1
|
Redox Regulation in Aging Lungs and Therapeutic Implications of Antioxidants in COPD. Antioxidants (Basel) 2021; 10:antiox10091429. [PMID: 34573061 PMCID: PMC8470212 DOI: 10.3390/antiox10091429] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 12/23/2022] Open
Abstract
Mammals, including humans, are aerobic organisms with a mature respiratory system to intake oxygen as a vital source of cellular energy. Despite the essentiality of reactive oxygen species (ROS) as byproducts of aerobic metabolism for cellular homeostasis, excessive ROS contribute to the development of a wide spectrum of pathological conditions, including chronic lung diseases such as COPD. In particular, epithelial cells in the respiratory system are directly exposed to and challenged by exogenous ROS, including ozone and cigarette smoke, which results in detrimental oxidative stress in the lungs. In addition, the dysfunction of redox regulation due to cellular aging accelerates COPD pathogenesis, such as inflammation, protease anti-protease imbalance and cellular apoptosis. Therefore, various drugs targeting oxidative stress-associated pathways, such as thioredoxin and N-acetylcysteine, have been developed for COPD treatment to precisely regulate the redox system. In this review, we present the current understanding of the roles of redox regulation in the respiratory system and COPD pathogenesis. We address the insufficiency of current COPD treatment as antioxidants and discuss future directions in COPD therapeutics targeting oxidative stress while avoiding side effects such as tumorigenesis.
Collapse
|
2
|
Dominari A, Hathaway III D, Kapasi A, Paul T, Makkar SS, Castaneda V, Gara S, Singh BM, Agadi K, Butt M, Retnakumar V, Chittajallu S, Taugir R, Sana MK, KC M, Razzack S, Moallem N, Alvarez A, Talalaev M. Bottom-up analysis of emergent properties of N-acetylcysteine as an adjuvant therapy for COVID-19. World J Virol 2021; 10:34-52. [PMID: 33816149 PMCID: PMC7995409 DOI: 10.5501/wjv.v10.i2.34] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/23/2021] [Accepted: 03/12/2021] [Indexed: 02/06/2023] Open
Abstract
N-acetylcysteine (NAC) is an abundantly available antioxidant with a wide range of antidotal properties currently best studied for its use in treating acetaminophen overdose. It has a robustly established safety profile with easily tolerated side effects and presents the Food and Drug Administration's approval for use in treating acetaminophen overdose patients. It has been proven efficacious in off-label uses, such as in respiratory diseases, heart disease, cancer, human immunodeficiency virus infection, and seasonal influenza. Clinical trials have recently shown that NAC's capacity to replenish glutathione stores may significantly improve coronavirus disease 2019 (COVID-19) outcomes, especially in high risk individuals. Interestingly, individuals with glucose 6-phosphate dehydrogenase deficiency have been shown to experience even greater benefit. The same study has concluded that NAC's ability to mitigate the impact of the cytokine storm and prevent elevation of liver enzymes, C-reactive protein, and ferritin is associated with higher success rates weaning from the ventilator and return to normal function in COVID-19 patients. Considering the background knowledge of biochemistry, current uses of NAC in clinical practice, and newly acquired evidence on its potential efficacy against COVID-19, it is worthwhile to investigate further whether this agent can be used as a treatment or adjuvant for COVID-19.
Collapse
Affiliation(s)
- Asimina Dominari
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Donald Hathaway III
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Abdulhusein Kapasi
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Trissa Paul
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Sarabjot Singh Makkar
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Valeria Castaneda
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Sirisha Gara
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Bishnu Mohan Singh
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Kuchalambal Agadi
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Maliha Butt
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Varadha Retnakumar
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Spandana Chittajallu
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Rahima Taugir
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Muhammad Khawar Sana
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Manish KC
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Sarah Razzack
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Niala Moallem
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Alina Alvarez
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| | - Michael Talalaev
- Division of Research and Academic Affairs, Larkin Health System, South Miami, FL 33143, United States
| |
Collapse
|
3
|
Calzetta L, Matera MG, Rogliani P, Cazzola M. Multifaceted activity of N-acetyl-l-cysteine in chronic obstructive pulmonary disease. Expert Rev Respir Med 2018; 12:693-708. [DOI: 10.1080/17476348.2018.1495562] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Luigino Calzetta
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Maria Gabriella Matera
- Department of Experimental Medicine, Unit of Pharmacology, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Paola Rogliani
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Mario Cazzola
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
4
|
Talikka M, Kostadinova R, Xiang Y, Mathis C, Sewer A, Majeed S, Kuehn D, Frentzel S, Merg C, Geertz M, Martin F, Ivanov NV, Peitsch MC, Hoeng J. The response of human nasal and bronchial organotypic tissue cultures to repeated whole cigarette smoke exposure. Int J Toxicol 2014; 33:506-17. [PMID: 25297719 DOI: 10.1177/1091581814551647] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Exposure to cigarette smoke (CS) is linked to the development of respiratory diseases, and there is a need to understand the mechanisms whereby CS causes damage. Although animal models have provided valuable insights into smoking-related respiratory tract damage, modern toxicity testing calls for reliable in vitro models as alternatives for animal experimentation. We report on a repeated whole mainstream CS exposure of nasal and bronchial organotypic tissue cultures that mimic the morphological, physiological, and molecular attributes of the human respiratory tract. Despite the similar cellular staining and cytokine secretion in both tissue types, the transcriptomic analyses in the context of biological network models identified similar and diverse biological processes that were impacted by CS-exposed nasal and bronchial cultures. Our results demonstrate that nasal and bronchial tissue cultures are appropriate in vitro models for the assessment of CS-induced adverse effects in the respiratory system and promising alternative to animal experimentation.
