N-acetylcysteine for antioxidant therapy: pharmacology and clinical utility

Abstract

Background : Glutathione is an endogenous antioxidant and has a ubiquitous role in many of the body's defences. Treatment with N -acetylcysteine (NAC) has been shown to increase levels of glutathione. NAC has been proposed as a treatment for several illnesses. Objectives : The efficacy and tolerability of NAC was examined across a range of conditions to evaluate the evidence supporting the use of NAC for each indication. Methods : A literature search was conducted using PubMed. Information was also collected from other online sources including the websites of the Therapeutic Goods Administration of Australia and the FDA. Results : Reports ranged from case studies to clinical trials. There is strong evidence to support the use of NAC for the treatment of paracetamol overdose and emerging evidence suggesting it has utility in psychiatric disorders, particularly schizophrenia and bipolar disorder. NAC is safe and well tolerated when administered orally but has documented risks with intravenous administration.

Potential Ameliorative Role of N-Acetylcysteine Against Testicular Dysfunction Induced by Titanium Dioxide in Male Albino Rats

“…Moreover, the changes in cytokines expression induced by TiO2 are ameliorated by NAC administration. NAC acts as antioxidant that stimulate GSH synthesis (Dodd et al, 2008) and is confirmed in this study by up-regulation of testicular GST expression in TiO2 administered rats. So, NAC may restore the disturbance between pro-oxidant and antioxidant mechaisms during oxidative stress and that are coincided with our findings.…”

“…Thus, NAC can restore the imbalance between pro-oxidant and antioxidant systems during oxidative stress. NAC is safe and well tolerated when administered orally while intravenous administrationof NAC induced some helath problems (Dodd et al, 2008). Rarely, higher doses of NAC causes skin affection as rashes, fever, headache.…”

“…Rarely, higher doses of NAC causes skin affection as rashes, fever, headache. It may cause drowsiness, low blood pressure and liver problems (Dodd et al, 2008).…”

The neuroprotective effect of N-acetylcysteine in spinal cord-injured rats

“…2 In the present study, NAC was used because of its ability to reduce oxidative stress by interfering with free radicals or up-regulating antioxidant systems. 18,19 Some beneficial effects of NAC application in SCI in an animal model were observed in the present study. The angle of hind paw rotation was significantly lower in the NAC group than in the control group.…”

An increased need for dietary cysteine in support of glutathione synthesis may underlie the increased risk for mortality associated with low protein intake in the elderly

“…(Glutathione interacts with GCL allosterically to inhibit its activity (Richman and Meister 1975)). An efficient way to achieve this, without increasing protein intake per se, is to supplement with N-acetylcysteine (NAC), a well-absorbed and chemically stable compound that is rapidly cleaved to liberate free cysteine soon after it is absorbed (Atkuri et al 2007;Dodd et al 2008). (Cysteine per se is too unstable to be employed as a concentrated supplement, and the cystine which it readily gives rise to is poorly absorbed.)…”