Uses for N-acetylcysteine (NAC)

[Sakura]

MT, do you think N-acetyl cysteine is a useful/worthwhile supplement?

[Momtezuma Tuatara]

MT, do you think N-acetyl cysteine is a useful/worthwhile supplement? for what?

I have only used it if I had very thick mucus....

[Sakura]

for what?

I have only used it if I had very thick mucus....

I bought it and gave it to DH when he's had a big asthma flare up and a cold at the same time. He had gobs and gobs of mucus and was sucking on his inhaler.

We have it at home now, was wondering if it was good for anything else.

[Momtezuma Tuatara]

I bought it and gave it to DH when he's had a big asthma flare up and a cold at the same time. He had gobs and gobs of mucus and was sucking on his inhaler.

We have it at home now, was wondering if it was good for anything else.
What have you found on a google search?

[Sakura]

What have you found on a google search?

It's helpful for various lung dysfunctions.

http://www.ncbi.nlm.nih.gov/pubmed/19165116?ordinalpos=19&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Improved outcomes for people who have sustained smoke inhalation.

http://www.ncbi.nlm.nih.gov/pubmed/19156472?ordinalpos=26&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Decreased incidence of acute kidney failure with use of radio contrast. (This is particularly relevant in my life right now because my father is just about to undergo minor surgery in his bladder and they will be using radio contrast.)

http://www.ncbi.nlm.nih.gov/pubmed/19136971?ordinalpos=38&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Assist in the management of cocaine addictions.

[Sakura]

http://tjp.dergisi.org/text.php3?id=77

Here is an interesting one about the use of topical N-AC.

http://www.smartskincare.com/resabstracts/aging-photo_kang_j-invest-dermatol_20030500.html
And another one that would be relevant in the "wrinkles" thread here. :)

[Momtezuma Tuatara]

1: Respir Care. (http://javascript<b></b>:AL_get(this, 'jour', 'Respir Care.');) 2007 Sep;52(9):1176-93; discussion 1193-7.http://www.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--www.rcjournal.com-pubmed-icon.gif (http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3027&itool=AbstractPlus-def&uid=17716385&db=pubmed&url=http://www.rcjournal.com/contents/09.07/09.07.1176.pdf) Links (http://javascript<b></b>:PopUpMenu2_Set(Menu17716385);)

Mucoactive agents for airway mucus hypersecretory diseases.

Rogers DF (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Rogers%20DF%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).
Airway Disease, National Heart & Lung Institute, Imperial College London, Dovehouse Street, London SW3 6LY, United Kingdom. duncan.rogers@imperial.ac.uk
Airway mucus hypersecretion is a feature of a number of severe respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF). However, each disease has a different airway inflammatory response, with consequent, and presumably linked, mucus hypersecretory phenotype. Thus, it is possible that optimal treatment of the mucus hypersecretory element of each disease should be disease-specific. Nevertheless, mucoactive drugs are a longstanding and popular therapeutic option, and numerous compounds (eg, N-acetylcysteine, erdosteine, and ambroxol) are available for clinical use worldwide. However, rational recommendation of these drugs in guidelines for management of asthma, COPD, or CF has been hampered by lack of information from well-designed clinical trials. In addition, the mechanism of action of most of these drugs is unknown. Consequently, although it is possible to categorize them according to putative mechanisms of action, as expectorants (aid and/or induce cough), mucolytics (thin mucus), mucokinetics (facilitate cough transportability), and mucoregulators (suppress mechanisms underlying chronic mucus hypersecretion, such as glucocorticosteroids), it is likely that any beneficial effects are due to activities other than, or in addition to, effects on mucus. It is also noteworthy that the mucus factors that favor mucociliary transport (eg, thin mucus gel layer, "ideal" sol depth, and elasticity greater than viscosity) are opposite to those that favor cough effectiveness (thick mucus layer, excessive sol height, and viscosity greater than elasticity), which indicates that different mucoactive drugs would be required for treatment of mucus obstruction in proximal versus distal airways, or in patients with an impaired cough reflex. With the exception of mucoregulatory agents, whose primary action is unlikely to be directed against mucus, well-designed clinical trials are required to unequivocally determine the effectiveness, or otherwise, of expectorant, mucolytic, and mucokinetic agents in airway diseases in which mucus hypersecretion is a pathophysiological and clinical issue. It is noteworthy that, of the more complex molecules in development, it is simple inhaled hypertonic saline that is currently receiving the greatest attention as a mucus therapy, primarily in CF.
PMID: 17716385 [PubMed - indexed for MEDLINE]

full article URL 10 mb pdf

http://www.rcjournal.com/contents/09.07/09.07.1176.pdf

[Momtezuma Tuatara]