Collapse
Affiliation(s)
- Marja Talikka
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Radina Kostadinova
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Yang Xiang
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Carole Mathis
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Alain Sewer
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Shoaib Majeed
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Diana Kuehn
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Stefan Frentzel
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Celine Merg
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Marcel Geertz
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Florian Martin
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Nikolai V Ivanov
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Manuel C Peitsch
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Julia Hoeng
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| |
Collapse
|
5
|
Sadowska AM, Manuel-Y-Keenoy B, De Backer WA. Antioxidant and anti-inflammatory efficacy of NAC in the treatment of COPD: discordant in vitro and in vivo dose-effects: a review. Pulm Pharmacol Ther 2006; 20:9-22. [PMID: 16458553 DOI: 10.1016/j.pupt.2005.12.007] [Citation(s) in RCA: 234] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Accepted: 12/16/2005] [Indexed: 01/07/2023]
Abstract
In order to develop efficient therapeutic regimes for chronic obstructive pulmonary disease (COPD), N-acetylcysteine (NAC) has been tested as a medication which can suppress various pathogenic processes in this disease. Besides its well-known and efficient mucolytic action, NAC meets these needs by virtue of its antioxidant and anti-inflammatory modes of action. NAC is a thiol compound which by providing sulfhydryl groups, can act both as a precursor of reduced glutathione and as a direct ROS scavenger, hence regulating the redox status in the cells. In this way it can interfere with several signaling pathways that play a role in regulating apoptosis, angiogenesis, cell growth and arrest and inflammatory response. Overall, the antioxidant effects of NAC are well documented in in vivo and in vitro studies. It successfully inhibits oxidative stress at both high and low concentrations, under acute (in vitro) and chronic administration (in vivo). With regard to its anti-inflammatory action, in contrast, the effects of NAC differ in vivo and in vitro and are highly dose-dependent. In the in vitro settings anti-inflammatory effects are seen at high but not at low concentrations. On the other hand, some long-term effectiveness is reported in several in vivo studies even at low dosages. Increasing the dose seems to improve NAC bioavailability and may also consolidate some of its effects. In this way, the effects that are observed in the clinical and in vivo studies do not always reflect the success of the in vitro experiments. Furthermore, the results obtained with healthy volunteers do not always provide incontrovertible proof of its usefulness in COPD especially when number of exacerbations and changes in lung function are chosen as the primary outcomes. Despite these considerations and in view of the present lack of effective therapies to inhibit disease progression in COPD, NAC and its derivatives, because of their multiple molecular modes of action, remain promising medication once doses and route of administration are optimized.
Collapse
Affiliation(s)
- A M Sadowska
- Department of Respiratory Medicine, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
| | | | | |
Collapse
|
6
|
Abstract
Airway mucus hypersecretion is a clinical and pathophysiological feature of a number of severe respiratory conditions, including asthma and chronic obstructive pulmonary disease (COPD). The importance of mucus hypersecretion to the morbidity and mortality of asthma is acknowledged, whereas in COPD it appears to affect only certain groups of patients, particularly the elderly and those prone to chest infections. Treatment with compounds that alter mucus is perceived as a therapeutic option, in particular in continental Europe, and numerous compounds have been developed and are available for clinical use worldwide. However, acceptance (or otherwise) of these drugs in guidelines for management of asthma or COPD has been hampered by lack of information from well designed clinical trials. In addition, the mechanism of action of most of these drugs is unknown and is it likely that any beneficial effects are due to activities other than, or in addition to, effects on mucus. Current information indicates that the most effective use of mucolytic drugs is long-term therapy for reduction of exacerbations of COPD. Cost-effective treatment would be in patients with poor lung function who have frequent or prolonged exacerbations or are repeatedly admitted to hospital.
Collapse
Affiliation(s)
- Duncan F Rogers
- Thoracic Medicine, National Heart & Lung Institute (Imperial College), Dovehouse Street, London SW3 6LY, UK.
| |
Collapse
|
9
|
Rogers DF, Godfrey RW, Castro K, Majumdar S, Jeffery PK. Effects of a new compound (Zy 15850A) on cigarette smoke-induced bronchitis in the rat. AGENTS AND ACTIONS 1991; 33:358-66. [PMID: 1950821 DOI: 10.1007/bf01986586] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The effect of 4H-4 phenylthieno-(3,2-C)-(1)-benzopyran-2-carboxylate (Zy 15850A) on mucous cell hyperplasia was examined in vivo using a well established rat model of cigarette smoke-induced bronchitis. Zy 15850A was given by gavage (25 mg/kg body weight) to male rats before and after sub-acute exposure (i.e. daily for 14 days) to an atmosphere of cigarette smoke (CS). CS significantly increased the thickness of the epithelium at three of the four sites studied in the trachea and in both of the intrapulmonary levels examined. CS increased the number of epithelial mucous cells in all intrapulmonary airways and also increased the mass of submucosal gland present in the larynx and upper trachea. Zy 15850A completely inhibited CS-induced increases in epithelial thickness in the upper trachea and the two intrapulmonary airway levels studied, and tended to inhibit CS-induced epithelial mucous cell hyperplasia in all the six intrapulmonary airway levels examined, with statistically significant inhibition in two. Zy 15850A had no inhibitory effect of the CS-induced enlargement of laryngo-tracheal submucosal glands. We conclude that, in the rat, the predominant inhibitory effect of Zy 15850A is on CS-induced epithelial thickening with weaker inhibitory effects on mucous cell hyperplasia and enlargement of submucosal glands. Zy 15850A is less effective than other mucoregulatory drugs or antiinflammatory agents we have tested in the same bronchitic model.
Collapse
Affiliation(s)
- D F Rogers
- Department of Lung Pathology, Royal Brompton & National Heart Hospital, London, U.K
| | | | | | | | | |
Collapse
|