Document Detail


Inhalation treatment with glutathione in patients with cystic fibrosis. A randomized clinical trial.
MedLine Citation:
PMID:  23631796     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE: Glutathione is the major antioxidant in the extracellular lining fluid of the lungs and depleted in patients with cystic fibrosis (CF).
OBJECTIVES: We aimed to assess glutathione delivered by inhalation as a potential treatment for CF lung disease.
METHODS: This randomized, double-blind, placebo-controlled trial evaluated inhaled glutathione in subjects with CF 8 years of age and older and FEV1 of 40-90% of predicted. Subjects were randomized to receive 646 mg glutathione in 4 ml (n = 73) or placebo (n = 80) via an investigational eFlow nebulizer every 12 hours for 6 months.
MEASUREMENTS AND MAIN RESULTS: FEV1 (absolute values), both as pre-post differences (P = 0.180) and as area under the curves (P = 0.205), were the primary efficacy endpoints, and were not different between the glutathione group and the placebo group over the 6-month treatment period. Exploratory analysis showed an increase of FEV1 from baseline over placebo of 100 ml or 2.2% predicted; this was significant at 3 months, but not later. Subjects receiving glutathione had neither fewer pulmonary exacerbations, nor better scores for quality of life. Whereas increased glutathione and metabolites in sputum demonstrated significant delivery to the lungs, there was no indication of diminished oxidative stress to proteins or lipids, and no evidence for anti-inflammatory or antiproteolytic actions of glutathione supplemented to the airways. The adverse event incidence was similar between glutathione and placebo.
CONCLUSIONS: Inhaled glutathione in the dose administered did not demonstrate clinically relevant improvements in lung function, pulmonary exacerbation frequency, or patient-reported outcomes. Glutathione delivery to the airways was not associated with changes in markers of oxidation, proteolysis, or inflammation. Clinical trial registered with www.clinicaltrials.gov (NCT00506688) and https://eudract.ema.europa.eu/index.html (EudraCT 2005-003870-88).
Authors:
Matthias Griese; Matthias Kappler; Claudia Eismann; Manfred Ballmann; Sibylle Junge; Ernst Rietschel; Silke van Koningsbruggen-Rietschel; Doris Staab; Claudia Rolinck-Werninghaus; Uwe Mellies; Thomas Köhnlein; Thomas Wagner; Susanne König; Helmut Teschler; Hans-Eberhard Heuer; Matthias Kopp; Susanne Heyder; Jutta Hammermann; Peter Küster; Marguerite Honer; Ulrich Mansmann; Ingrid Beck-Speier; Dominik Hartl; Carola Fuchs; ; Andreas Hector
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  188     ISSN:  1535-4970     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-07-02     Completed Date:  2013-09-12     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  83-9     Citation Subset:  AIM; IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00506688
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Adult
Antioxidants / therapeutic use*
Cystic Fibrosis / drug therapy*
Double-Blind Method
Female
Forced Expiratory Volume
Glutathione / administration & dosage*
Humans
Male
Respiratory Function Tests / methods,  statistics & numerical data
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Antioxidants; GAN16C9B8O/Glutathione
Investigator
Investigator/Affiliation:
Christa Acevedo / ; Patricia Berger / ; Claudia Eismann / ; Carola Gruber / ; Irene Komprobst / ; Inis Konig / ; Nadine Kordt / ; Heidrun Makowski / ; Annette Meyer / ; Christine Nagel / ; Silke Przygoda / ; Ingrid Rainer / ; Holger Schultingkemper / ; Inge Wortmann / ; Jutta Bend / ; Nina Blumchen / ; Manfred Keller / ; Maria Feilcke / ; Rainald Fischer / ; Judith Glockner-Pagel / ; Ann-Christin Grimmelt / ; Andrea Guttler / ; Sylvia Hafkemeyer / ; Tim Hirche / ; Rudolf Huber / ; Franziska Jonas / ; Janine Kalkowski / ; Martin Knoch / ; Matthias Kochanek / ; Cordula Korner-Rettberg / ; Caroline Kroner / ; Sabine Matena / ; Konrad Maier / ; Hans-Helge Muller / ; Andreas Reimann / ; Annette Sauer-Heilbronn / ; Christian Schroter / ; Christina Smaczny /
Comments/Corrections
Comment In:
Am J Respir Crit Care Med. 2014 Jan 15;189(2):234-5   [PMID:  24428658 ]
Am J Respir Crit Care Med. 2014 Jan 15;189(2):233-4   [PMID:  24428657 ]

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