Effects of N-acetylcysteine on bacterial clearance

Abstract. The aim of this study was to investigate whether the oxygen radical scavenger N -acetylcysteine ( N -AC) impairs bacterial clearance, thus predisposing the host to increased risk of disease. Blood clearance of Escherichia coli and organ colonization were investigated in anaesthetized rabbits after pretreatment with N -AC (250 mg kg^-1 body weight, n = 16) and in sham-operated animals ( n = 12). To enable quantification of the clearance process, defined numbers of exogenous E. coli [1.3 times 108 colony-forming units (CFUs)] were injected intravenously. Parameters monitored were kinetics of bacterial elimination from the blood, and polymorphonuclear leucocyte (PMN) oxidative burst activity. Samples of liver, kidney, spleen and lung were collected for bacterial counts. Compared with controls, pretreatment with N -AC resulted in delayed bacterial elimination from blood and higher organ colonization with increased numbers of E. coli in liver, lung and kidney ( P < 0.05). N -AC treatment was associated with a suppressed PMN oxidative burst activity. Impaired bacterial clearance and enhanced organ colonization in N -AC-treated animals correlated with reduced oxidative burst activity, suggesting impaired granulocyte-dependent bacterial killing due to N -AC application.     

N-乙酰半胱氨酸对慢性阻塞性肺疾病患者血淋巴细胞DNA损伤的影响

目的　探讨N -乙酰半胱氨酸 (NAC)治疗不同病期慢性阻塞性肺疾病 (COPD)的疗效。方法　 49例稳定期、急性发作期COPD患者 ,随机分为观察组 (2 5例 )和对照组 (2 4例 ) ,观察组除给予常规治疗外 ,加用NAC(每次 2 0 0mg ,3/d ,连用 2个月 ) ;对照组仅给予常规治疗。治疗前后观察所有患者外周血淋巴细胞DNA损伤程度。结果　治疗前后比较 ,观察组稳定期、急性发作期DNA损伤明显降低 ,差异有显著性 (P <0 .0 5)。对照组稳定期DNA损伤程度亦有一定程度的改善 ,但差异无显著性 (P >0 .0 5) ,急性发作期DNA损伤程度降低 ,差异有显著性 (P <0 .0 5)。结论　COPD患者体内存在氧化 -抗氧化失衡 ,抗氧化治疗可降低COPD患者外周血淋巴细胞DNA损伤程度 ,急性发作期出现氧化应激。     

Effect of NMDA on Production of Reactive Oxygen Species by Human Lymphocytes

Low concentrations (<20 M) of N-methyl-D-aspartate (NMDA), an agonist of specific receptors of brain glutamatergic systems, promote the formation of reactive oxygen species (ROS) both in the whole blood and in lymphocyte fraction. Further increase in NMDA concentrations led to progressive increase in ROS content in the whole blood, but to its decrease in lymphocyte suspension. The activating effect of NMDA is abolished by antioxidant N-acetylcysteine (5 mM) and NMDA-type glutamate receptor antagonist MK-801 (5 M). Phorbol myristate acetate (PMA, 1 M) also increased ROS content in the examined structures. This effect was antagonized by N-acetylcysteine, but not MK-801.     

Development and in Vitro Evaluation of Systems to Protect Peptide Drugs from Aminopeptidase N

Purpose. Develop and evaluate systems to prevent aminopeptidase N caused enzymatic degradation of perorally administrated peptide drugs. Methods. Bacitracin was covalently bound to the unabsorbable carrier matrix poly(acrylic acid) (paa) in order to avoid any dilution effects of the inhibitor in the intestine as well as systemic toxic side effects. The inhibitory effect of this conjugate, of neutralized paa and N-acetylcysteine was evaluated using a brush border membrane model. Results. Whereas within 6 h of incubation 65.3 ± 3.7 mol/1 of the substrate (L-leucine p-nitroanilide) was hydrolyzed under our assay conditions, this metabolism was reduced to 44.5 ± 6.3 mol/1 and 49.0 ± 8.8 mol/1 (n = 3–5; ± S.D.) using 1.5% bacitracin-polymer conjugate and 0.5% N-acetylcysteine, respectively. The same amount of bacitracin as immobilized to the polymer exhibited a comparably weaker inhibitory effect. Neutralized paa did not inhibit membrane bound aminopeptidase N. Covering the membrane with a thin mucus layer led to a significantly lowered inhibitory effect of all tested agents. Conclusions. The immobilization of enzyme inhibitors to a carrier matrix and the use of N-acetylcysteine as a novel inhibitor are promising strategies in order to overcome the enzymatic barrier caused by membrane bound peptidases. However the use of effective mucolytic agents seems to be a prerequisite.     

