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Effect of N-acetylcysteine in treatment of COPD with pulmonary interstitial fibrosis, inflammatory factors and VEGF levels


Jie Yang
Yuanping Cai
Qiaofa Lu
Bo Zhang

Abstract

Purpose: To investigate the efficacy of N-acetylcysteine as an adjuvant therapy in chronic obstructive pulmonary disease (COPD) with  pulmonary interstitial fibrosis (PIF), and its effect on inflammatory factors and serum vascular endothelial growth factor (VEGF) levels.


Methods: A total of 94 patients with COPD-PIF from May 2020 to May 2022 in Wuhan Fourth Hospital, China were equally randomized into  study and control groups. Control group was administered conventional treatment while the study group was given N-acetylcysteine  in addition to conventional treatment. Therapeutic efficacy, forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, blood gas, pulmonary fibrosis, and oxidative stress were evaluated. Changes in inflammatory factors, serum  vascular endothelial growth factor (VEGF), and incidence of adverse drug reactions were compared.


Results: The study group showed  significantly higher efficacy, FEV1, FVC, FEV1/FVC compared to control group (p < 0.05). Also, study group showed significantly higher  partial pressure of oxygen (PaO2), blood oxygen saturation, superoxide dismutase (SOD), and glutathione (GSH) levels after treatment  compared to control group (p < 0.05). Platelet-derived growth factor (PDGF), transforming growth factor (TGF-β), vascular cell adhesion  molecule (VCAM), tumor necrosis factor (TNF), interleukin-6 (IL-6), and vascular endothelial growth factor (VEGF) levels after treatment  were significantly lower in the study group than in the control group (p < 0.05).


Conclusion: N-acetylcysteine as an adjuvant therapy for  COPD-IF is highly effective, improves lung function and oxidative stress, reduces airway inflammation, and VEGF, and attenuates the  degree of hypoxia and pulmonary fibrosis with no serious adverse effects. A larger sample size, multicenter, randomized trials to validate  these findings and evaluate the downstream regulatory mechanism of Nacetylcysteine in COPD-PIF.


Journal Identifiers


eISSN: 1596-9827
print ISSN: 1596-5996