Glutathione Depletion Accelerates Cigarette Smoke-Induced Inflammation and Airspace Enlargement.

The study objective was to assess age-related changes in glutathione (GSH) adaptive response to cigarette smoke (CS) exposure. Older cigarette smokers show a decline (67%) in lung epithelial lining fluid (ELF) GSH and a 1.8-fold decreased GSH adaptive response to cigarette smoking with a concomitant elevation (47%) of exhaled nitric oxide compared with younger smokers. In order to isolate the changes in tissue GSH from other age-related effects, pharmacological inhibition of the rate limiting step in GSH synthesis was employed to examine the lung's response to CS exposure in young mice. The γ-glutamylcysteine ligase inhibitor L-buthionine-sulfoximine (BSO) was administered in the drinking water (20 mM) to decrease by half the in vivo GSH levels to those found in aged mice and humans. Mice were then exposed to CS (3 h/day) for 5 or 15 days. Biochemical analysis of the ELF and lung tissue revealed an inhibition of the CS-induced GSH adaptive response by BSO with a concurrent increase in mixed protein-GSH disulfides indicating increased cysteine oxidation. The prevention of the GSH adaptive response led to an increase in pro-inflammatory cytokines present in the lung. Airspace enlargement is a hallmark of lung emphysema and was observed in mice treated with BSO and exposed to CS for as little as 15 days, whereas these types of changes normally take up to 6 months in this model. BSO treatment potentiated both lung elastase and matrix metalloproteinase activity in the CS group. These data suggest that age-related decline in the GSH adaptive response can markedly accelerate many of the factors thought to drive CS-induced emphysema.

A psychoeducational codependency support group for older adults who reside in the community: friends supporting friends.

Older adults with loved ones who are dependent on alcohol or drugs often experience the adverse effects of a codependent relationship. Many experience anxiety, low self-esteem, depression, and suicidal thoughts. A pilot psychoeducational codependency support group was developed to promote well-being and reduce the adverse effects of codependency among older persons. The study participants were a voluntary convenience sample of 22 older adults (ages 65 and older) residing in the community. A pretest and posttest were administered. Six 90-minute group sessions based on a curriculum developed by the authors were held during a 2-month period. Yalom's Therapeutic Factors were used to evaluate the group process. Results indicated that older adults benefit from a psychoeducational support group format and that codependency issues can be reduced.