This property is an important mechanism of action in the prophylaxis of contrast-induced nephropathy and the potentiation of nitrate-induced vasodilation. In addition to its antioxidant action, N-acetylcysteine acts as a vasodilator by facilitating the production and action of nitric oxide. 2 By correcting or preventing glutathione depletion, N-acetylcysteine may ameliorate the inflammation that occurs in conditions such as chronic obstructive pulmonary disease (COPD), influenza, and idiopathic pulmonary fibrosis. 3 Because de novo synthesis is the primary mechanism by which glutathione is replenished, cysteine availability can limit the rate of glutathione synthesis during times of oxidative stress. Of glutathione's three component amino acids (i.e., glutamate, glycine, and cysteine), cysteine has the lowest intracellular concentration. For information about the SORT evidence rating system, go to. 3Ī = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. It thereby exerts a profound protective effect on cells.
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2 Glutathione is critically important for detoxifying an array of toxic substances, including xenobiotics (chemicals foreign to biologic systems), peroxide compounds, and other free radical–generating molecules. Supplementation with N-acetylcysteine has been shown to increase levels of glutathione, the body's major anti-oxidant. These clinical applications stem from its ability to support the body's antioxidant and nitric oxide systems during stress, infections, toxic assault, and inflammatory conditions.
Preliminary studies suggest that N-acetylcysteine may also have a role as a cancer chemopreventive, an adjunct in the eradication of Helicobacter pylori, and prophylaxis of gentamicin-induced hearing loss in patients on renal dialysis.Īlthough N-acetylcysteine is widely known as an antidote to acetaminophen overdose, 1 it has multiple other uses supported by varying levels of evidence. Other applications for N-acetylcysteine supplementation supported by scientific evidence include prevention of chronic obstructive pulmonary disease exacerbation, prevention of contrast-induced kidney damage during imaging procedures, attenuation of illness from the influenza virus when started before infection, treatment of pulmonary fibrosis, and treatment of infertility in patients with clomiphene-resistant polycystic ovary syndrome. N-acetylcysteine is the acetylated variant of the amino acid L-cysteine and is widely used as the specific antidote for acetaminophen overdose.
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