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Published ahead of print on March 4, 2004, doi:10.1164/rccm.200310-1465OC

Am. J. Respir. Crit. Care Med., Volume 169, Number 9, May 2004, 1022-1027

A more recent version of this article appeared on May 1, 2004
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Submitted on October 31, 2003
Accepted on February 27, 2004

Does Oxidative Stress Alter Quadriceps Endurance in Chronic Obstructive Pulmonary Disease?

Christelle Koechlin*, Annabelle Couillard, David Simar, Jean Paul Cristol, Helene Bellet, Maurice Hayot, and Christian Prefaut

* To whom correspondence should be addressed. E-mail: christelle_koechlin{at}hotmail.com.

The role of exercise-induced oxidative stress in the reduced quadriceps endurance of chronic obstructive pulmonary disease (COPD) patients has never been shown. We conducted a randomized, double-blind and crossover study in which 9 severe patients performed localized dynamic quadriceps endurance tests at 40% of maximal strength after oral treatment with the antioxidant, N-acetylcysteine, and placebo. Venous blood was sampled before, immediately after exercise and 6 hours later. Endurance time improved by 25% after N-acetylcysteine treatment compared to placebo (p<0.05). Superoxide anion (oxidant) release by stimulated phagocytes decreased after treatment (p<0.05). No change in the antioxidant system was observed. Lipid peroxidation, an index of oxidative stress, was significantly increased 6 hours after exercise in the placebo condition (p<0.05), but not after treatment. Advanced oxidized protein products, another index of oxidative stress, were also increased 6 hours after exercise, by 139±27% in the placebo condition but only by 54±19% after treatment (P<0.05). This study shows that N-acetylcysteine treatment in COPD reduced basal disturbance in the pro-oxidant system, improved endurance time and prevented exercise-induced oxidative stress. Oxidative stress thus seems to be implicated in the reduced quadriceps endurance of COPD patients.
Key words: N-acetylcysteine, antioxidant, placebo, endurance, superoxide anion.




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