This is the cochrane review study Januaary 2009:

Plain language summary

Mucolytic drugs to treat acute upper and lower respiratory tract infections in children without chronic broncho-pulmonary disease
Acetylcysteine and carbocysteine are the most commonly prescribed mucolytic drugs. This systematic review aimed at assessing their efficacy and safety for treating acute upper and lower respiratory tract infections (ARTIs) in children without chronic broncho-pulmonary disease. A subgroup analysis among patients younger than two years was performed.

Forty-nine studies met the inclusion criteria. Six trials involving 497 participants were included to study efficacy and compared acetylcysteine or carbocysteine to placebo. Thirty-four studies including the previous six were eligible to study safety and involved 2064 paediatric patients.

The results of this review suggest actual but limited efficacy of acetylcysteine and carbocysteine and a good overall safety among children older than two years of age. However, the number of patients included was limited and the methodological quality was questionable. These results should also take into consideration the fact that acetylcysteine and carbocysteine are prescribed for self-limiting diseases (e.g., acute cough, bronchitis). Regarding children younger than two years, given concerns about safety, these drugs should only be used for ARTIs in the context of a randomised controlled trial.

Full pdf attached

[Momtezuma Tuatara]

Theoretically it could also be used during whooping cough, as both an anti-oxidant to help combat toxins, and to thin mucus, if the mucus is really thick, but I've only heard of one person using it.

Usually, sodium ascorbate thins out the mucous well enough for children to cope.

[Momtezuma Tuatara]

Reprod Biomed Online. (http://javascript<b></b>:AL_get(this, 'jour', 'Reprod Biomed Online.');) 2008 Nov;17(5):722-6.http://www.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--images.ingentaselect.com-images-linkout-ingentaconnect.gif (http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3152&itool=AbstractPlus-def&uid=18983759&db=pubmed&url=http://openurl.ingenta.com/content/nlm?genre=article&issn=1472-6483&volume=17&issue=5&spage=722&aulast=Amin) Links (http://javascript<b></b>:PopUpMenu2_Set(Menu18983759);)

N-acetyl cysteine for treatment of recurrent unexplained pregnancy loss.

Amin AF (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Amin%20AF%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Shaaban OM (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Shaaban%20OM%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Bediawy MA (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Bediawy%20MA%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).
Department of Obstetrics and Gynaecology, Women's Health Centre, Faculty of Medicine, Assiut University, Assiut, Egypt. ahmedamen1@yahoo.com
Pregnancy could be associated with a state of oxidative stress that could initiate and propagate a cascade of changes that may lead to pregnancy wastage. This process of oxidative stress may be suppressed by the antioxidant effect of N-acetyl cysteine (NAC).

The current study aimed to evaluate the effect of NAC therapy in patients diagnosed with unexplained recurrent pregnancy loss (RPL). The study was a prospective controlled study performed in the Women's Health Centre, Assiut University, Egypt.

A group of 80 patients with history of recurrent unexplained pregnancy loss were treated with NAC 0.6 g + folic acid 500 microg/day and

compared with an aged-matched group of 86 patients treated with folic acid 500 microg/day alone.

NAC + folic acid compared with folic acid alone caused a significantly increased rate of continuation of a living pregnancy up to and beyond 20 weeks [P < 0.002, relative risk (RR) 2.9, 95% confidence interval (CI) 1.5-5.6].

NAC + folic acid was associated with a significant increase in the take-home baby rate as compared with folic acid alone (P < 0.047, RR 1.98, 95% CI 1.3-4.0).

