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

Hum Exp Toxicol. 2007 Sep;26(9):697-703. doi: 10.1177/0960327107083452.

Abstract

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • APACHE
  • Acetylcysteine / administration & dosage
  • Acetylcysteine / therapeutic use*
  • Adult
  • Antioxidants / administration & dosage
  • Antioxidants / metabolism
  • Antioxidants / therapeutic use*
  • Biomarkers / blood
  • Blood Platelets / drug effects*
  • Blood Platelets / metabolism
  • Female
  • Glutathione / blood*
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Oxidative Stress / drug effects*
  • Respiratory Distress Syndrome / blood
  • Respiratory Distress Syndrome / drug therapy*
  • Respiratory Distress Syndrome / metabolism
  • Sulfhydryl Compounds / blood*
  • Treatment Outcome
  • Up-Regulation

Substances

  • Antioxidants
  • Biomarkers
  • Sulfhydryl Compounds
  • Glutathione
  • Acetylcysteine