A systematic review of the role of vitamin insufficiencies and supplementation in COPD

<p>Abstract</p> <p>Background</p> <p>Pulmonary inflammation, oxidants-antioxidants imbalance, as well as innate and adaptive immunity have been proposed as playing a key role in the development of COPD. The role of vitamins, as assessed either by food frequency questionnaires or measured in serum levels, have been reported to improve pulmonary function, reduce exacerbations and improve symptoms. Vitamin supplements have therefore been proposed to be a potentially useful additive to COPD therapy.</p> <p>Methods</p> <p>A systematic literature review was performed on the association of vitamins and COPD. The role of vitamin supplements in COPD was then evaluated.</p> <p>Conclusions</p> <p>The results of this review showed that various vitamins (vitamin C, D, E, A, beta and alpha carotene) are associated with improvement in features of COPD such as symptoms, exacerbations and pulmonary function. High vitamin intake would probably reduce the annual decline of FEV1. There were no studies that showed benefit from vitamin supplementation in improved symptoms, decreased hospitalization or pulmonary function.</p

Antioxidant therapies in COPD

Oxidative stress is an important feature in the pathogenesis of COPD. Targeting oxidative stress with antioxidants or boosting the endogenous levels of antioxidants is likely to be beneficial in the treatment of COPD. Antioxidant agents such as thiol molecules (glutathione and mucolytic drugs, such as N-acetyl-L-cysteine and N-acystelyn), dietary polyphenols (curcumin, resveratrol, green tea, catechins/quercetin), erdosteine, and carbocysteine lysine salt, all have been reported to control nuclear factor-kappaB (NF-κ B) activation, regulation of glutathione biosynthesis genes, chromatin remodeling, and hence inflammatory gene expression. Specific spin traps such as α-phenyl-N-tert-butyl nitrone, a catalytic antioxidant (ECSOD mimetic), porphyrins (AEOL 10150 and AEOL 10113), and a superoxide dismutase mimetic M40419 have also been reported to inhibit cigarette smoke-induced inflammatory responses in vivo. 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 will be effective in the treatment of COPD. Various approaches to enhance lung antioxidant capacity and clinical trials of antioxidant compounds in COPD are discussed

Respiratory effects of chronic animal feed dust exposure

Turkey-Aim-The aim of our study was to assess the prevalence of chronic work related respiratory symptoms and to determine lung function abnormalities in animal feed industry workers. Method-108 workers with a mean age of +/- SD: 32 +/- 7.11 yr employed in the animal feed industry and 108 unexposed subjects as a control group were enrolled in the study. All subjects filled out a questionnaire on their respiratory symptoms. Pulmonary function tests (PFTs) were conducted. Airborne dust (respirable fraction) was sampled during an 8-h work shift. Dust sampling was performed with a Casella AFC 123 machine. Results-A significantly higher prevalence of work related upper and lower respiratory tract symptoms such as cough (12%), dyspnea (5.6%) and sinusitis (8.3%) were found among the workers than in the control group (p=0.001, p=0.04 and p=0.008 respectively). Irritation symptoms such as pruritis of the eyes (11.1%), skin lesions (7.4%) and nose symptoms (8.3%) were also significantly higher among workers that in the control group (p=0.001, p=0.014 and p=0.005 respectively). The mean PFTs (predicted %) of the workers; forced vital capacity (FVC)% +/- SD (85.23 +/- 12.06), 1-s forced expiratory volume (FEV1)% SD (88.73 +/- 13.09), peak expiratory flow (PEF)% +/- SD (70.64 +/- 18.76) and forced expiratory flow rate at 25-75% of the FVC (FEF25-71)% +/- SD (88.42 +/- 25.94) were found significantly lower than in the control group (P<0.0001, P<0.0001, P<0.0001, P<0.0001 respectively). Our data indicate that exposure to animal feed dust is an important factor in the occurrence of respiratory symptoms and decline in lung functions