The effect of Selenium supplementation versus N-acetylcysteine on clinical outcomes of patients with Idiopathic Pulmonary Fibrosis.

Abstract

Idiopathic pulmonary fibrosis (IPF), the common aggressive form of the idiopathic interstitial pneumonias of unknown cause. It is chronic, progressive, irreversible, fibrosing and lethal lung disease with a poor prognosis. (Carminati, 2010) The histological hallmark of IPF pattern is patchy interstitial fibrosis. The fibrosis is temporary heterogeneous with architectural destruction, dense scarring with honey combing and scattered fibroblast foci. (Carminati, 2010) IPF is an age related lung disease that occurs in middle aged elderly adults (median age at diagnosis is 66 years, range 55-75 years), and is limited to the lungs. The annual incidence of IPF is rising and estimated to be between 4.6 and 16.3 per 100, 000 people and the prevalence is 13 to 20 cases per 100, 000. There is a higher predominance of the disease in men (1.5 to 1.7; 1) than in women and frequency increases with age. It has a poor prognosis with a 5 year mortality rate between 50 and 70 %. (King et al., 2011) The most important environmental risk factors are cigarette smoking and exposure to metal and wood dust. Genetic transmission occurs in about 0.5-3.7% of patients with IPF. The influence of several comorbid conditions: obesity, diabetes mellitus, gastroesophageal reflux, pulmonary hypertension, obstructive sleep apnea, CAD and emphysema – on clinical course of IPF remains to be fully defined. (King et al., 2011)