Abstract
Introduction This study was aimed to investigate the effects of N-acetylcysteine (NAC) on chronic obstructive pulmonary disease (COPD) and the change of Th17/Treg cytokine imbalance. Material and Methods. A total of 121 patients with stable COPD at the stage of C or D were consecutively enrolled and randomly divided into 2 groups. Patients in the treatment group received NAC granules (0.2 g × 10 bags, 0.4 g each time, 3 times/d) for half a year. The control group was treated with the same amount of placebo therapy. The peripheral blood of the patient was collected and the cytokine, T lymphocyte subsets were detected. Results We found the oral administration of NAC could regulate Th17/Treg balance to resist inflammation in COPD patients. Serum testing showed that the proportion of Treg in CD4+ T cells has increased and the Th17/Treg ratio has decreased during the NAC treatment. In vitro studies, we found that NAC regulated Th17/Treg balance through Hypoxia Inducible Factor-1α pathway. Conclusions Our result could provide new diagnosis and treatment for elderly patients with COPD from the perspective of immunity ideas.
Highlights
This study was aimed to investigate the effects of N-acetylcysteine (NAC) on chronic obstructive pulmonary disease (COPD) and the change of Th17/Treg cytokine imbalance
Previous studies demonstrated that increased IL-17 level and decreased IL-10 level in serum were positively correlated with the progression of COPD [20, 21]
To determine whether oral NAC regulated the level of IL-17, IL-10, and other related inflammation cytokine in the serum, we obtained peripheral blood from the patient with COPD for further evaluation
Summary
This study was aimed to investigate the effects of N-acetylcysteine (NAC) on chronic obstructive pulmonary disease (COPD) and the change of Th17/Treg cytokine imbalance. Chronic obstructive pulmonary disease (COPD) belongs to a class of common chronic respiratory diseases characterized by irreversible continuous airflow limitation and high fatality rate, which currently places a huge burden on the world’s disease economy [1]. It is associated with both airway and extrapulmonary inflammation, as indicated by increased reactive oxygen species (ROS) levels and proinflammatory markers in peripheral blood. There are limited data on the anti-inflammatory activity of NAC in COPD patients
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