A combination of N-acetyl cysteine and propolis attenuates oxidative-inflammatory parameters during COPD exacerbation

Abstract

OBJECTIVE: The aim of this study was to determine any differences in ox- idative stress and inflammation parameters in COPD patients treated with either N-acetyl cys- teine (NAC) alone or with NAC in combination with propolis (NACP). PATIENTS AND METHODS: Forty COPD pa- tients in the exacerbation phase were enrolled into the study and were treated with either NAC (NAC group; n=20) or NACP (NACP group; n=20) twice daily for one month. Redox status was de - termined by measuring superoxide anion (O 2 .– ), advanced oxidation protein products (AOPP), total oxidative status (TOS), prooxidative-anti- oxidant balance (PAB), malondialdehyde (MDA), ischemia modified albumin (IMA) and sever- al other antioxidant markers: superoxide dis- mutase (SOD), paraoxonase 1 (PON1), total sulf- hydryl groups (SHG) and total antioxidant status (TAS). Interleukins 6, 8 and 17 were measured as markers of inflammatory status. RESULTS: Both groups had similar socio-de - mographic and clinical characteristics. Af- ter treatment significantly higher SHG [0.446 (0.395-0.516) vs. 0.292 (0.270-0.325), p<0.001] and significantly lower TOS – 50.6 [49.7-53.4 vs. 73.2 (50.9-84.6), p<0.05] – and IMA [0.650 (0.629-0.682) vs. 0.709 (0.667-0.756), p<0.05] – were found in the NACP group compared to the NAC group. Factorial analysis indicated a larger oxidative stress-inflammatory load in the NAC group after treatment. CONCLUSIONS: From an oxidative stress and inflammatory status perspective, treatment with NACP was more successful than with NAC. The inclusion of propolis into therapy for COPD patients, especially those in the exacerbation phase, could prove beneficial.