Table 1.
Clinical application of antioxidants summary table
| Class of antioxidants | Examples | Clinical application (RCT or other) | Reference(s) |
|---|---|---|---|
| Thiols | N-acetylcysteine, carbocysteine | Decreased COPD exacerbation rate (RCT). | 117,118 |
| Nrf2 activators | Sulforaphane | No RCTs yet. Ex vivo/in vitro study demonstrates improved glucocorticoid sensitivity in alveolar macrophages from COPD patients. | 102 |
| Food/plant-derived polyphenols | Curcumin, resveratrol | No RCTs yet. Oral curcumin in a mouse model of emphysema attenuated lung lavage neutrophils and mean linear intercept measurements. | 123 |
| Dietary modifications | Increased fruit and vegetable intake | Large population review studies demonstrated positive association with FEV1 with increased flavonoid intake (solid fruits) and decreased COPD-associated mortality risk in men. A single RCT over a 3-year period with increased fruit and vegetable intake demonstrated increased FEV1 (% predicted) and decreased exacerbation rate. | 127–129,133 |
| Vitamins | Vitamins C, E, and D | Important to address deficiencies. Insufficient data to suggest high-dose supplementation to temper respiratory pathology. Often used in combination with other nutrient supplements, herbs, or diet modifications. | 126,128,142–144 |
Abbreviations: COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; Nrf2, nuclear factor erythroid 2-related factor 2; RCT, randomized controlled trial.