In conclusion, NAC is a well-tolerated drug that could be a potentially effective treatment in patients with unexplained RPL.
PMID: 18983759 [PubMed - indexed for MEDLINE]

Related Articles


Protective effect of N-acetylcysteine against fetal death and preterm labor induced by maternal inflammation. (http://www.ncbi.nlm.nih.gov/pubmed/12548218?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed) [Am J Obstet Gynecol. 2003]
Effect of N-acetylcysteine on oxidative stress and ventricular function in patients with myocardial infarction. (http://www.ncbi.nlm.nih.gov/pubmed/16440146?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed) [Heart Vessels. 2006]
ReviewRecurrent pregnancy loss with antiphospholipid antibody: a systematic review of therapeutic trials. (http://www.ncbi.nlm.nih.gov/pubmed/11777524?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=3&log$=relatedreviews&logdbfrom=pubmed) [Obstet Gynecol. 2002]

[Momtezuma Tuatara]

N.B. Animal model only (mice) :

1: Am J Obstet Gynecol. (javascript:AL_get(this, 'jour', 'Am J Obstet Gynecol.');) 2003 Jan;188(1):203-8.http://www.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--linkinghub.elsevier.com-ihub-images-PubMedLink.gif (http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3048&itool=AbstractPlus-def&uid=12548218&db=pubmed&url=http://linkinghub.elsevier.com/retrieve/pii/S0002937802714427) Links (javascript:PopUpMenu2_Set(Menu12548218);)

Protective effect of N-acetylcysteine against fetal death and preterm labor induced by maternal inflammation.

Buhimschi IA (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Buhimschi%20IA%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Buhimschi CS (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Buhimschi%20CS%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Weiner CP (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Weiner%20CP%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA. ibuhimsc@med.wayne.edu
OBJECTIVE: Intrauterine and maternal systemic infections are proposed causes of preterm labor.

The resulting prematurity is associated with 75% of infant mortality and 50% of long-term neurologic handicaps.

We hypothesize that free radicals generated in large quantities during an inflammatory response shift the fetomaternal redox balance to an oxidative state, compromising the fetus.

Thus, if our working hypothesis is correct, selective inactivation of free radicals with N-acetylcysteine (NAC), an antioxidant and glutathione (GSH) precursor, would improve the outcome of preterm deliveries associated with inflammation. We tested aspects of this hypothesis in an animal model of preterm labor and fetal damage (death).

STUDY DESIGN: NAC (1 g/kg) was administered orally to C57Bl/6 mice injected intraperitoneally with either 10 microg lipopolysaccharide (LPS) or saline solution (CRL) on day 16 of gestation. The latency period (time from injection to delivery of the first pup) and fetal viability were recorded. To discriminate between an effect of prematurity from an effect of inflammation, and to document any improvement in survival, mice were killed at 3, 6, and 16 hours after injection. Maternal and fetal redox states were approximated by measuring hepatic GSH. RESULTS: Each C57Bl/6 LPS-treated mouse delivered prematurely after a significantly shorter latency period (LPS: 16.8 hours [95% CI 15.9-17.6] vs CRL: 54.7 hours [95% CI 43.8-65.5]). NAC doubled the latency interval of LPS-treated animals to 35.2 hours (95% CI 21.0-49.2).

(Lipopolysaccharide = endotoxin - Hilary)

LPS alone resulted in a 100% rate of stillbirth. Fifty-eight percent of fetuses were already dead 16 hours after LPS. In contrast, only 33% of fetuses were dead 16 hours after LPS (P =.001) when NAC was given. LPS was followed by a reduction in maternal (LPS: 26.3 nmol/mg [95% CI 19.9-32.8] vs CRL: 41.3 nmol/mg [95% CI 34.7-47.9, P <.01]) and fetal GSH (LPS: 19.7 nmol/mg [95% CI 11.7-27.8] vs CRL: 34.5 nmol/mg [95% CI 32.0-37.0, P <.001]). This decline was reversed by NAC (NAC/LPS maternal GSH: 37.0 nmol/mg [95% CI 22.5-51.5] and fetal GSH: 28.4 nmol/mg [95% CI 22.8-33.9]). Importantly, maternal liver GSH impacted on fetal survival. NAC/LPS mothers with living pups 16 hours after LPS had significantly higher liver GSH compared with NAC/LPS mothers whose pups died in utero. In fact, all NAC-treated mice whose hepatic GSH exceeded 20 nmol/mg had living fetuses at 16 hours.

CONCLUSION: Maternal inflammation in C57Bl/6 mice results in oxidative stress associated with maternal and fetal GSH depletion. Oxidative stress damages the fetus independent of prematurity. Restoration of maternal and fetal oxidative balance by NAC protects the fetus and reduces the rate of preterm birth.
PMID: 12548218 [PubMed - indexed for MEDLINE]