The progression and exacerbations of
chronic obstructive pulmonary disease (
COPD) are intimately associated with tobacco
smoke/biomass fuel-induced oxidative and
aldehyde/carbonyl stress. Alterations in redox signaling proinflammatory
kinases and
transcription factors,
steroid resistance, unfolded protein response, mucus hypersecretion, extracellular matrix remodeling, autophagy/apoptosis, epigenetic changes, cellular senescence/aging, endothelial dysfunction, autoimmunity, and skeletal muscle dysfunction are some of the pathological hallmarks of
COPD. In light of the above it would be prudent to target systemic and local oxidative stress with agents that can modulate the
antioxidants/ redox system or by boosting the endogenous levels of
antioxidants for the treatment and management of
COPD. Identification of various
antioxidant agents, such as
thiol molecules (
glutathione and
mucolytic drugs, such as
N-acetyl-L-cysteine, N-acystelyn,
erdosteine,
fudosteine,
ergothioneine, and
carbocysteine lysine salt), dietary
natural product-derived
polyphenols and other compounds (
curcumin,
resveratrol,
green tea catechins,
quercetin sulforaphane,
lycopene, acai,
alpha-lipoic acid,
tocotrienols, and
apocynin) have made it possible to modulate various biochemical aspects of
COPD. Various researches and clinical trials have revealed that these
antioxidants can detoxify
free radicals and
oxidants, control expression of redox and
glutathione biosynthesis genes, chromatin remodeling, and ultimately inflammatory gene expression. In addition, modulation of cigarette
smoke-induced oxidative stress and related cellular changes have also been reported to be effected by synthetic molecules. This includes specific spin traps like α-phenyl-N-tert-butyl nitrone, a catalytic
antioxidant (ECSOD mimetic),
porphyrins (
AEOL 10150 and AEOL 10113), and a
superoxide dismutase mimetic M40419, lipid peroxidation and protein carbonylation blockers/inhibitors, such as
edaravone and lazaroids/
tirilazad,
myeloperoxidase inhibitors, as well as specialized pro-resolving mediators/inflammatory resolving
lipid mediators,
omega-3 fatty acids,
vitamin D, and
hydrogen sulfide. According to various studies it appears that the administration of multiple
antioxidants could be a more effective mode used in the treatment of
COPD. In this review, various pharmacological and dietary approaches to enhance lung
antioxidant levels and beneficial effects of
antioxidant therapeutics in treating or intervening the progression of
COPD have been discussed.