Since
inflammation and oxidative stress are fundamental in the pathophysiology of neonatal
meconium aspiration syndrome (MAS), various anti-inflammatory drugs have been used in experimental and clinical studies on MAS. This pilot study evaluated therapeutic potential of
N-acetylcysteine in modulation of meconium-induced
inflammation and oxidative
lung injury.
Oxygen-ventilated adult rabbits were intratracheally given 4 ml/kg of meconium (25 mg/ml) or saline (Sal, n = 6). Thirty minutes later, meconium-instilled animals were treated with intravenous
N-acetylcysteine (10 mg/kg, Mec + NAC, n=6) or were non-treated (Mec, n = 6). All animals were
oxygen-ventilated for additional 5 hours. Total and differential blood leukocyte counts were determined at baseline, and at 1, 3 and 5 h of the treatment. After sacrificing animals, left lung was saline-lavaged and total and differential cell counts in the bronchoalveolar lavage fluid were determined. Right lung was used for biochemical analyses and for estimation of wet-dry weight ratio. In lung tissue homogenate,
thiobarbituric acid-reactive substances (
TBARS),
dityrosine,
lysine-lipid peroxidation (LPO) products, and total
antioxidant status (TAS) were detected. In isolated lung mitochondria,
TBARS,
dityrosine,
lysine-LPO products,
thiol group content, conjugated dienes, and activity of
cytochrome c oxidase were estimated. To evaluate systemic effects of meconium instillation and NAC treatment,
TBARS and TAS were determined also in plasma. To evaluate participation of eosinophils in the meconium-induced
inflammation,
eosinophil cationic protein (ECP) was detected in plasma and lung homogenate. Meconium instillation increased oxidation markers and ECP in the lung and decreased TAS (all P<0.05). NAC treatment reduced ECP and oxidation markers (all P<0.05, except of
dityrosine in homogenate and conjugated dienes in mitochondria) and prevented a decrease in TAS (P<0.01) in lung homogenate compared to Mec group. In plasma, NAC decreased
TBARS (P<0.001) and ECP, and increased TAS (both P<0.05) compared to Mec group. Concluding,
N-acetylcysteine diminished meconium-induced
inflammation and oxidative
lung injury.