (E), a
mucomodulatory compound, has shown important antioxidant properties.
10 pack/year), randomly received
E 300 mg, N-acetylcysteine (NAC) 600 mg, or placebo,
twice daily for ten days. Reversibility
to salbutamol 200 µg was tested in baseline,
after four and ten days of each treatment. ROS and 8-isoprostane
blood levels were measured on the same days. Between-treatment
comparison was performed by ANOVA and t-test or Wilcoxon
test, and p < 0.05 assumed.
E enhanced FEV1 reversibility after four and ten days significantly
(+5.1% and +5.0%; both
p < 0.01 vs. placebo), while NAC only
showed a transient effect at day 4 (+3.0%,
p < 0.05), but not at day 10
(+1.3%, p = ns).