Double-blind controlled trial of lecithinized superoxide dismutase in patients with idiopathic interstitial pneumonia – short term evaluation of safety and tolerability

BMC Pulmonary Medicine

Tohru Mizushima²  Shoji Kudoh⁶  Toshihiro Nukiwa³  Yukihiko Sugiyama⁴  Ken Ohta⁵  Arata Azuma¹  Koichiro Kamio¹ 

[1]Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan

[2]Department of Analytical Chemistry, Faculty of Pharmacy, Keio University, Tokyo, Japan

[3]South Miyagi Medical Center, Miyagi, Japan

[4]Division of Pulmonary Medicine, Department of Medicine, Jichi Medical School, Tochigi, Japan

[5]National Hospital Organization, Tokyo National Hospital, Tokyo, Japan

[6]Fukujuji Hospital, Tokyo, Japan

关键词: Surfactant protein-A;    Lactate dehydrogenase;    Multicenter double-blind clinical study;    Zn-superoxide dismutase;    Lecithinized human Cu;    Fibrotic nonspecific interstitial pneumonia;    Idiopathic pulmonary fibrosis;    Idiopathic interstitial pneumonia;   

Others  :  862903
DOI  :  10.1186/1471-2466-14-86

 received in 2013-05-23, accepted in 2014-05-07,  发布年份 2014

【 摘 要 】

Background

Idiopathic interstitial pneumonias such as idiopathic pulmonary fibrosis or fibrotic nonspecific interstitial pneumonia are irreversible progressive pulmonary diseases that often have fatal outcomes. Although the etiology of idiopathic interstitial pneumonias is not yet fully understood, anti-fibrotic and anti-inflammatory agents have shown limited therapeutic effectiveness. Reactive oxygen species and their cytotoxic effects on the lung epithelial cells have been reported to participate in the pathophysiology of the disease. Because superoxide dismutase catalyzes the detoxification of reactive oxygen species, we developed lecithinized superoxide dismutase for the treatment of patients with idiopathic interstitial pneumonias.

Methods

A multicenter, randomized, placebo-controlled trial was conducted as a pilot study to investigate the safety and effectiveness of 40 or 80 mg lecithinized superoxide dismutase in patients with progressive idiopathic interstitial pneumonias who presented with either idiopathic pulmonary fibrosis or corticosteroid-resistant fibrotic nonspecific interstitial pneumonia and showed arterial oxygen tension compatible with stage III or IV on the Japanese severity grading scale for idiopathic interstitial pneumonias. Before and following infusion of lecithinized superoxide dismutase for 28 days, the primary endpoint of forced vital capacity and the secondary endpoints of lactate dehydrogenase, surfactant protein-A, surfactant protein-D and Krebs von den Lungen-6 levels were measured in the serum.

Results

The primary endpoint of forced vital capacity did not improve significantly in the lecithinized superoxide dismutase groups in comparison with the placebo group. The secondary endpoints of lactate dehydrogenase and surfactant protein-A levels were significantly attenuated by 28 days in the higher-dose (80 mg) group. However, these changes returned to the baseline levels by 56 days after the cessation of lecithinized superoxide dismutase. Adverse events and mortality in the drug-treated groups did not differ from those in the placebo group.

Conclusions

Treatment with lecithinized superoxide dismutase is safe and improves the levels of serum markers such as lactate dehydrogenase and surfactant protein-A in patients with advanced idiopathic interstitial pneumonias with severe respiratory dysfunction. Considering the results of the current study, further investigations into the effects and treatment potential of long-term administration of lecithinized superoxide dismutase may be warranted.

Trial registration

University hospital Medical Information Network (UMIN) clinical trials registry no.000000752

【 授权许可】

   
2014 Kamio et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 5.

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