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Clin. Cardiol. 24, 511515 (2001)
Qing Lu, M.D., Ingemar Björkhem , M.D., Ph.D., R.-J. Xiu, M.D., Ph.D., Peter Henriksson, M.D., Ph.D., Anna Freyschuss, M.D., Ph.D.
Division of Clinical Chemistry and Department of Medicine, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden
Summary
Background: Cigarette smoking provokes marked acute changes in the microcirculatory vasculature, including a reduced blood flow velocity. In accordance with the hypothesis that the reduced blood flow is due to an imbalance between pro-oxidants and oxidants, we recently showed that most of the reduction could be reversed by a high dose of vitamin C.
Hypothesis: In the present work we tested the hypothesis that N-acetylcysteine, a mucolyticum and an antioxidant, may have an effect on the smoking-induced changes observed by vital capillary microscopy of the nailfold.
Methods: In all, 37 healthy volunteers of both genders and with varied smoking habits were treated with N-acetylcysteine 200 mg t.i.d. for 2 weeks. In vivo investigation of the microcirculation by capillaroscopy was performed before and after treatment.
Results: Treatment with N-acetylcysteine significantly reduced the smoking-induced relative decrease in capillary blood flow velocity in a group of volunteers with varied smoking habits (p = 0.0016). The preventive effect was clearly significant in smokers (p = 0.003).
Conclusion: Treatment with N-acetylcysteine has a positive impact on microcirculatory flow during smoking, particularly in habitual smokers.
Key words: microcirculation, capillary blood flow velocity, antioxidant, N-acetylcysteine, smoking, endothelium
This work was supported by grants from King Gustaf V and Queen Victoria Foundation, the Knut and Alice Wallenberg Foundation, the Swedish Match AB, The Swedish Heart and Lung Foundation, and the Swedish Society of Medicine.
Address for reprints:
Anna Freyschuss, M.D.
Cardiology Unit, C1 88
Huddinge University Hospital
141 86 Stockholm, Sweden
Received: May 24, 2000
Accepted with revision: October 9, 2000