N-Acetylcysteine Improves Inflammatory Response in COPD Patients by Regulating Th17/Treg Balance Through Hypoxia Inducible Factor-1 Pathway

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2021 Jul 14

PMID 34258270

Citations 15

Authors

Xiaopeng Liu

Zhixiong Hu

Haiying Zhou

Affiliations

Soon will be listed here.

Abstract

Introduction: This study was aimed to investigate the effects of N-acetylcysteine (NAC) on chronic obstructive pulmonary disease (COPD) and the change of Th17/Treg cytokine imbalance. . A total of 121 patients with stable COPD at the stage of C or D were consecutively enrolled and randomly divided into 2 groups. Patients in the treatment group received NAC granules (0.2 g × 10 bags, 0.4 g each time, 3 times/d) for half a year. The control group was treated with the same amount of placebo therapy. The peripheral blood of the patient was collected and the cytokine, T lymphocyte subsets were detected.

Results: We found the oral administration of NAC could regulate Th17/Treg balance to resist inflammation in COPD patients. Serum testing showed that the proportion of Treg in CD4+ T cells has increased and the Th17/Treg ratio has decreased during the NAC treatment. In vitro studies, we found that NAC regulated Th17/Treg balance through Hypoxia Inducible Factor-1 pathway.

Conclusions: Our result could provide new diagnosis and treatment for elderly patients with COPD from the perspective of immunity ideas.

Citing Articles

Differential proteins from EVs identification based on tandem mass tags analysis and effect of Treg-derived EVs on T-lymphocytes in COPD patients.

Tao X, Xu Z, Tian H, He J, Wang G, Tao X Respir Res. 2024; 25(1):349.

PMID: 39342213 PMC: 11439212. DOI: 10.1186/s12931-024-02980-2.

Clinical value of Vitamin-D combined with budesonide/formoterol and theophylline sodium glycinate sustained-release tablets in the treatment of chronic obstructive pulmonary disease patients.

Ni X, Zhou S, Wang C, Chen S, Hu J, Zhang S Pak J Med Sci. 2024; 40(7):1391-1396.

PMID: 39092061 PMC: 11255827. DOI: 10.12669/pjms.40.7.9495.

Retracted: N-Acetylcysteine Improves Inflammatory Response in COPD Patients by Regulating Th17/Treg Balance through Hypoxia Inducible Factor-1 Pathway.

International B Biomed Res Int. 2024; 2024:9753627.

PMID: 38550205 PMC: 10977163. DOI: 10.1155/2024/9753627.

Screening of potential key ferroptosis-related genes in Chronic Obstructive Pulmonary Disease.

Cao Y, Pan H, Yang Y, Zhou J, Zhang G Int J Chron Obstruct Pulmon Dis. 2023; 18:2849-2860.

PMID: 38059012 PMC: 10697092. DOI: 10.2147/COPD.S422835.

Transcriptome profiling of regulatory T cells from children with transient hypogammaglobulinemia of infancy.

Rutkowska-Zapala M, Grabowska A, Lenart M, Kluczewska A, Szaflarska A, Kobylarz K Clin Exp Immunol. 2023; 214(3):275-288.

PMID: 37936298 PMC: 10719223. DOI: 10.1093/cei/uxad116.

References

Zhang Z, Yan J, Taheri S, Liu K, Shi H . Hypoxia-inducible factor 1 contributes to N-acetylcysteine's protection in stroke. Free Radic Biol Med. 2013; 68:8-21. PMC: 3943875. DOI: 10.1016/j.freeradbiomed.2013.11.007. View

Salve V, Atram J . N-Acetylcysteine Combined with Home Based Physical Activity: Effect on Health Related Quality of Life in Stable COPD Patients- A Randomised Controlled Trial. J Clin Diagn Res. 2017; 10(12):OC16-OC19. PMC: 5296478. DOI: 10.7860/JCDR/2016/23668.8980. View

Chen J, Gu C, Chen X, Dai C, Zhao S, Xie H . Clinicopathological and prognostic analyses of 86 resected pulmonary lymphoepithelioma-like carcinomas. J Surg Oncol. 2020; 123(2):544-552. DOI: 10.1002/jso.26276. View

Zhang J, Zhang J, Liu H, Zhao Z, Fang L, Liu L . Effect of N-acetylcysteine in COPD patients with different microsomal epoxide hydrolase genotypes. Int J Chron Obstruct Pulmon Dis. 2015; 10:917-23. PMC: 4437521. DOI: 10.2147/COPD.S79710. View

