Department of Pharmacology, M.P. Shah Medical College, Jamnagar, Gujarat, India.
Ann Thorac Med. 2011 Oct;6(4):221-6. doi: 10.4103/1817-1737.84777.
The protease-antiprotease hypothesis proposes that inflammatory cells and oxidative stress in chronic obstructive pulmonary disease (COPD) produce increased levels of proteolytic enzymes (neutrophil elastase, matrix metalloproteinases [MMP]) which contribute to destruction of parenchyma resulting in progressive decline in forced expiratory volume in one second. Doxycycline, a tetracycline analogue, possesses anti-inflammatory properties and inhibits MMP enzymes.
To assess the effect of 4 weeks doxycycline in a dose of 100 mg once a day in patients of moderate to severe COPD with stable symptoms.
In an interventional, randomized, observer-masked, parallel study design, the effect of doxycycline (100 mg once a day for 4 weeks) was assessed in patients of COPD having stable symptoms after a run-in period of 4 weeks. The study participants in reference group did not receive doxycycline. The parameters were pulmonary functions, systemic inflammation marker C-reactive protein (CRP), and medical research council (MRC) dyspnea scale. Use of systemic corticosteroids or antimicrobial agents was not allowed during the study period.
A total of 61 patients completed the study (31 patients in doxycycline group and 30 patients in reference group). At 4 weeks, the pulmonary functions significantly improved in doxycycline group and the mean reduction in baseline serum CRP was significantly greater in doxycycline group as compared with reference group. There was no significant improvement in MRC dyspnea scale in both groups at 4 weeks.
The anti-inflammatory and MMP-inhibiting property of doxycycline might have contributed to the improvement of parameters in this study.
蛋白酶-抗蛋白酶假说提出，慢性阻塞性肺疾病（COPD）中的炎症细胞和氧化应激会产生高水平的蛋白水解酶（中性粒细胞弹性蛋白酶、基质金属蛋白酶 [MMP]），从而导致实质破坏，导致一秒用力呼气容积进行性下降。多西环素是一种四环素类似物，具有抗炎特性并抑制 MMP 酶。
评估 100mg 剂量的多西环素（每天一次）对稳定期中重度 COPD 患者的影响。
在一项干预性、随机、观察者设盲、平行研究设计中，在经过 4 周的导入期后，评估稳定期 COPD 患者（每天一次，共 4 周）使用多西环素（100mg）的效果。参考组的研究参与者未接受多西环素。评估的参数包括肺功能、系统炎症标志物 C 反应蛋白（CRP）和医学研究委员会（MRC）呼吸困难量表。在研究期间不允许使用全身皮质类固醇或抗菌药物。
共有 61 名患者完成了研究（多西环素组 31 名，参考组 30 名）。4 周后，多西环素组的肺功能显著改善，与参考组相比，多西环素组的基线血清 CRP 降低幅度明显更大。两组在 4 周时的 MRC 呼吸困难量表均无明显改善。
多西环素的抗炎和 MMP 抑制特性可能有助于改善本研究中的参数。
