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N‐Acetylcysteine Improves the Clinical Conditions of Mustard Gas‐Exposed Patients with Normal Pulmonary Function Test
Author(s) -
Ghanei Mostafa,
Shohrati Majid,
Jafari Mehrdad,
Ghaderi Soleyman,
Alaeddini Farshid,
Aslani Jafar
Publication year - 2008
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/j.1742-7843.2008.00318.x
Subject(s) - acetylcysteine , medicine , placebo , bronchiolitis obliterans , pulmonary function testing , gastroenterology , anesthesia , sputum , bronchitis , surgery , lung , antioxidant , pathology , tuberculosis , biochemistry , chemistry , alternative medicine , lung transplantation
Administration of N‐acetylcysteine may be effective in diseases caused by oxidative–antioxidative imbalance. We aimed to determine the effect administration for 4 months of N‐acetylcysteine (1200 mg daily) on sulfur mustard‐induced bronchiolitis obliterans in patients with normal pulmonary function test. In a double‐blind clinical trial, 144 patients with bronchiolitis obliterans due to sulfur mustard and bronchiolitis obliterans syndrome class 0, randomly entered to group 1 (n = 72, N‐acetylcysteine) and group 2 (n = 72, placebo). The changes in dyspnoea, wake‐up dyspnoea, cough and sputum were measured after 4 months using a ‘delta value’ (i.e. symptom score after 4 months – symptom score before the trial). Spirometric findings were measured at the beginning of the trial, 2 months later and 4 months later. Dyspnoea (delta value: –0.78 (0.61), P < 0.001), wake‐up dyspnoea (delta value: –0.57 (0.64), P < 0.001), and cough (delta value: –0.86 (0.63), P < 0.001) improved after 4 months of N‐acetylcysteine administration compared to the control group. N‐acetylcysteine reduced sputum from 76.9% (n = 40) of cases before the trial to 9.6% (n = 5) of cases after the trial. Spirometric components were significantly improved in N‐acetylcysteine group compared to the placebo group: FEV1 (P < 0.0001), FVC (P = 0.014) and FEV1/FVC (P = 0.003). A 4‐month trial with 1200 mg oral N‐acetylcysteine per day can be used for treating bronchitis, but is also effective in treating bronchiolitis. It also prevents sulfur mustard‐induced oxidative stress, and can be used in the treatment of sulfur mustard‐induced pulmonary disease.