Effect of Intravenous N-acetylcysteine on Plasma Total Homocysteine and Inflammatory Cytokines During High Flux Hemodialysis

Tsai, Jen Pi; Yang, Fwu Lin; Wang, Hsiu-Po; Fang, Te Chao; Lee, Ru Ping; Hsu, Bang Gee

doi:10.1016/s1016-3190(10)60047-x

Cited by 8 publications

(7 citation statements)

References 25 publications

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“…In disagreement with these results, a randomized, placebo-controlled, crossover trial reported a NAC-dependent rise of homocysteine removal during HD session which resulted in improved endothelial dysfunction [273]. Moreover, intravenous NAC during HD sessions was found to significantly decrease total homocysteine plasma levels in maintenance HD patients [274, 275]. The beneficial effect of NAC on homocysteine removal was more pronounced in dialysis patients with residual renal function (RRF).…”

Section: Exogenous Antioxidant Supplementation In Hd and Pd Patientsmentioning

confidence: 99%

Antioxidant Supplementation in Renal Replacement Therapy Patients: Is There Evidence?

Liakopoulos

Roumeliotis

Bozikas

et al. 2019

Oxidative Medicine and Cellular Longevity

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The disruption of balance between production of reactive oxygen species and antioxidant systems in favor of the oxidants is termed oxidative stress (OS). To counteract the damaging effects of prooxidant free radicals, all aerobic organisms have antioxidant defense mechanisms that are aimed at neutralizing the circulating oxidants and repair the resulting injuries. Antioxidants are either endogenous (the natural defense mechanisms produced by the human body) or exogenous, found in supplements and foods. OS is present at the early stages of chronic kidney disease, augments progressively with renal function deterioration, and is further exacerbated by renal replacement therapy. End-stage renal disease patients, on hemodialysis (HD) or peritoneal dialysis (PD), suffer from accelerated OS, which has been associated with increased risk for mortality and cardiovascular disease. During HD sessions, the bioincompatibility of dialyzers and dialysate trigger activation of white blood cells and formation of free radicals, while a significant loss of antioxidants is also present. In PD, the bioincompatibility of solutions, including high osmolality, elevated lactate levels, low pH, and accumulation of advanced glycation end-products trigger formation of prooxidants, while there is significant loss of vitamins in the ultrafiltrate. A number of exogenous antioxidants have been suggested to ameliorate OS in dialysis patients. Vitamins B, C, D, and E, coenzyme Q10, L-carnitine, a-lipoic acid, curcumin, green tea, flavonoids, polyphenols, omega-3 polyunsaturated fatty acids, statins, trace elements, and N-acetylcysteine have been studied as exogenous antioxidant supplements in both PD and HD patients.

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Section: Exogenous Antioxidant Supplementation In Hd and Pd Patientsmentioning

confidence: 99%

Antioxidant Supplementation in Renal Replacement Therapy Patients: Is There Evidence?

Liakopoulos

Roumeliotis

Bozikas

et al. 2019

Oxidative Medicine and Cellular Longevity

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“…NAC is used for mucolytic therapy and in the treatment of obstructive pulmonary diseases, tuberculosis and cystic fibrosis in human medicine. In addition to the mucolytic effect of NAC, it also has antioxidant (Boothe 2001, AHFS Drug Information 2010), cytoprotective and antiinflamatuary effects (Kim et al 2000, Olivos-Garcia et al 2007, Tsai et al 2010. Moreover, it has been indicated that NAC has preventive and detractive effects on biofilm formation and bactericidal effects at the concentration of 80 mg/mL by deformation of uncolonized bacteria (Cammarato et al 2012).…”

Section: Introductionmentioning

confidence: 99%

The effect of N-acetylcysteine on the treatment of clinical endometritis and pregnancy rate in dairy cows

