Efficacy of Ascorbic Acid (Vitamin C) and/N-Acetylcysteine (NAC) Supplementation on Nutritional and Antioxidant Status of Male Chronic Obstructive Pulmonary Disease (COPD) Patients

Pirabbasi, Elham; Shahar, Suzana; Manaf, Zahara Abdul; Rajab, Nor Fadilah; Manap, Roslina Abdul

doi:10.3177/jnsv.62.54

Cited by 41 publications

(42 citation statements)

References 28 publications

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“…Dietary vitamin C has also been shown to lower oxidative stress, increase collagen synthesis, and restore vascular endothelial growth factor levels and proliferation of alveolar cells in the lungs 9. Extensive studies have shown that vitamin C intake provides protection against the development of COPD 1,8,27,28. Our results corroborate the findings of these studies.…”

Section: Discussionsupporting

confidence: 89%

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Dietary vitamin C intake protects against COPD: the Korea National Health and Nutrition Examination Survey in 2012

Park¹,

Byun²,

Kim³

et al. 2016

COPD

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BackgroundVitamin C, as an antioxidant, has recently been suggested to provide protection against COPD; however, only few national cohort studies have investigated these effects. We aimed to confirm the protective effects of vitamin C against COPD in Korean patients.Patients and methodsWe analyzed the data of 3,283 adults aged ≥40 years (representing 23,541,704 subjects) who underwent pulmonary function tests and responded to questionnaires on smoking history and vitamin C intake, with stratification variables and sampling weight designated by the Korea 2012 National Health and Nutrition Examination Survey.ResultsAmong all the subjects, 512 (representing 3,459,679 subjects; 15.6%) were diagnosed as having COPD based on pulmonary function test results. Male gender, old age, residence in suburban/rural regions, low household income, low educational level, an occupation in agriculture or fisheries, and heavy smoking were significantly associated with COPD. Low intake of nutrients, including potassium, vitamin A, carotene, retinol, and vitamin C, was significantly associated with COPD. The prevalence of COPD in heavy smokers with the lowest quartile (Q1, <48.50 mg; 63.0%) and low-middle quartile (Q2, 48.50−84.38 mg; 56.4%) of vitamin C intake was significantly higher than that in subjects with the high-middle quartile (Q3, 84.38−141.63 mg; 29.5%) and highest quartile (Q4, >141.63 mg; 32.6%) of vitamin C intake (P=0.015). In multivariate analysis, male gender, old age, heavy smoking, and a low intake of vitamin C were significant independent risk factors for COPD. A significant reduction of 76.7% in COPD risk was observed with a Q3 vitamin C intake compared to Q1 vitamin C intake (odds ratio, 0.233; 95% confidence interval, 0.094−0.576) in heavy smokers.ConclusionThis large-scale national study suggests that dietary vitamin C provides protection against COPD, independent of smoking history, in the general Korean population.

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Section: Discussionsupporting

confidence: 89%

“…Supplementation with vitamin C, as an antioxidant, improves antioxidant status in COPD 1. Several epidemiologic studies2,3 and prospective studies4,5 revealed protective effects of vitamin C intake on COPD.…”

Section: Introductionmentioning

confidence: 99%

Dietary vitamin C intake protects against COPD: the Korea National Health and Nutrition Examination Survey in 2012

Park¹,

Byun²,

Kim³

et al. 2016

COPD

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“…2,3 In many chronic respiratory diseases, clinical trials of N-acetylcysteine have been carried out and results have shown that it relieved symptoms and improved quality of life. 4,5 Hypertonic saline is salty water and is found to be beneficial when nebulized in many chronic respiratory diseases. It has various mechanisms of action; it produces osmotic pressure which causes addition of water to surface of airway and this rheological quality makes the mucus suitable for clearance through cough.…”

Section: Introductionmentioning

confidence: 99%

Airway Clearance in Bronchiectasis: A Randomized Control Trial of N-Acetylcysteine with 3% hypertonic saline

