Changes in blood ROS, e-NO, and some pro-inflammatory mediators in bronchial secretions following erdosteine or placebo: A controlled study in current smokers with mild COPD

Anti-oxidant interventions consist in reduction of direct oxidant damage by removing oxidant agents and/or by supplementing reducing agents with anti-oxidant effects. Aim: Aim of the present study was to investigate the anti-oxidant effects of erdosteine, a recent drug currently used in chronic obstructive pulmonary disease (COPD) for its rheological activity. At present, no data are available on current smokers with COPD to our knowledge. Methods: Two groups of 10 persons matched for sex; age (65.0 yr +/- 8.4 S.D. and 65.3 yr +/- 6.5 S.D.); basal FEV1 (88.7% pred +/- 6.8 S.D. and 85.2% pred +/- 5.8 S.D.); and cigarette consumption (25.4 pack/yr +/- 3.5 S.D. and 28.1 pack/yr +/- 2.3 S.D.) entered a controlled, double blind, parallel groups study. They were randomized to receive erdosteine 600 mg daily or placebo for 10 days. IL-6; IL-8; TNF alpha were measured in bronchial secretions in bsln, after 4, 7, and 10 days of Erdosteine or placebo; e-NO and both ROS and 8-Isoprostane in blood were also measured at the same experimental times. Statistics: ANOVA: a t-test with Bonferroni correction; p<0.05 was accepted. Results: Blood ROS and IL-8 in bronchial secretions dropped significantly following erdosteine starting from day 4 (both p<0.01), while 8-isoprostane drop was significant only after day 10 (p<0.02), and the e-NO decrease proved evident but not significant. No significant changes were observed in the placebo group. Conclusions: Erdosteine affects substantially some pro-inflammatory cytokines specifically involved in oxidative stress in current smokers with mild COPD. Effects appeared differently time-dependent. Further long-term studies are needed to confirm these pilot data and to assess their long-term clinical relevance. (C) 2007 Elsevier Ltd. All rights reserved.