N Acetylcysteine Could Make Lung Cancer Screening Safer

N-acetylcysteine could make lung cancer screening safer

Tuesday, November 6, 2012. The results of a study reported on October 26, 2012 in the journal Carcinogenesis suggest that administration of the antioxidant amino acid N-acetylcysteine (NAC) could help protect men and women at risk of lung cancer from the cancer-promoting effects of computed tomography (CT) screening. Annual CT screening of heavy current and former smokers who are at high risk of developing lung cancer was found to reduce lung cancer mortality by 20 percent in comparison with screening with chest x-rays in a recent trial. However, a concern has been raised regarding the risks associated with the relatively high amount of radiation delivered by CT scans, which could induce cancer in normal cells or promote the growth of precancerous cells.

Researchers at Wake Forest School of Medicine in North Carolina treated male and female mice with NNK (a carcinogen found in tobacco smoke) and exposed them to varying doses of whole body CT radiation or no radiation weekly for four weeks. A separate group of female mice was given a diet enhanced with N-acetylcysteine beginning three days before irradiation, and continuing for the four week radiation treatment period. Some females that did not undergo radiation also received a diet enhanced with NAC.

"We chose NAC as this agent has been shown to inhibit lung tumor formation in mice and to attenuate increases in reactive oxygen species and subsequent DNA damage by a variety of environmental stressors," author Mark Steven Miller and his colleagues write. "In addition, NAC is a relatively inexpensive nutriceutical that is readily available over-the-counter."

Eight months following the final radiation treatment, the mice were examined for lung tumors. Irradiated mice had up to twice the incidence of tumors compared to those that did not undergo radiation, with females experiencing greater effects than males. Treatment with NAC resulted in an amount of tumor formation in irradiated mice comparable to that of animals that were not irradiated.

"Our data suggest that exposure of sensitive populations to CT radiation increases the risk of tumorigenesis and that antioxidants may prevent the long term carcinogenic effects of low dose radiation exposure," the authors conclude. "This would allow annual screening with CT while preventing the potential long term toxicity of radiation exposure."

Vitamin D may help protect smokers' lungs

The American Journal of Respiratory and Critical Care Medicine published an article ahead of print on July 19, 2012 that suggests a protective effect for adequate vitamin D levels on lung function in smokers.

Researchers from Brigham and Women's Hospital and Boston University School of Medicine evaluated data from 626 older men who participated in the Normative Aging Study. Serum vitamin D levels and lung function were assessed during three visits between 1984 and 2003.

Although no association between lung function and vitamin D levels was found in the population as a whole, when smokers were separately analyzed, a protective effect for higher vitamin D levels on lung function emerged. Mean forced expiratory volume in one second (FEV1) was lower among smokers whose vitamin D was deficient at 20 nanograms per milliliter (ng/mL) or lower in comparison with smokers whose levels were sufficient, and a more rapid rate of decline in FEV1 over time occurred among deficient participants.

"We examined the relationship between vitamin D deficiency, smoking, lung function, and the rate of lung function decline over a 20 year period in a cohort of 626 adult white men from the Normative Aging Study," stated lead author Nancy E. Lange, MD, MPH, of Brigham and Women's Hospital's Channing Laboratory. "We found that vitamin D sufficiency (defined as serum vitamin D levels of greater than 20 ng/ml) had a protective effect on lung function and the rate of lung function decline in smokers."

"Our results suggest that vitamin D might modify the damaging effects of smoking on lung function," she added. "These effects might be due to vitamin D's anti-inflammatory and antioxidant properties. If these results can be replicated in other studies, they could be of great public health importance. Future research should also examine whether vitamin D protects against lung damage from other sources, such as air pollution."

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