Shehzad¹,

Mannan

Alam³

et al. 2019

JIMDC

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Background: N-Acetylcysteine and 3% hypertonic saline are being used effectively for sputum clearance in chronic cases of bronchiectasis for quite some time. However, their use in acute condition of the disease seems to be underexplored. The objective of our study is to compare the role of nebulized N-acetylcysteine and 3% hypertonic saline in clearing the airway in patients with acute exacerbation of bronchiectasis. Material and Methods: A total of 136 confirmed cases of bronchiectasis were enrolled in this study. This randomized controlled trial was done in chest ward of Nishtar Hospital Multan from January 2015 to March 2017. Sampling was done by non-probability consecutive sampling and patients were divided into two groups A and B by lottery method. Verbal informed consent was taken from all participants. Group A participants received nebulization of N acetylcysteine mixed in normal saline for ten minutes, while group B participants were nebulized with 10ml of 3% hypertonic saline for ten minutes. Group B was active control group in the study. Data was collected on pre-designed Proforma, and analyzed by SPSS version 22. Numerical variables such as saturation, weight of sputum, age and blood pressure was analyzed by using t test. These were considered significant if the p value was equal or less than 0 .05. For qualitative variables chi square test was applied. Results: The mean O2 saturation of Group A, before and after treatment, was 92.11±3.07% and 94.47±2.18%, respectively. The difference was statistically significant (p value =0.001). The sputum weight of Group A, before and after treatment, was 2.63±2.39 g and 7.41±1.38 g, respectively. The difference was statistically significant (p value =0.001). The frequency of rhonchi of Group A, before and after treatment, was 52% and 76%, respectively. The difference was statistically significant (p value =0.003). While, for Group B, the mean O2 saturation, before and after treatment, was 92.36±3.13% and 93.49±2.27%, respectively. The difference was statistically significant (p value =0.012). The sputum weight, before and after treatment, was 3.11±2.01 g and 5.56±1.02 g, respectively. The frequency of rhonchi, before and after treatment, was 45% and 74% respectively. Again, the difference was statistically significant. Conclusion: Both nebulized N-acetylcysteine and 3% hypertonic saline cause airway clearance by enhancing sputum expectoration in patients with acute exacerbation of bronchiectasis equally. Both these agents also improve oxygen saturation in acute exacerbation of bronchiectasis significantly.

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“…As we mentioned above, cysteine is frequently identified as rate-limiting, which provides the rationale as to why N-acetylcysteine (NAC) is used as a supplement for GSH support [69]. NAC is a substance widely used in experimental research [98,99] and clinical studies [100,101]. Although the anti-inflammatory properties of NAC have been described in various experimental studies [102,103], its effect on fever was not previously known.…”

Section: Fever In Rats Treated With N-acetyl-l-cysteine (Nac)mentioning

confidence: 99%

New Insights into the Role of Glutathione in the Mechanism of Fever

Wrotek

Sobocińska

Kozłowski

et al. 2020

IJMS

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Glutathione is one of the most important and potent antioxidants. The development of pharmacological compounds that can either increase or decrease glutathione concentrations has allowed investigation into the role of glutathione in various biological processes, including immune responses. Recent findings have shown that glutathione not only affects certain factors involved in immunological processes but also modifies complex immune reactions such as fever. Until recently, it was not known why some patients do not develop fever during infection. Data suggest that fever induction is associated with oxidative stress; therefore, antioxidants such as glutathione can reduce pyrexia. Surprisingly, new studies have shown that low glutathione levels can also inhibit fever. In this review, we focus on recent advances in this area, with an emphasis on the role of glutathione in immune responses accompanied by fever. We describe evidence showing that disturbed glutathione homeostasis may be responsible for the lack of fever during infections. We also discuss the biological significance of the antipyretic effects produced by pharmacological glutathione modulators.

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Efficacy of Ascorbic Acid (Vitamin C) and/N-Acetylcysteine (NAC) Supplementation on Nutritional and Antioxidant Status of Male Chronic Obstructive Pulmonary Disease (COPD) Patients

Cited by 41 publications

References 28 publications

Dietary vitamin C intake protects against COPD: the Korea National Health and Nutrition Examination Survey in 2012

Dietary vitamin C intake protects against COPD: the Korea National Health and Nutrition Examination Survey in 2012

Airway Clearance in Bronchiectasis: A Randomized Control Trial of N-Acetylcysteine with 3% hypertonic saline

New Insights into the Role of Glutathione in the Mechanism of Fever

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