Antioxidant therapeutic advances in COPD

Chronic obstructive pulmonary disease (COPD) is associated with a high incidence of morbidity and mortality. Cigarette smoke-induced oxidative stress is intimately associated with the progression and exacerbation of COPD and therefore targeting oxidative stress with antioxidants or boosting the endogenous levels of antioxidants is likely to have beneficial outcome in the treatment of COPD. Among the various antioxidants tried so far, thiol antioxidants and mucolytic agents, such as glutathione, N-acetyl-L-cysteine, N-acystelyn, erdosteine, fudosteine and carbocysteine; Nrf2 activators; and dietary polyphenols (curcumin, resveratrol, and green tea catechins/quercetin) have been reported to increase intracellular thiol status along with induction of GSH biosynthesis. Such an elevation in the thiol status in turn leads to detoxification of free radicals and oxidants as well as inhibition of ongoing inflammatory responses. In addition, specific spin traps, such as α-phenyl-N-tert-butyl nitrone, a catalytic antioxidant (ECSOD mimetic), porphyrins (AEOL 10150 and AEOL 10113), and a SOD mimetic M40419 have also been reported to inhibit cigarette smoke-induced inflammatory responses in vivo in the lung. Since a variety of oxidants, free radicals and aldehydes are implicated in the pathogenesis of COPD, it is possible that therapeutic administration of multiple antioxidants and mucolytics will be effective in management of COPD. However, a successful outcome will critically depend upon the choice of antioxidant therapy for a particular clinical phenotype of COPD, whose pathophysiology should be first properly understood. This article will review the various approaches adopted to enhance lung antioxidant levels, antioxidant therapeutic advances and recent past clinical trials of antioxidant compounds in COPD

Real-life characteristics of asthma inhaler device use in South Korea

Background and Aims: Historically, dry powder inhalers (DPIs) were considered to provide better airway distribution, easier identification of empty devices, and easier handling when compared to pressurized metered dose inhalers (pMDIs). Prior research into the major handling errors with inhaler device use has shown that errors result in comparable impairment of asthma control in both DPIs and pMDIs. Our own research has demonstrated that patients who are prescribed similar types of preventer inhaler devices to their reliever have better asthma control. Patients prescribed pMDI inhaled corticosteroid/long acting beta agonist relievers could benefit from switching from a DPI to a pMDI. The Health Insurance Review and Assessment (HIRA) database provides coverage of medical claims for over 50 million people in Korea and offers the opportunity to study asthma control on a national basis. The aim of this study was to provide a review of the possibilities of the Korean HIRA database in preparation for a study to investigate the effect on asthma control when patients switch inhaler types. Methods: Methodology from previous literature describing the HIRA database was analysed. We focused on the identification of asthma patients, their clinical characteristics (e.g. exacerbations, comorbidities), real-life medication switching behaviour, healthcare resource use (including medication) and associated costs. Results: Patient medical history could be constructed from primary and secondary diagnosis associated with individual database entries. Asthma exacerbations could be proxied by a prescription of acute oral corticosteroids, hospital admission or emergency room attendance associated with a diagnosis of asthma, lower respiratory infection or respiratory failure. Patients could be considered switch patients if they received a prescription of a pMDI after prescription of ≥2 DPI inhalers. Additional variables that were available included medication and hospitalisation cost. Conclusions: The HIRA database will allow studies analysing switch success of inhaler types in terms of persistence, asthma control and healthcare resource utilisation

Oryza sativa COI Homologues Restore Jasmonate Signal Transduction in Arabidopsis coi1-1 Mutants

10.1371/journal.pone.0052802PLoS ONE81e5280

Synthesis and evaluation of stilbene derivatives as a potential imaging agent of amyloid plaques

10.1016/j.bmc.2010.06.044Bioorganic and Medicinal Chemistry18227724-7730BMEC