Effects of acetylcysteine on micro-inflammation and pulmonary ventilation in chronic obstructive pulmonary disease exacerbation

BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is a serious complication of chronic obstructive pulmonary disease,often characterized by increased morbidity and mortality.In traditional Chinese medicine,AECOPD is linked to phlegm-heat and blood-stasis,presenting symptoms like thick sputum,fever,and chest pain.It has been shown that acetylcysteine inhalation in conjunction with conventional therapy significantly reduced inflammatory markers and improved lung function parameters in patients with AECOPD,suggesting that acetylcysteine may be an important adjunctive therapy for patients with phlegm-heat-blood stasis type AECOPD.AIM To investigate the effect of acetylcysteine on microinflammation and lung ventilation in patients with phlegm-heat and blood-stasis-type AECOPD.METHODS One hundred patients with phlegm-heat and blood-stasis-type AECOPD were randomly assigned to two groups.The treatment group received acetylcysteine inhalation(10%solution,5 mL,twice daily)along with conventional therapy,whereas the control group received only conventional therapy.The treatment duration was 14 d.Inflammatory markers(C-reactive protein,interleukin-6,and tumor necrosis factor-alpha)in the serum and sputum as well as lung function parameters(forced expiratory volume in one second,forced vital capacity,and peak expiratory flow)were assessed pre-and post-treatment.Acetylcysteine inhalation led to significant reductions in inflammatory markers and improvements in lung function parameters compared to those in the control group(P<0.05).This suggests that acetylcysteine could serve as an effective adjunct therapy for patients with phlegm-heat and blood-stasis-type AECOPD.RESULTS Acetylcysteine inhalation significantly reduced inflammatory markers in the serum and sputum and improved lung ventilation function parameters in patients with phlegm-heat and blood-stasis type AECOPD compared with the control group.These differences were statistically significant(P<0.05).The study concluded that acetylcysteine inhalation had a positive effect on microinflammation and lung ventilation function in patients with this type of AECOPD,suggesting its potential as an adjuvant therapy for such cases.CONCLUSION Acetylcysteine inhalation demonstrated significant improvements in reducing inflammatory markers in the serum and sputum,as well as enhancing lung ventilation function parameters in patients with phlegm-heat and bloodstasis type AECOPD.These findings suggest that acetylcysteine could serve as a valuable adjuvant therapy for individuals with this specific type of AECOPD,offering benefits for managing microinflammation and optimizing lung function.

Schistosoma japonicum egg antigen up-regulates fibrogenesis and inhibits proliferation in primary hepatic stellate cells in a concentration-dependent manner

AIM:To investigate the effects of different concentrations of Schistosoma japonicum(S.japonicum) egg antigen on fibrogenesis and apoptosis in primary hepatic stellate cells(HSCs).METHODS:A mouse model of schistosomiasis-associated liver fibrosis(SSLF) was established by infecting mice with schistosomal cercaria via the abdomen.HSCs were isolated from SSLF mice by discontinuous density gradient centrifugation,and their identity was confirmed by immunofluorescence double staining of α-smooth muscle actin(α-SMA) and desmin.The growth inhibitory effect and 50% inhibitory concentration(IC50) of S.japonicum egg antigen for primary HSCs(24 h) were determined using a cell counting kit-8(CCK-8) assay.The expression levels of α-SMA,matrix metalloproteinase-9(MMOL/LP-9) and tissue inhibitor of metalloproteinases-1(TIMP-1) in HSCs in response to different concentrations of S.japonicum egg antigen were detected by Western blotting and real-time reverse transcription-polymerase chain reaction.The levels of phospho-P38(P-P38),phospho-Jun N-terminal kinase(P-JNK) and phospho-Akt(P-AKT) in HSCs were detected by Western blotting.RESULTS:An SSLF mouse model was established,and primary HSCs were successfully isolated and cultured.S.japonicum egg antigen inhibited HSC proliferation in a concentration-dependent manner.The IC50 of the S.japonicum egg antigen was 244.53 ± 35.26 μg/mL.S.japonicum egg antigen enhanced α-SMA expression at both the mRNA and protein levels and enhanced TIMP-1 expression at the mRNA level in HSCs(P < 0.05),whereas the expression of MMOL/LP-9 was attenuated at both the mRNA and protein levels in a concentration-dependent manner(P < 0.05).A high concentration of S.japonicum egg antigen enhanced P-P38,P-JNK and P-AKT activation(P < 0.05).The changes in α-SMA and MMOL/LP-9 expression induced by S.japonicum egg antigen were closely correlated with P-P38 and P-JNK activation(P < 0.05).The attenuation of MMOL/LP-9 was also correlated with P-AKT activation(P < 0.05),but the increase in α-SMA expression was not.TIMP-1 expression was not correlated with P-P38,P-JNK or P-AKT activation.CONCLUSION:S.japonicum egg antigen promotes fibrogenesis,activates the P38/JNK mitogen-activated protein kinase and AKT/PI3K signaling pathways and inhibits proliferation in primary HSCs isolated from SSLF mice in a concentration-dependent manner.