N-乙酰半胱氨酸和氯胺酮联用对脑缺血再灌注损伤的影响

目的:研究巯基供体物质N 乙酰半胱氨酸(NAC)和非竞争性NMDA受体拮抗剂氯胺酮(KT)联用对小鼠脑缺血再灌注损伤的影响。方法:雄性ICR小鼠,随机分为假手术组、生理盐水组(0 .0 1L·g- 1)、氯胺酮组(15mg·kg- 1)、N 乙酰半胱氨酸组(75mg·kg- 1)和联合组(KT 15mg·kg- 1 NAC75mg·kg- 1)。参照蒋晓帆等建立的方法,制备局灶性短暂性脑缺血再灌注模型(tMCAO) ,再灌注后6、2 4h测定神经行为缺陷评分,处死TTC染色测定脑梗死面积百分比;制备不完全性脑缺血再灌注模型(2 VO) ,在再灌注0 .5、2和6h时取全脑制成10 %匀浆,比色法测定MDA含量、SOD和GSH Px活力。结果:(1)短暂性局灶性脑缺血再灌注后6、2 4h ,各组小鼠脑组织均有不同程度梗死灶、神经行为缺陷明显,与生理盐水组比较,药物联合组可显著改善缺血再灌注小鼠的神经行为缺陷(均为P <0 .0 1) ,减少脑梗死面积百分比(均为P <0 .0 1) ,药物单用对以上指标有轻度的改善作用(P >0 .0 5 )。(2 )联合用药可明显改善脑细胞损伤。(3)与假手术组比较,不完全性全脑缺血再灌注损伤0 .5、2和6h后,生理盐水组小鼠MDA含量显著升高(均为P <0 .0 1) ,SOD活性(均为P <0 .0 1)和GSH Px活性均显著降低(均为P <0 .0 1)。与生理盐水组比较,联合组可显著地降低缺血再灌注小鼠脑组织     

MMP-9/TIMP-1在脂多糖和N-乙酰半胱氨酸干预体外孵育胎膜中的表达及意义

目的探讨感染引发早产的可能机制及N-乙酰半胱氨酸(NAC)预防感染引发早产的可行性。方法取20例正常择期剖宫产孕妇(无妊娠合并症及临产征兆)的胎膜在体外进行孵育,共分成5组:0 h组(取下后未经孵育的胎膜),24 h组,48 h组,72 h细菌内毒素脂多糖组(LPS组),72 h LPS NAC组(LPS NAC组)。首先评价体外孵育胎膜的存活力,然后应用逆转录聚合酶链反应(RT-PCR)分别测定5组胎膜的基质金属蛋白酶-9(MMP-9)及金属蛋白酶组织抑制因子-1(TIMP-1)mRNA表达水平的变化,最后比较LPS组和LPS NAC组MMP-9/TIMP-1比值的变化。结果体外孵育胎膜的存活力达到83%±1.9%,RT-PCR可见0 h组及48 h组的MMP-9表达微弱,24 h组的表达较前两组增强(P<0.05),LPS组的表达最强(与24 h组比较P<0.01),LPS NAC组的表达低于LPS组(P<0.01),各组TIMP-1的表达无明显区别(P>0.05),LPS NAC组较LPS组MMP-9/TIMP-1比值明显降低(P<0.01)。结论MMP-9/TIMP-1比值升高可能是感染引发早产的机制之一,NAC有望在预防和治疗早产中发挥作用。     

乙酰半胱氨酸对小鼠酒精中毒的影响

目的 :观察5 %N—乙酰—L—半胱氨酸 (NAC)口服液对小鼠醉酒后血清乙醇浓度和肝、胃组织乙醇脱氢酶活性的影响。方法 :用生理盐水或5 %NAC口服液灌服小鼠30min后 ,再灌服白酒 ,记录小鼠翻正反射消失 (醉酒 )至恢复 (醒酒 )所需时间及24h内小鼠的死亡只数 ;另对小鼠以相同灌服方法连续6d灌服后眼眶取血并处死小鼠 ,立即取出其肝脏和胃 ,分别用生化比色法测定血清乙醇浓度和肝、胃组织乙醇脱氢酶活性。结果 :在醉酒实验中 ,与对照组比较 ,服用5 %NAC口服液组小鼠从饮酒到醉酒的时间明显延长 (P<0 01) ,醒酒时间明显缩短 ,且小鼠的死亡率明显降低 (P<0 05) ;服用5 %NAC口服液组小鼠血清乙醇浓度明显低于单纯服用白酒的小鼠 (P<0 01)。结论 :5 %NAC口服液具有解酒作用。     

N-acetylcysteine for the prevention of contrast-induced nephropathy in patients with pre-existing renal insufficiency or diabetes: a systematic review and meta-analysis

