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Astım Atağındaki Hastalarda Inhaler N-Asetil-L-Sistein Tedavisinin Indükte Balgamda Glutatyon ve Nitrit Seviyeleri Üzerine Etkisi

Effect of Inhaled N-Acetyl-L-Cysteine Treatment on Induced Sputum Glutathione and Nitrite

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Abstract (2. Language): 
Objective: An imbalance between oxidants-antioxidants is known to play an important role in the pathogenesis of asthma, especially during exacerbation. The aim of this study was to investigate the effect of N-acetyl-L-cysteine (NAC) treatment on the levels of sputum nitrit (NO2-) and reduced glutathione (GSH) contents in patients with asthma during exacerbations. Materials and Methods: The study had a double blind, placebo controlled design. Induced sputum GSH, NO2-, cell counts and plasma NO2- contents were evaluated in 11 healthy controls (HCs) and 25 patients with asthma during exacerbation before and after treatment. Fifteen patients with acute asthma attack were treated with inhaled NAC during exacerbation. Results: Plasma-sputum NO2- and sputum GSH contents were significantly higher in subjects with asthma subgroups than HCs (p<0.01 for NAC treatment group, p<0.005 for placebo treatment group, for plasma NO2-; p<0.001 for both groups for sputum NO2-; p<0.001 for both groups for sputum GSH). NAC treatment group had higher GSH contents in sputum samples after treatment which were, however, not significantly different from those before treatment. There was a significant decrease in sputum (p<0.005 for NAC treatment group, p<0.01 for placebo group) and plasma NO2- (p<0.005 for NAC treatment group, p<0.01 for placebo group) levels in both NAC treatment group and placebo group after treatment when compared with the pretreatment levels. Conclusion: These findings indicated that addition of NAC to standard attack therapy does not modify the oxidant-antioxidant status in asthma patients during exacerbation. ©2008, Firat University, Medical Faculty.
Abstract (Original Language): 
Amaç: Oksidanlar ile antioksidanlar arasındaki dengesizlik astım patogenezinde, özellikle de ataklar sırasında önemli rol oynamaktadır. Bu çalışmanın amacı N-asetil-L-sistein (NAC) tedavisinin astım atağındaki hastaların balgam nitrit (NO2-) ve redükte glutatyon (GSH) seviyeleri üzerine etkilerini araştırmaktır. Gereç ve Yöntem: Bu çift-kör plasebo kontrollü bir çalışmadır. Onbir sağlıklı kontrol (SK) ve 25 astım atağındaki hastanın indükte balgamlarında GSH, NO2- seviyeleri, hücre sayımları ve plazma NO2- seviyeleri tedavi öncesi ve sonrası dönemde değerlendirildi. Akut astım atağındaki 15 hastaya atak süresince inhaler NAC tedavisi verildi. Bulgular: Astım subgruplarında plazma ve balgam NO2- ve balgam GSH seviyeleri SK grubunda anlamlı derecede yüksek bulundu (plazma NO2-seviyesi için; NAC tedavisi alan grupta p<0.01, plasebo uygulanan grupta p<0.005, balgam GSH ve NO2-seviyesi için her iki gruptap<0.001). NAC tedavisi alan grubun balgam GSH seviyesi tedavi sonrasında, tedavi öncesi değere göre anlamlı olmamakla birlikte artış gösterdi. NAC tedavisi ve plasebo uygulanan her iki grupta balgam ve plazma NO2- seviyeleri tedavi sonrasında anlamlı derecede azaldı (balgam NO2- seviyesi için NAC tedavisi alan grupta p<0.005, plasebo uygulanan grupta p<0.01; plazma NO2- seviyesi için NAC tedavisi alan grupta p<0.005, plasebo uygulanan grupta p<0.01). Sonuç: Bu bulgular astım hastalarına atak sırasında standart atak tedavisine NAC eklenmesinin oksidan-antioksidan dengeyi değiştirmediğini göstermektedir. ©200008, Fırat Üniversitesi, Tıp Fakültesi
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