N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial

Moslehi, Amir; Taghizadeh-Ghehi, Maryam; Gholami, Kheirollah; Hadjibabaie, Molouk; Jahangard‐Rafsanjani, Zahra; Sarayani, Amir; Javadi, Mohammad Reza; Esfandbod, Mohsen; Ghavamzadeh, Ardeshir

doi:10.1038/bmt.2014.34

Cited by 36 publications

(27 citation statements)

References 38 publications

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“…Moreover, it participates in inflammation response, by activating of NF-kB. Moslehi et al (2014) evaluated the efficacy of this glutathione precursor in a double-blind, randomized study in leukemic patients, showing a significantly lower OM rate in patients receiving NAC than patients receiving placebo. A rinse formulation of NAC was also shown to be effective in mitigating radiation-induced OM.…”

Section: Management Of Gastrointestinal Mucositis: Current and Investmentioning

confidence: 99%

New Frontiers in the Pathobiology and Treatment of Cancer Regimen-Related Mucosal Injury

et al. 2017

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Mucositis is a common complication of chemotherapy, radiotherapy and targeted agents. It often affects compliance to anticancer therapies as it frequently causes schedule delays, interruptions or discontinuations of treatment. Moreover, the economic impact related to the management of mucositis is topical and several estimations of additional hospital costs due to this clinical condition have been recently reported. The ability to determine risk factors for mucositis, to early detect its onset, to assess correctly the degree of this toxicity and to plan its multidisciplinary management are all key elements to guarantee the quality of life of patients and to avoid useless dose reduction or interruption of treatment. The pathogenesis of mucositis is multifactorial and it is classily subdivided into oral and gastrointestinal mucositis according to its anatomic presentation. Treatment and patients’ related factors might help in predicting the frequency and the potential degree of symptoms onset. Here we discuss about clinical presentation and pathogenesis of mucositis in relation to different kinds of treatments. Moreover, we focus on therapeutic and prevention strategies, describing past and present management according to international guidelines and the most promising new data about agents potentially able to further improve the treatment of mucositis in the next future.

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Section: Management Of Gastrointestinal Mucositis: Current and Investmentioning

confidence: 99%

New Frontiers in the Pathobiology and Treatment of Cancer Regimen-Related Mucosal Injury

et al. 2017

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“…In patients undergoing stem cell transplantation, NAC was delivered intravenously at 100 mg/kg daily for 21 days (Ataei et al, 2015). In patients with oral mucositis, NAC was delivered intravenously at 100 mg/kg per day for at least 2 weeks (Moslehi et al, 2014). In humans, oral NAC administration is associated with nausea and vomiting whereas intravenous administration may result in anaphylactic reactions, which can lead to death in rare instances (Algren, 2008).…”

Section: Discussionmentioning

confidence: 99%

Investigation of the therapeutic potential of N-acetyl cysteine and the tools used to define nigrostriatal degeneration in vivo

Nouraei

Zarger

Weilnau

et al. 2016

Toxicology and Applied Pharmacology

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The glutathione precursor N-acetyl-L-cysteine (NAC) is currently being tested on Parkinson's patients for its neuroprotective properties. Our studies have shown that NAC can elicit protection in glutathione-independent manners in vitro. Thus, the goal of the present study was to establish an animal model of NAC-mediated protection in which to dissect the underlying mechanism. Mice were infused intrastriatally with the oxidative neurotoxicant 6-hydroxydopamine (6-OHDA; 4 μg) and administered NAC intraperitoneally (100 mg/kg). NAC-treated animals exhibited higher levels of the dopaminergic terminal marker tyrosine hydroxylase (TH) in the striatum 10d after 6-OHDA. As TH expression is subject to stress-induced modulation, we infused the tracer FluoroGold into the striatum to retrogradely label nigrostriatal projection neurons. As expected, nigral FluoroGold staining and cell counts of FluoroGold+ profiles were both more sensitive measures of nigrostriatal degeneration than measurements relying on TH alone. However, NAC failed to protect dopaminergic neurons 3 weeks following 6-OHDA, an effect verified by four measures: striatal TH levels, nigral TH levels, nigral TH+ cell counts, and nigral FluoroGold levels. Some degree of mild toxicity of FluoroGold and NAC was evident, suggesting that caution must be exercised when relying on FluoroGold as a neuron-counting tool and when designing experiments with long-term delivery of NAC—such as clinical trials on patients with chronic disorders. Finally, the strengths and limitations of the tools used to define nigrostriatal degeneration are discussed.

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“…Other agent studied for prevention of mucositis is N-acetyl cysteine having antioxidant activity. It is shown that N-acetyl cysteine reduces the incidence and duration of severe mucositis [15]. Palifermin (keratinocytes growth factor 1) is an agent used to prevent from formation of oral mucositis.…”

Section: Discussionmentioning

confidence: 99%

Preventive effect of selenium pretreatment against cisplatin-induced oral mucositis in rats

et al. 2016

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Objectives. The aim of the present study was to investigate the protective role of selenium against cisplatininduced oral mucositis in rats. Methods. Healthy wistar albino rats (n=21) were randomly divided into three groups: Cisplatin (Cis), cisplatin and selenium (Cis+Se) and control (C). Cisplatin was administered for 3 days to Cis and Cis+Se groups. Cis+Se group received selenium 5 days before cisplatin injection and continued for 11 consecutive days. Malondialdehyde (MDA) levels of the rats were determined before and at the end of experimental protocol. The tongues of rats were harvested for immunuhistochemical examinations. Results. In biochemichal analysis, MDA levels significantly increased in the Cis group (p=0.018). On the contrary, there was no significant difference between pretreatment and posttreatment MDA levels in Cis+Se group (p=0.128). In the immunohistochemical examinations of lingual tissues stained with anti-caspase-3, when the Cis and Cis+Se groups were compared, there were significantly more immunopositivity in the Cis group and significantly less immunopositivity in the Cis+Se group (p<0.05). Conclusions. Selenium might have played a protective role against cisplatin-induced oral mucositis in rats. Further studies are necessary before its clinical use in patients.Eur Res J 2017;3(1):11-15

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N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial

Cited by 36 publications

References 38 publications

New Frontiers in the Pathobiology and Treatment of Cancer Regimen-Related Mucosal Injury

New Frontiers in the Pathobiology and Treatment of Cancer Regimen-Related Mucosal Injury

Investigation of the therapeutic potential of N-acetyl cysteine and the tools used to define nigrostriatal degeneration in vivo

Preventive effect of selenium pretreatment against cisplatin-induced oral mucositis in rats

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