Improvement by N-acetylcysteine of acute respiratory distress syndrome through increasing intracellular glutathione, and extracellular thiol molecules and anti-oxidant power: evidence for underlying toxicological mechanisms

Abstract

<jats:p> In acute respiratory distress syndrome (ARDS), there is extensive overproduction of free radicals to the extent that endogenous anti-oxidants are overwhelmed, permitting oxidative cell damage. The present study examined the benefit of the anti-oxidant compound N-acetylcysteine (NAC) in the management of ARDS by measuring patient's intracellular glutathione (inside red blood cells) and extracellular (plasma) anti-oxidant defense biomarkers and outcome. Twenty-seven ARDS patients were recruited from the intensive care unit of a teaching Hospital and randomly divided into two groups. Both groups were managed similarly by regular treatments but 17 patients received NAC 150 mg/kg at the first day that followed by 50 mg/kg/day for three days and 10 patients did not receive NAC. Treatment by NAC increased extracellular total anti-oxidant power and total thiol molecules and also improved intracellular glutathione and the outcome of the patients. In conclusion, patients with ARDS are in a deficient oxidant—anti-oxidant balance that can get a significant benefit if supplemented with NAC. Human &amp; Experimental Toxicology (2007) 26, 697—703 </jats:p>

Antiinflammatory Effect of N-Acetylcysteine Combined with Exogenous Surfactant in Meconium-Induced Lung Injury

“…In the present study, exogenous surfactant was combined with NAC which has potent anti-oxidative and anti-inflammatory properties and is reportedly devoid of any serious adverse effects. NAC has been successfully used for suppression of inflammation in patients with acute respiratory distress syndrome (Soltan-Sharifi et al 2007), for attenuation of oxidative stress and inflammation in asphyxiated newborn piglets ventilated with 100 % O 2 (Østerholt et al 2012), and in hyperoxic lung injury in guinea pigs (Langley and Kelly 1993).…”

Effect of N-acetylcysteine on the Murine Model of Colitis Induced by Dextran Sodium Sulfate Through Up-Regulating PON1 Activity

“…N-acetylcysteine (NAC) is known to act by raising intracellular concentrations of cysteine and hence of reduced glutathione (GSH) and by scavenging reactive oxygen species [13]. Recently, Fatemeh et al stated that NAC has adequate potential for protection against DSS-induced colitis in mice by ameliorating colonic inflammation, oxidative and nitrosative stress of colonic damage, SOD and CAT activities, and colon TNF-a concentration [14].…”

Molecular evidences on the benefit of N-acetylcysteine in experimental colitis

“…The synthetic thiol compound N-acetylcysteine (NAC) is one of the powerful antioxidants that has been mainly introduced in the treatment of acetaminophen overdosage, but in recent years its positive effects in other disease models have been indicated [23,24]. NAC is known to act by raising the intracellular concentrations of cysteine and hence reducing the concentration of glutathione (GSH) and/or scavenging radical oxygen species [23].…”