Abstract

Purpose: To identify benefit of N-acetylcysteine (NAC) on patients with pre-existing renal insufficiency or diabetes. Background: NAC administration is a common method for prevention of contrast-induced nephropathy (CIN). Nevertheless, its benefit on patients with pre-existing renal insufficiency or diabetes remains uncertain and controversial. Methods: Randomized controlled trials (RCTs) to evaluate the efficacy of NAC for the prevention of CIN in patients with pre-existing renal insufficiency or diabetes were searched from the databases of MEDLINE, EMBASE, and Cochrane library. Pooled odds ratio (OR) with 95% confidence interval (95% CI) were calculated using fixed-effects model by the Mantel–Haenszel test. Results: Twenty RCTs involving 3466 subjects (1756 assigned to NAC and 1710 assigned to the control) were included in the pre-existing renal dysfunction group. Pooled analysis suggested a significant reduction in CIN among this group (OR, 0.76; 95% CI, 0.61–0.93; p?=?0.008). However, the nine trials comparing NAC versus control among patients with diabetes (NAC, 367 subjects; control, 358 subjects) showed no benefit of NAC for prevention of CIN (OR?=?0.87; 95% CI, 0.58–1.30; p?=?0.50). No significant heterogeneity was detected (p?=?0.07; I²?=?34% for the group of pre-existing renal dysfunction; p?=?0.40; I²?=?5% for the group of diabetes). Conclusion: Our results suggest that NAC decreases the incidence of contrast-induced nephropathy among patients with pre-existing renal insufficiency. The benefit was not existed in patients with diabetes.     

N-acetylcysteine protects against star fruit-induced acute kidney injury

Background: Star fruit (SF) is a popular fruit, commonly cultivated in many tropical countries, that contains large amount of oxalate. Acute oxalate nephropathy and direct renal tubular damage through release of free radicals are the main mechanisms involved in SF-induced acute kidney injury (AKI). The aim of this study was to evaluate the protective effect of N-acetylcysteine (NAC) on SF-induced nephrotoxicity due to its potent antioxidant effect.

Materials and methods: Male Wistar rats received SF juice (4?mL/100?g body weight) by gavage after a 12?h fasting and water deprivation. Fasting and water deprivation continued for 6?h thereafter to warrant juice absorption. Thereafter, animals were allocated to three experimental groups: SF (n?=?6): received tap water; SF?+?NAC (n?=?6): received NAC (4.8?g/L) in drinking water for 48?h after gavage; and Sham (n?=?6): no interventions. After 48?h, inulin clearance studies were performed to determine glomerular filtration rate. In a second series of experiment, rats were housed in metabolic cages for additional assessments.

Results: SF rats showed markedly reduced inulin clearance associated with hyperoxaluria, renal tubular damage, increased oxidative stress and inflammation. NAC treatment ameliorated all these alterations. Under polarized light microscopy, SF rats exhibited intense calcium oxalate birefringence crystals deposition, dilation of renal tubules and tubular epithelial degeneration, which were attenuate by NAC therapy.

Conclusions: Our data show that therapeutic NAC attenuates renal dysfunction in a model of acute oxalate nephropathy following SF ingestion by reducing oxidative stress, oxaluria, and inflammation. This might represent a novel indication of NAC for the treatment of SF-induced AKI.     

N-乙酰半胱氨酸联合甲基强的松龙治疗放射性肺损伤临床研究

目的探讨使用N-乙酰半胱氨酸(NAC)治疗放射性肺损伤的临床效果和应用价值。方法将100例放射性肺损伤患者随机平均分为甲基强的松龙治疗组(对照组)和甲强龙+N-乙酰半胱氨酸治疗组(治疗组),每组50例,疗程14天。4周后观察2组临床疗效。并分别于第1天和第14天观察血浆TNF-α、IL-6、TGF-β1和CRP水平变化。结果 4周后甲强龙治疗组总有效率为78%,甲强龙+N-乙酰半胱氨酸治疗组为88%,两组间临床疗效的差异有统计学意义(χ2=4.461,P<0.05)。2治疗组在第1天时血浆TNF-α、IL-6、TGF-β1和CRP水平无统计学差异(P均>0.05)。在第14天时,2治疗组血浆TNF-α、IL-6、TGF-β1和CRP水平较前明显下降,各指标差异均有统计学意义(P均<0.05)。同时,与甲强龙治疗组相比甲强龙+N-乙酰半胱氨酸组血浆TNF-α、IL-6、TGF-β1和CRP水平下降更明显,差异均有统计学意义(P均<0.05)。结论本研究发现在常规使用甲强龙治疗的基础上加用N-乙酰半胱氨酸进行辅助治疗,能有效减轻放射性肺损伤的临床症状,同时降低血浆TNF-α、IL-6、TGF-β1和CRP水平。N-乙酰半胱氨酸对于放射性肺损伤有保护作用,可常规应用于临床治疗。