BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity worldwide, characterised by persistent airflow limitation, mucus hypersecretion, oxidative stress and airway inflammation. N-acetylcysteine (NAC) have anti-oxidant and anti-inflammatory properties, which have been shown an uncertain benefit in COPD patients. METHOD: Systematic searches were conducted in Cochrane, Medline and Embase electronic databases. A meta-analysis was performed to evaluate the different effect between high and low-dose NAC treatment on COPD exacerbation. RESULTS: This review yielded 11 studies. The methodological quality of included studies were scored using the Jadad score, with a scale of 1 to 5 (score of 5 being the highest). Data showed high-dose NAC can reduce both the total number of exacerbations (RR = 0.59, 0.47 to 0.74, 95%CI, p < 0.001) and the proportion of patients with at least one exacerbation (RR = 0.76, 0.59 to 0.98, 95%CI, p = 0.03). In the low-dose group, subgroup with jadad ≤ 3 showed a significant decrease (RR = 0.69, 0.61 to 0.77, 95%CI, p < 0.001) in the proportion of patients with exacerbation, the other subgroup with Jadad score > 3 showed no significant decrease (RR = 0.98, 0.90 to 1.06, 95%CI, p = 0.59). And low-dose NAC showed no benefit in the total number of exacerbations (RR = 0.97, 0.68 to 1.37, 95%CI, p = 0.85). Neither high nor low-dose NAC treatment showed benefit in forced expiratory volume in one second(FEV1)(WMD = 1.08, -9.97 to 12.13, 95%CI, p = 0.85). CONCLUSION: Long-term high-dose NAC treatment may lead to a lower rate of exacerbations. But the effect of low-dose NAC treatment remains uncertain. Further researches are needed to confirm this outcome and to clarify its mechanisms.
BACKGROUND:Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity worldwide, characterised by persistent airflow limitation, mucus hypersecretion, oxidative stress and airway inflammation. N-acetylcysteine (NAC) have anti-oxidant and anti-inflammatory properties, which have been shown an uncertain benefit in COPDpatients. METHOD: Systematic searches were conducted in Cochrane, Medline and Embase electronic databases. A meta-analysis was performed to evaluate the different effect between high and low-dose NAC treatment on COPD exacerbation. RESULTS: This review yielded 11 studies. The methodological quality of included studies were scored using the Jadad score, with a scale of 1 to 5 (score of 5 being the highest). Data showed high-dose NAC can reduce both the total number of exacerbations (RR = 0.59, 0.47 to 0.74, 95%CI, p < 0.001) and the proportion of patients with at least one exacerbation (RR = 0.76, 0.59 to 0.98, 95%CI, p = 0.03). In the low-dose group, subgroup with jadad ≤ 3 showed a significant decrease (RR = 0.69, 0.61 to 0.77, 95%CI, p < 0.001) in the proportion of patients with exacerbation, the other subgroup with Jadad score > 3 showed no significant decrease (RR = 0.98, 0.90 to 1.06, 95%CI, p = 0.59). And low-dose NAC showed no benefit in the total number of exacerbations (RR = 0.97, 0.68 to 1.37, 95%CI, p = 0.85). Neither high nor low-dose NAC treatment showed benefit in forced expiratory volume in one second(FEV1)(WMD = 1.08, -9.97 to 12.13, 95%CI, p = 0.85). CONCLUSION: Long-term high-dose NAC treatment may lead to a lower rate of exacerbations. But the effect of low-dose NAC treatment remains uncertain. Further researches are needed to confirm this outcome and to clarify its mechanisms.
Authors: Shi B Chia; Evan A Elko; Reem Aboushousha; Allison M Manuel; Cheryl van de Wetering; Joseph E Druso; Jos van der Velden; David J Seward; Vikas Anathy; Charles G Irvin; Ying-Wai Lam; Albert van der Vliet; Yvonne M W Janssen-Heininger Journal: Am J Physiol Cell Physiol Date: 2019-11-06 Impact factor: 4.249
Authors: Xiaohua Xu; Robert Balsiger; Jean Tyrrell; Prosper N Boyaka; Robert Tarran; Estelle Cormet-Boyaka Journal: Biochim Biophys Acta Date: 2015-02-16
Authors: Shaopeng Yuan; Martin Hollinger; Marrah E Lachowicz-Scroggins; Sheena C Kerr; Eleanor M Dunican; Brian M Daniel; Sudakshina Ghosh; Serpel C Erzurum; Belinda Willard; Stanley L Hazen; Xiaozhu Huang; Stephen D Carrington; Stefan Oscarson; John V Fahy Journal: Sci Transl Med Date: 2015-02-25 Impact factor: 17.956
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Authors: Mojtaba Abdul Roda; Mariam Sadik; Amit Gaggar; Matthew T Hardison; Michael J Jablonsky; Saskia Braber; James Edwin Blalock; Frank A Redegeld; Gert Folkerts; Patricia L Jackson Journal: PLoS One Date: 2014-05-16 Impact factor: 3.240