Traş

Dinç²,

Üney³

2014

EurasianJVetSci

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Tras B, Dinc DA, Uney K. Süt ineklerinde klinik endometritisin tedavisi ve gebelik oranı üzerine N-asetilsistein'in etkisi. Amaç: Bu çalışmada süt ineklerinde klinik endometritisin tedavisi ve gebelik oranı üzerine N-asetilsistein (NAS)'in etkisinin belirlenmesi amaçlandı. Gereç ve Yöntem: Çalışma, ticari bir süt işletmesinde 50-60 günlük gönüllü bekleme süresinden sonra endometritisin klinik bulgularını gösteren 36 inek üzerinde gerçekleştirildi. Klinik endometritis, vajinada belirlenen uterus akıntısının değerlendirilmesiyle tanımlandı. İneklerden servikal svap örnekleri mikroorganizma ve tedavi için en etkili antibakteriyel ajanı belirlemek için toplandı. İnekler rastgele NAS tedavisi yapılan (NAS-T) ve yapılmayan (nNAS-T) olmak üzere iki gruba ayrıldı. NAS-T grubuna (n=18) %2'lik NAS uygulamasından 12 saat sonra amoksisilin trihidrat+potasyum klavulanat (3500 mg+875 mg) uygulaması yapıldı ve bu uygulama üç gün tekrar edildi. nNAS-T grubuna (n=18), NAS-T grubunda uygulanan tedavi protokolündeki NAS uygulaması yerine 100 mL serum fizyolojik uygulaması yapıldı. Tedavi oranı, tedaviyi takiben gerçekleşen ilk doğal östrusta klinik endometritisin bulgularını göstermeyen (vaginal muayenede şeffaf veya yarı şeffaf mukus) ineklerin oranı olarak tanımlandı. Hayvanlar tedaviden sonraki ilk doğal östrusta suni yolla tohumlandı. Bulgular: NAS-T grubunda tedavi (%83.3) ve gebelik (%66.7) oranlarının nNAS-T grubuna (sırasıyla %55.5 ve %27.8) göre önemli derecede yüksek olduğu belirlendi (P<0.05). Öneri: İneklerde klinik endometritisin tedavisinde NAS kullanımı, tedavi başarısını ve gebelik oranını artırabilir.

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“…Overall, these studies have reported mixed results, with a recent meta-analysis of 86 randomized controlled trials by Subramanian et al showing that there may be a small benefit of low-dose NAC administration on CIN [ 49 ]. In chronic hemodialysis patients, NAC administration has been shown to decrease circulating homocysteine levels [ 50 , 51 ] as well as decrease other inflammatory markers, including asymmetric dimethylarginine and malondialdehyde. Other benefits noted in these studies include improved renal anemia [ 51 , 52 ].…”

Section: Reviewmentioning

confidence: 99%

“…Other benefits noted in these studies include improved renal anemia [ 51 , 52 ]. Interestingly, Tsai et al showed that NAC administration decreased homocysteine levels the greatest in patients with some preserved renal function and had minimal effects in completely anuric patients, which supports that the beneficial effects seen are due to improvement in nephron function [ 50 ]. This was corroborated by Ahmadi et al who showed improvements in residual glomerular filtration rate in a separate randomized control trial [ 53 ].…”

Section: Reviewmentioning

confidence: 99%

The Role of Glutathione Metabolism in Chronic Illness Development and Its Potential Use as a Novel Therapeutic Target

Hristov¹

2022

Cureus

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Glutathione (GSH) is the most abundant thiol antioxidant in the human body and serves many important biochemical functions, including the regulation of vitamins, such as vitamins D, E, and C, and detoxification of drugs and toxins. As a powerful antioxidant, GSH is particularly important as a regulator of mitochondrial metabolism and a free radical scavenger that limits oxidative damage to cellular components. Low GSH levels have been associated with many chronic pro-inflammatory conditions, such as metabolic syndrome, cardiovascular, renal, and hepatic disease, as well as neurodegenerative conditions and autoimmune diseases. Given GSH's known direct protective role in mitochondrial metabolism and its association with chronic diseases of highly metabolically active tissues, this review aims to examine the literature for evidence that low GSH levels may be an important causative factor in the development of chronic illnesses. Because no large prospective human trials have been conducted using direct measurements of GSH, this review focused on the more common biomarker gamma-glutamyl transferase (GGT) which is directly correlated to low GSH levels. Several large prospective studies support this hypothesis by demonstrating that higher GGT levels are correlated with the risk of developing metabolic syndrome and cardiovascular disease in a dose-dependent fashion. Furthermore, as a corollary to this hypothesis, human and animal trials utilizing GSH augmentation using precursor supplementation in chronic conditions, including metabolic syndrome, cardiovascular disease, hepatic disease, renal disease, and neurodegenerative conditions, were also reviewed. While many of these trials were preliminary and small, there is strong evidence that GSH supplementation leads to improved outcomes in all of these chronic conditions. This review seeks to highlight these studies as preliminary evidence demonstrating the contributory role of GSH in chronic disease progression because a simple and cost-effective strategy can be created to screen for, track, and intervene in susceptible patients in the primary care setting at the earliest possible time in the disease process. Such a novel strategy would impact the majority of chronic diseases contributing to the bulk of morbidity and mortality in the Western world, and, thus, even minor benefits across many conditions may substantially impact population-wide health and longevity.

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Effect of Intravenous N-acetylcysteine on Plasma Total Homocysteine and Inflammatory Cytokines During High Flux Hemodialysis

Cited by 8 publications

References 25 publications

Antioxidant Supplementation in Renal Replacement Therapy Patients: Is There Evidence?

Antioxidant Supplementation in Renal Replacement Therapy Patients: Is There Evidence?

The effect of N-acetylcysteine on the treatment of clinical endometritis and pregnancy rate in dairy cows

The Role of Glutathione Metabolism in Chronic Illness Development and Its Potential Use as a Novel Therapeutic Target

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