Acetilcisteína: Una actualización clínica y farmacológica sobre su efecto mucolítico. Estudio de revisión / Acetylcisteine. A clinical and pharmacological actualization with special. Reference to its mucolytic efect

The authors present a clinical and farmacological evaluation of the effect and safety of N-acetylcysteine in chronic obstructive diseases. The N-actylcysteine (NAC) is a sulphorated amino acid employed as an mucolytic agent. The efficacy and tolerability of oral NAC as compared with other agents was determined, in the mucolytic treatment on mucus hypersecretion and in the management of respiratory tract fluids and sputums from cigarette smokers, and also as a bronchial mucus fluidifying agent. A sistematic review and analysis of the effect of NAC and its effectiveness. In the treatment of acute respiratory disorders in children was determined

Cyclosporin A reduces airway mucus secretion and mucociliary clearance in rats

PURPOSE: To assay the effects of cyclosporin A on mucus secretion from goblet cells and on mucociliary transport in situ in rats. METHODS: Twenty-one male Wistar rats were assigned to 3 groups: control (n = 5), saline (n = 8), and cyclosporin A (n = 8). After 30 days of drug therapy, the rats were killed, and the lungs were removed from the thoracic cavity. Mucus samples were collected, and the transport rate was evaluated in vitro using a bullfrog palate model. Mucociliary transport was timed in situ by direct view of particles trapped on the mucus moving across the respiratory tract. Finally, the amount of stored mucins in the goblet cells of the respiratory epithelium was measured. RESULTS: Drug dosage measurements showed that cyclosporine blood concentration at the moment the rats were killed was 1246.57 ± 563.88 ng/mL. The in vitro transport rate was significantly lower (P < .001) in the cyclosporin A-treated group. Also, the in-situ mucociliary transport rate was decreased in all cyclosporin A-treated animals when compared to the saline group (P = .02). Mucus quantity measurements showed a significant decrease on both acid (P = .01) and neutral (P = .02) mucus production from goblet cells in the animals submitted to cyclosporin A therapy. The correlation between the percentage of total mucus and in vitro transport rate was positive and significant (r = 0.706, P < .001), as was the correlation between the percentage of total mucus and the in situ mucociliary transport rate (r = 0.688, P = .001). CONCLUSION: This study shows that cyclosporin A plays an important role in the impairment of the mucociliary clearance in rats by reducing both acid and neutral mucus production from goblet cells and causing a decrease in the mucociliary transport velocity.

OBJETIVO: Avaliar os efeitos da ciclosporina A sobre a produção de muco das células caliciformes e sobre o transporte mucociliar in situ de ratos. MÉTODOS: Vinte e um ratos machos Wistar foram distribuídos em três grupos: Controle (n=5), Salina (n=8) e Ciclosporina A (n=8). Após 30 dias de terapia, os ratos foram mortos e os pulmões removidos da cavidade torácica. Amostras de muco foram coletadas e a medida da transportabilidade in vitro foi realizada através de um modelo de palato de rã. A velocidade do transporte mucociliar foi medida através da observação direta do deslocamento de partículas aderidas ao muco do epitélio ciliado brônquico. Por fim, efetuamos a quantificação das mucinas estocadas nas células caliciformes do epitélio respiratório. RESULTADOS: O valor médio da concentração sangüínea da ciclosporina no momento do sacrifício dos ratos foi de 1.246,57 ± 563,88 ng/ml. A transportabilidade do muco in vitro foi estatisticamente menor (p < 0.001) no grupo tratado com ciclosporina. Da mesma forma, houve um decréscimo na velocidade de transporte mucociliar nos animais imunossuprimidos em relação aos que receberam o placebo (p = 0.02). Houve diminuição significativa na quantidade de muco ácido (p = 0,01) e neutro (p = 0,02) produzidos pelas células caliciformes nos animais tratados com ciclosporina. A correlação entre a porcentagem de muco e a transportabilidade in vitro foi positiva e significante (r = 0.706, p < 0.001), assim como entre a porcentagem do muco e o transporte mucociliar in situ (r = 0.688, p = 0.001). CONCLUSÃO: O presente estudo mostra que a ciclosporina A age no sistema mucociliar causando um sério prejuízo através da redução na produção de muco ácido e neutro pelas células caliciformes como também a diminuição da velocidade de transporte mucociliar in situ e a transportabilidade do muco in vitro.

Effect of benzalkonium chloride on urinary mucus concentration following augmentation ileocystoplasty in mice

Ileocystoplasty is a popular technique used for treatment of low-capacity urinary bladders. One of its major down sides is the ability of the intestinal mucosa to secrete mucous, with its related urinary complications. Benzalkonium chloride is an irreversible ganglion blocker. Its local application to the augmenting ileal patch could reduce the acetyl choline-mediated mucus secretion. The aim of this study was to evaluate the effect of benzalkonium chloride on urinary mucus concentration following augmentation ileocystoplasty in mice. Ileocystoplasty was performed experimentally in a group of albino mice, benzalkonium chloride was applied locally to the ileal patch in half of them. Twenty survivors from each group were evaluated by 24-hours urine collection and mucus concentration assessment. Histopathological evaluation of the urinary bladders was carried out three weeks later. In the benzalkonium group, the mean urinary mucous concentration was significantly lower than the control group [P<0.001]. In the former group, the histopathological examination revealed no reactions that might have resulted from benzalkonium application, together with a marked reduction in the mucus secretion activities in all specimens. Benzalkonium chloride might be used to reduce the incidence of mucus-related complications in ileocystoplasty. Its use in humans, as well as the adverse effects due to systemic absorption is still to be investigated

Thioctic acid protection against ethanol-induced gastric mucosal lesions involves sulfhydryl and prostagladin participation

Thioctic acid, a sulfhydryl agent, given orally macroscopically protected the gastric mucosa from 96 percent ethanol-induced lesions in a dose-and time dependent fashion. The inhibition of the lesions was 56.0 and 90.3 percent at doses of 25 and 50 mg/Kg, respectively. The duration of its protective effect was appoximately 120 minutes. Histopathologically, the oral administration of thioctic acid prevented necrotic mucosal lesions in the deeper part of the mucosa but did not protect the surface epithelial cells against ethanol challenge. Gastric motility measured by a ballon method, was dose-dependently inhibited by the oral administration of thioctic acid. Thioctic acid protection was suppressed by pretreatment with indomethacin (30 mg/Kg), a cyclooxygenase inhibitor, and iodoacetamide (100 mg/Kg), a sulfhydryl bloker. The gastric motility inhibited by oral thioctic acid was not reversed by indomethacin or iodoacetamide. These doses of indomethacin or iodomethamide were administered because previously they had been used to suppress endogenous prostagladins, and nonprotein sulfhydryls of the gastric mucosa, respectively. There was an increase in the fluid volume retained in the gastric lumen for thioctic acid (50 mg/Kg) at 30,60,90, and 120 minutes after administration. There was an increase in the mucus volume retained in the gastric lumen for thioctic acid (50, 25 mg/Kg) at 120 minutes after administration. The lesion area in the rats treated with 70 mul of vehicle and in the rats treated with 250 mul of vehicle were significantly higher than in the rats treated with 450 mul of vehicle. The present study suggests that thioctic acid administered orally, affered protection to the rat gastric mucosa against 96 percent ethanol-induced lesions. This protective effect appears to be dependent on prostagladin-and sulfhydryl-sensitive mechanisms, together with an increase in both the fluid volume and the mucus volume retained in the gastric lumen, and is not associated with the inhibition of gastric motor activity.