Abstract
Idiopathic pulmonary fibrosis (IPF) is a common aggressive form of the idiopathic interstitial pneumonias of unknown cause. It is chronic, progressive, irreversible, fibrosing and lethal lung disease with a poor prognosis. The cardinal symptom of IPF is dyspnea; however, other pulmonary and extra-pulmonary symptoms are often present. The study aims to implement a novel pharmaceutical approach by administration of selenium accompanied with prednisone in an attempt to improve clinical outcome of IPF patients to decrease other medications toxicities and improve patients’ quality of life. This study was conducted at Kasr El-Ainy Chest Hospitals, from April 2012 to March 2014.The work included forty clinically and radiologically diagnosed cases of IPF and twenty healthy controls, they were subdivided into Group I: twenty IPF patients received; N-acetyl cysteine (NAC) 600 mg/3 times (for 3 months).Group II: twenty IPF patients received: Selenium 200 mcg/day (for 3 months). All cases subjected to medical history, clinical examination, plain X-ray chest, and High resolution computed tomography (HRCT), 6-minute walk test, and spirometry. All patients signed informed consents. The comparison of Selenium group with NAC revealed a significant increase in both of forced vital capacity (FVC) and Forced expiratory volume in the first second (FEV1) (p= 0.008, 0.016, respectively), using a Mann-Whitney test. There was no remarkable adverse drug reactions observed in both groups, and no serious drug interactions. This study showed that selenium supplementation in IPF patients’ significantly improved pulmonary functions, which reflect an antioxidant capacity. In addition patients’ clinical presentation shown as significant decrease of coughing and dyspnea on exertion.
Highlights
Idiopathic pulmonary fibrosis (IPF), the common aggressive form of the idiopathic interstitial pneumonias of unknown cause
The present study demonstrated that the mean ± SD age among the IPF patients was 51.5 ± 8.5 with no statistically significant difference
In this study we explored the impact of selenium supplementation on improvement of patients lung functions and walking distance
Summary
Idiopathic pulmonary fibrosis (IPF), the common aggressive form of the idiopathic interstitial pneumonias of unknown cause It is chronic, progressive, irreversible, fibrosing and lethal lung disease with a poor prognosis (Raghu et al 2011).The histological hallmark of IPF pattern is patchy interstitial fibrosis.(Bois 2012) The fibrosis is temporary heterogeneous with architectural destruction, dense scarring with honey combing and scattered fibroblast foci(Raghu et al 2011). (Pardo and Selman 2012)There is a higher predominance of the disease in men (1.5 to 1.7; 1) than in women and frequency increases with age It has a poor prognosis with a 5 year mortality rate between 50 and 70 % (Loomis-King, Flaherty, and Moore 2013).The most important environmental risk factors are cigarette smoking and exposure to metal and wood dust. PANTHERIPF trial (2009-sep. 2014) stressed on that currently used triple-drug therapy consisting of prednisone, is a potentially harmful combination to people with IPF that the arm with this combination was stopped for safety concerns.(Loomis-King et al 2013).The study aims to implement a novel pharmaceutical approach by administration of Selenium in an attempt to improve clinical outcome of IPF patients, decrease other medications toxicities and improve patients’ quality of life
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