The protective effects of ambroxol on radiation lung injury and influence on production of transforming growth factor β1 and tumor necrosis factor α

Abstract

The aim of this article was to investigate the effect of ambroxol on radiation lung injury and the expression of transforming growth factor beta(1) (TGF-beta(1)), as well as tumor necrosis factor alpha (TNF-alpha) in plasma. Totally, 120 patients with locally advanced lung cancer in radiotherapy were randomized into treatment and control groups. Patients in the treatment group took ambroxol orally at a dosage of 90 mg, three times per day for 3 months from the beginning of radiotherapy. The expression of TGF-beta(1) and TNF-alpha in plasma was analyzed. The clinical symptoms and lung diffusing capacity were monitored using high resolving power computed tomography. The level of TGF-beta(1) in the control group was increased (11.8 +/- 5.5 ng/ml), whereas in ambroxol-treated patients, the increase was not significant (5.6 +/- 2.6 ng/ml, P < 0.001). Radiotherapy-induced elevation of TNF-alpha levels, seen in control patients, was also abolished after treatment with ambroxol (5.1 +/- 1.0 vs. 2.4 +/- 0.8 ng/ml, P < 0.001). In the treatment group, carbon monoxide diffusion capacity was not significantly decreased at 6, 12, and 18 months post-radiotherapy, compared with the control group (P < 0.05). Ambroxol decreased the expression of TGF-beta(1) and TNF-alpha, and minimized the diminishment of lung diffusion capacity after radiotherapy.

Curcumin Attenuates Radiation-Induced Inflammation and Fibrosis in Rat Lungs

“…It was recently reported that irradiated patients with locally advanced lung cancer who received ambroxol treatment exhibited a statistically significant decrease in serum TGF-β1 compared to a control group [42]. Our results support the concept that serum TGF-β1 is a useful parameter for evaluating treatment effects in patients with radiation-induced lung injuries.…”

More than Expectorant: New Scientific Data on Ambroxol in the Context of the Treatment of Bronchopulmonary Diseases

“…Further studies were published investigating the prevention of pulmonary complications in severely ill patients by ambroxol [28][29][30][31][32][33][34].…”

Ambroxol hydrochloride in the management of idiopathic pulmonary fibrosis: Clinical trials are the need of the hour

“…[20] showed that the expression of TGF-β1, as well as TNF-α in plasma did not rise in ambroxol treated lung cancer patients on radiation therapy as compared with the controls. The DLCO was also preserved in the ambroxol treated patients.…”

“…[1516171819] Even in human studies, the agent was to able to block the expression of TGF-β1 and TNF-α in plasma and preserving the DLCO of the lungs in lung cancer patients on radiation therapy. [20]…”