Table 1 Development of antioxidants and protease inhibitors for COPD
From: Progress in the mechanism and targeted drug therapy for COPD
Drug | Mechanism/effect | Clinical progress | Reference |
|---|---|---|---|
N-acetylcysteine (NAC) /glutamines | Suppressing oxidative stress | DBPCRT PANTHEON trial (1 year) found 600 mg bid NAC reduced the degree of deterioration in GOLDII-III COPD patients (Chinese Clinical Trials Registry TRC-09000460), Another study (NCT01136239) also found that it was reduced only in high-risk patients, and an improvement in airway function was also observed. However, some low-dose studies (600 mg/day) found no benefit (NCT00184977; the rest are not registered). | |
SOD/GPx | Reduce ROS | SOD and glutathione peroxidase GPx have good anti-inflammatory effects on smoking-induced lung inflammation in animal models, and clinical trials are underway | |
Sulforaphane | Increase the gene expression of Nrf2, downregulates inflammation-associated production of ROS and reactive nitrogen species (RNS) | Sulforaphanetrial (4 weeks) in COPD patients did not induce the expression of Nrf2 genes or have an effect on oxidative stress, airway inflammation, or lung function (NCT01335971). | |
Resveratrol | SIRT1 activator | Resveratrol (12 weeks) in COPD patients is under wayb (NCT03819517). A comprehensive assessment of cardiovascular health will be conducted. | |
SRT1720 | SIRT1 activator | SRT1720 could protect against AECII apoptosis in rats with emphysema and thus could be used in COPD treatment. | |
AZD1236 | Anti MMP-9 and MMP-12 | AZD1236 (6 weeks) in moderate- to-severe COPD patients did not reach statistical significance or have effect on COPD clinical symptoms. | |
Sivelestat (ONO-5046) | Protect the lung from NE-mediated tissue damage and control the exuberant inflammatory response | Japan approved ONO-5046 for the treatment of ALI and ARDS. However, many countries have not approved Siveles for clinical use, due to the uncertainty of the randomised double-blind trial results. | |
AZD9668 | Protect the lung from NE-mediated tissue damage and control the exuberant inflammatory response | AZD9668 (12 weeks) combined with budesonide/formoterol has no effect on lung function, quality of life and lung function in COPD patients |