Li X, Pan X, Qiu D . Imbalances of Th17 and Treg cells and their respective cytokines in COPD patients by disease stage. Int J Clin Exp Med. 2015; 7(12):5324-9. PMC: 4307485. View

Ritchie A, Wedzicha J . Definition, Causes, Pathogenesis, and Consequences of Chronic Obstructive Pulmonary Disease Exacerbations. Clin Chest Med. 2020; 41(3):421-438. PMC: 7423341. DOI: 10.1016/j.ccm.2020.06.007. View

Noack M, Miossec P . Th17 and regulatory T cell balance in autoimmune and inflammatory diseases. Autoimmun Rev. 2014; 13(6):668-77. DOI: 10.1016/j.autrev.2013.12.004. View

Moitra S . N-acetylcysteine (NAC) in COPD: benefits often lost in trials. QJM. 2018; 112(5):387-388. DOI: 10.1093/qjmed/hcy166. View

Decrue F, Gorlanova O, Usemann J, Frey U . Lung functional development and asthma trajectories. Semin Immunopathol. 2020; 42(1):17-27. DOI: 10.1007/s00281-020-00784-2. View

10.

Dang E, Barbi J, Yang H, Jinasena D, Yu H, Zheng Y . Control of T(H)17/T(reg) balance by hypoxia-inducible factor 1. Cell. 2011; 146(5):772-84. PMC: 3387678. DOI: 10.1016/j.cell.2011.07.033. View

11.

Vargas-Rojas M, Ramirez-Venegas A, Limon-Camacho L, Ochoa L, Hernandez-Zenteno R, Sansores R . Increase of Th17 cells in peripheral blood of patients with chronic obstructive pulmonary disease. Respir Med. 2011; 105(11):1648-54. DOI: 10.1016/j.rmed.2011.05.017. View

12.

Suha T, Asli M, Aynur S, Yunus K, Ahmet M, Selim D . Effects of N-acetylcysteine and ethyl pyruvate on ischemia-reperfusion injury in experimental electrical burn model. Am J Emerg Med. 2016; 34(7):1217-24. DOI: 10.1016/j.ajem.2016.03.032. View

13.

Su Y, Jalalvand F, Thegerstrom J, Riesbeck K . The Interplay Between Immune Response and Bacterial Infection in COPD: Focus Upon Non-typeable . Front Immunol. 2018; 9:2530. PMC: 6230626. DOI: 10.3389/fimmu.2018.02530. View

14.

Matera M, Calzetta L, Cazzola M . Oxidation pathway and exacerbations in COPD: the role of NAC. Expert Rev Respir Med. 2015; 10(1):89-97. DOI: 10.1586/17476348.2016.1121105. View

15.

Barbi J, Pardoll D, Pan F . Metabolic control of the Treg/Th17 axis. Immunol Rev. 2013; 252(1):52-77. PMC: 3576873. DOI: 10.1111/imr.12029. View

16.

Chan S, Selemidis S, Bozinovski S, Vlahos R . Pathobiological mechanisms underlying metabolic syndrome (MetS) in chronic obstructive pulmonary disease (COPD): clinical significance and therapeutic strategies. Pharmacol Ther. 2019; 198:160-188. PMC: 7112632. DOI: 10.1016/j.pharmthera.2019.02.013. View

17.

Zhang M, Wan Y, Jin Y, Xin J, Zhang J, Xiong X . Cigarette smoking promotes inflammation in patients with COPD by affecting the polarization and survival of Th/Tregs through up-regulation of muscarinic receptor 3 and 5 expression. PLoS One. 2014; 9(11):e112350. PMC: 4223024. DOI: 10.1371/journal.pone.0112350. View

18.

Gu C, Huang Z, Chen X, Liu C, Rocco G, Zhao S . TEAD4 promotes tumor development in patients with lung adenocarcinoma via ERK signaling pathway. Biochim Biophys Acta Mol Basis Dis. 2020; 1866(12):165921. DOI: 10.1016/j.bbadis.2020.165921. View

19.

Polverino F, Seys L, Bracke K, Owen C . B cells in chronic obstructive pulmonary disease: moving to center stage. Am J Physiol Lung Cell Mol Physiol. 2016; 311(4):L687-L695. PMC: 5142126. DOI: 10.1152/ajplung.00304.2016. View

20.

Zhang Q, Ju Y, Ma Y, Wang T . N-acetylcysteine improves oxidative stress and inflammatory response in patients with community acquired pneumonia: A randomized controlled trial. Medicine (Baltimore). 2018; 97(45):e13087. PMC: 6250560. DOI: 10.1097/MD.0000000000013087. View