Clinical results of N-acetylcysteine after major hepatic surgery: a review

Abstract:Reactive oxygen species (ROS) are widely believed to cause or aggravate several human pathologies such as neurodegenerative diseases, cancer, stroke and many other ailments. Antioxidants are assumed to counteract the harmful effects of ROS and therefore prevent or treat oxidative stress-related diseases. In this report, recent human studies exploring the efficiency of antioxidants in prevention and treatment of various diseases are reviewed. Few antioxidants including edaravone (for ischemic stroke in Japan), Nacetylcysteine (for acetaminophen toxicity), alfa-lipoic acid (for diabetic neuropathy) and some flavonoids (polyphenolic compounds present in dietary plants), such as micronized purified flavonoid fraction (diosmin and hesperidin) and oxerutins (for chronic venous insufficiency) as well as baicalein and catechins (for osteoarthritis) have found accepted clinical use. However, despite much enthusiasm in the 1980s and 1990s, many well-known agents such as antioxidant vitamins and also more recently developed compounds such as nitrones have not successfully passed the scrutiny of clinical trials for prevention and treatment of various diseases. This has given rise to a pessimistic view of antioxidant therapy, however, the evidence from human epidemiological studies about the beneficial effects of dietary antioxidants and preclinical in vitro and animal data are compelling. We have probably wasted too much time on agents like antioxidant vitamins instead of focusing on more disease specific, target-directed, highly bioavailable antioxidants. We here discuss possible reasons for the lack of success in some clinical trials and seek to provide some suggestions to be considered if antioxidant therapy is to succeed as an effective therapeutic strategy.

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“…NAC seems to be a safe drug with limited side effects that appear to be mostly anaphylactoid in nature [106,109,110].…”

Section: Treatment Beneficialmentioning

confidence: 99%

Clinical and pharmacological aspects of bath salt use: A review of the literature and case reports

Miotto¹,

Striebel²,

Cho

et al. 2013

Drug and Alcohol Dependence

121

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“…There are numerous potential mechanisms of action by which NAC may exert protective effects 13 . But the interesting about this experiment was to see the enormous increase in binuclear hepatocytes, after use of NAC.…”

Section: Discussionmentioning

confidence: 99%

Effect of N-acetylcysteine in liver ischemia-reperfusion injury after 30% hepatectomy in mice

et al. 2012

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PURPOSE:Evaluate the effect of N-acetylcysteine in liver remnant after hepatectomy associated to ischemia-reperfusion injury in mice. METHODS: Male adult BALB/c mice, weighing 20-22g were used. Animals were anesthetized with ketamine (70 mg/kg) and xylazine (10 mg/kg); received N-acetylcysteine (150 mg/kg, H-IR-NAC group) or vehicle (H-IR group). Surgical procedures were performed under 10X magnification. Partial hepatectomy (30%) was followed by ischemia-reperfusion injury (30 minutes of ischemia and 60 minutes of reperfusion). Blood sample and liver tissue were removed before animal was euthanized. AST and ALT were evaluated in blood samples and histomorphological analyses were performed in remnant liver. Groups were compared by Mann-Whitney test, and it was considered significant when p<0.05. RESULTS: Biochemical evaluations showed reduced levels of ALT in NAC group (H-IR-

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“…The rabbit a rodent to be larger and easier handling was considered appropriate for this research [9][10][11][12][13][14][15][16][17][18][19][20][21] . To these factors is associated with ease of anesthesia protocol, which provided adequate hypnosis and analgesia, an anesthetic for up to 60 minutes.…”

Section: Discussionmentioning

confidence: 99%

“…Ischemia/reperfusion (I/R) play an important role in hepatic resections, liver transplants and in hemorrhagic shock 8,9 .…”

Section: Introductionmentioning

confidence: 99%

The role of N-acetyl-cysteine in the lung remote injury after hepatic ischemia and reperfusion in rabbits

Castro

Lauz

et al. 2012

Acta Cir. Bras.

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PURPOSE:To study the lesions in the lung of rabbits caused by ischemia/reperfusion hepatic (I/R) after the use of N-acetyl-cysteine (NAC). METHODS: Twenty-four rabbits distributed in two groups: control group GI (n = 12) 5% glucose solution and experiment group GII (n = 12) NAC. The animals were pre-anesthetized with 1% acepromazine maleate and anesthetized with ketamine 10% and 2% xylazine intramuscularly. The GI and GII were given glucose solution intravenously or NAC 15min before occlusion of the hepatic pedicle (30 min). After the period of reperfusion of 24h (n = 6) or 48h (n = 6), liver and lung samples were collected for histology and immunohistochemistry to assess the impairment of cell. RESULTS:The animals of GII and GII-24h-48h showed parenchyma liver close to normal, when using NAC. The GII and GII-24h-48h showed lower thickness of alveolar cells that GI and GI-24h-48h. The expression of caspase 3 in lung cells GII presented smaller value compared to the GI group. CONCLUSION: N-acetyl-cysteine administered 15min prior to the injury ischemia/reperfusion had a significant protective role by minimizing lung injury and apoptotic morphology in the period observed. Key words: Acetylcysteine. Lung. Reperfusion. Ischemia. Liver. Rabbits. RESUMO OBJETIVO:Estudar as lesões no fígado e no pulmão de coelhos, provocadas pela isquemia/reperfusão hepática (I/R) moduladas pelo uso da N-acetil-cisteína (NAC). MÉTODOS: Vinte e quatro coelhos distribuídos em dois grupos: Grupo controle GI (n=12) solução de glicose 5% e Grupo experimento GII (n=12) NAC. Os animais foram pré-anestesiados com maleato de acepromazina 1% e anestesiados com cloridrato de quetamina 10% e xilazina 2% via intramuscular. Os grupos GI e GII receberam solução glicosada ou NAC respectivamente via endovenosa 15min antes da oclusão do pedículo hepático (30 min). Após iniciou-se o período de reperfusão por 24h (n=6) ou 48h (n=6), terminada a reperfusão, amostras do fígado e pulmão foram coletadas para a histologia e imunoistoquímica para avaliar o comprometimento celular. RESULTADOS: Os animais do grupo GII-24h e GII-48h apresentaram arquitetura do parênquima hepático próximo do normal, quando se utilizou NAC. Os grupos GII-24h e GII-48h apresentaram menor espessura das células alveolares que os grupos GI-24h e GI-48h. A expressão da caspase 3 nas células pulmonares do grupo GII, apresentou valor menor comparada ao grupo GI. CONCLUSÃO: A N-acetil-cisteína administrada 15min prévios a lesão da isquemia/reperfusão teve um papel protetor significativo minimizando as lesões morfológicas e apoptóticas pulmonares nos períodos observados. Descritores: Acetilcisteína. Pulmão. Reperfusão. Isquemia. Fígado. Coelhos.

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Clinical results of N-acetylcysteine after major hepatic surgery: a review

Cited by 26 publications

References 34 publications

Clinical and pharmacological aspects of bath salt use: A review of the literature and case reports

Clinical and pharmacological aspects of bath salt use: A review of the literature and case reports

Effect of N-acetylcysteine in liver ischemia-reperfusion injury after 30% hepatectomy in mice

The role of N-acetyl-cysteine in the lung remote injury after hepatic ischemia and reperfusion in rabbits

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