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 oxidative stress and inflammation parameters in COPD patients treated with either N-acetyl cysteine (NAC) alone or with NAC in combination with propolis (NACP). PATIENTS AND METHODS: Forty COPD patients 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 determined by measuring superoxide anion (O2.-), advanced oxidation protein products (AOPP), total oxidative status (TOS), prooxidative-antioxidant balance (PAB), malondialdehyde (MDA), ischemia modified albumin (IMA) and several other antioxidant markers superoxide dismutase (SOD), paraoxonase 1 (PON1), total sulfhydryl 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-demographic and clinical characteristics. After 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.