Improved oxidative status in major abdominal surgery patients after N-acetyl cystein supplementation

Abstract

BackgroundIncreased levels of reactive oxygen species during and after surgery may affect inflammatory response, post-operative adhesion molecule formation, and hemodynamic stability. The glutathione redox cycle is an important regulator in oxidative stress and its reduced forms scavenge free radicals. N-acetyl cysteine, a precursor of reduced glutathione, is considered as a potentially therapeutic wide spectrum agent in clinical practice. We therefore examined whether N-acetyl cysteine improves some biochemical parameters in cancer patients undergoing major abdominal surgery.MethodsThirty-three patients diagnosed with pancreas, stomach, rectum, colon malignancies, and undergoing major abdominal surgery at Ankara Numune Training and Research Hospital were randomly divided into two groups; control (CON) and N-acetyl cysteine (NAC). The NAC group had 1,200 mg N-acetyl cysteine starting two days before the operation day, in addition to isonitrogenous and isocaloric total parenteral nutrition of 1.2 g/kg protein, 25 kcal/kg, and 60:40 carbohydrate/fat ratio. Blood and urine samples were drawn two days before the operation, on operation day, and on the first, third, and fifth days post-operation.ResultsPlasma malondialdehyde was significantly lower in the NAC group (P < 0.001). N-acetyl cysteine treatment did not affect plasma levels of vitamin A, C or E. The NAC group exhibited a higher ratio of reduced glutathione to oxidised glutathione (P = 0.019). Urinary nitrate level was also significantly lower in the NAC group (P = 0.016).ConclusionThe study demonstrated the clinical importance of N-acetyl cysteine supplementation on antioxidant parameters in abdominal surgery patients. In these patients N-acetyl cysteine and vitamin administration can be considered as an effective method for improvement of oxidative status.

Oral N-Acetyl Cysteine Administration Improved Oxidative Status in Medical Radiation Workers

“…In the current research, it was the first time, to observe an increase in erythrocyte GSH and decrease in plasma MDA and AOPPS levels in medical radiation workers after oral administration of NAC. Many previous studies reported a decrease in GSH levels in MRWs group and were agreed with our result [20][21][22][23][24][25][26]. Interventional radiology workers subgroup showed lower GSH levels than the CR and CT workers subgroups.…”

“…[25] dedicated that administration of NAC 400 and 800 mg of NAC for 12 weeks could decrease oxidative stress in workers exposed to lead by increasing GSH synthesis and also Kuyumcu et.al. [24] and Holmay MJ. et.al.…”

The Effects of Subchronic Methionine Overload Administered Alone or Simultaneously with L-cysteine or N-acetyl-L-cysteine on Body Weight, Homocysteine Levels and Biochemical Parameters in the Blood of Male Wistar Rats

“…The antioxidative capacity of N-acetyl-Lcysteine was also demonstrated in a model of chronic liver damage in rats (32). A study conducted in humans showed that the supplementation with N-acetyl-L-cysteine improved the oxidative status of patients after surgical treatments in the abdomen, which indicates the importance of the clinical application of this substance (33). Cysteine also has protective effects on the digestive tract, as shown in an experimental model of stomach ulcer in rats (34).…”

Protective impact of N-acetyl-L-cysteine on methionine stimulatory effects in rat colon

“…N-acetil-L-cistein može da utiče na nekoliko signalnih puteva, uključujući apoptozu, angiogenezu, rast ćelija, redoks regulisanu gensku ekspresiju i inflamatorni odgovor (13,14). Studija sprovedena na humanoj populaciji pokazala je da primena NAC poboljšava oksidativni status pacijenata posle hirurških zahvata u abdomenu, što ukazuje na značaj kliničke primene ove supstance (15) . Cilj ovog rada bio je da ispita uticaj NAC na histološke promene u tkivima digestivnog trakta pacova u uslovima suphronične stimulacije metioninom.…”