Updates on N-acetylcysteine including recent studies on antioxidant function and other interesting properties of this compound.

Eroglu N, Erduran E, Reis GP, Bahadır A. Therapeutic effect of N-acetylcysteine on chemotherapy-induced liver injury [published online ahead of print, 2020 Apr 1]. Ir J Med Sci. 2020;10.1007/s11845-020-02219-1. doi:10.1007/s11845-020-02219-1

Kreitman K, Nair SP, Kothadia JP. Successful Treatment of Crizotinib-Induced Fulminant Liver Failure: A Case Report and Review of Literature. Case Reports Hepatol. 2020;2020:8247960. Published 2020 Mar 10. doi:10.1155/2020/8247960

Kularatne RN, Bulumulla C, Catchpole T, et al. Protection of human retinal pigment epithelial cells from oxidative damage using cysteine prodrugs [published online ahead of print, 2020 Mar 27]. Free Radic Biol Med. 2020;S0891-5849(19)32456-6. doi:10.1016/j.freeradbiomed.2020.03.024

Rodrigues MS, Pieri BLDS, Silveira GB, et al. Reduction of oxidative stress improves insulin signaling in cardiac tissue of obese mice. Einstein (Sao Paulo). 2020;18:eAO5022. Published 2020 Mar 23. doi:10.31744/einstein_journal/2020AO5022

Woodcock EA, Lundahl LH, Khatib D, Stanley JA, Greenwald MK. N-acetylcysteine reduces cocaine-seeking behavior and anterior cingulate glutamate/glutamine levels among cocaine-dependent individuals [published online ahead of print, 2020 Mar 24]. Addict Biol. 2020;e12900. doi:10.1111/adb.12900

Hou J, Chen L, Zhou M, et al. Multi-Layered Polyamide/Collagen Scaffolds with Topical Sustained Release of N-Acetylcysteine for Promoting Wound Healing. Int J Nanomedicine. 2020;15:1349–1361. Published 2020 Feb 28. doi:10.2147/IJN.S232190

Clara Gausterer J, Saidov N, Ahmadi N, et al. Intratympanic application of poloxamer 407 hydrogels results in sustained N-acetylcysteine delivery to the inner ear [published online ahead of print, 2020 Mar 12]. Eur J Pharm Biopharm. 2020;S0939-6411(20)30061-8.

Lee PH, Hong J, Jang AS. N-acetylcysteine decreases airway inflammation and responsiveness in asthma by modulating claudin 18 expression [published online ahead of print, 2020 Feb 28]. Korean J Intern Med. 2020;10.3904/kjim.2019.105. doi:10.3904/kjim.2019.105

Back SE, Gray K, Santa Ana E, et al. N-acetylcysteine for the treatment of comorbid alcohol use disorder and posttraumatic stress disorder: Design and methodology of a randomized clinical trial [published online ahead of print, 2020 Feb 19]. Contemp Clin Trials. 2020;91:105961.

Pesko MJ, Burbige EM, Sannar EM, et al. The Use of N-acetylcysteine Supplementation to Decrease Irritability in Four Youths With Autism Spectrum Disorders. J Pediatr Pharmacol Ther. 2020;25(2):149–154. doi:10.5863/1551-6776-25.2.149

Bauerlein DK, Akbar HN, von Rosenvinge EC, Loughry ND, John PR. Benefit of N-Acetylcysteine in Postoperative Hepatic Dysfunction: Case Report and Review of Literature. Case Reports Hepatol. 2019;2019:4730381. Published 2019 Dec 17. doi:10.1155/2019/4730381

Jo YS, Choi IS, So YK. The Use of Inhaled N-Acetylcysteine for Laryngopharyngeal Reflux Disease: A Randomized Controlled Trial [published online ahead of print, 2019 Dec 14]. J Voice. 2019;S0892-1997(19)30466-7. doi:10.1016/j.jvoice.2019.11.017

N-acetylcysteine is a chemical compound derived from N-acetyl and a prodrug of the endogenous amino acid L-cysteine. It occurs as a fine white powder.

What it is used for and where

It has long been used as an adjuvant in bronchitis in the role of fluidifying agent and expectorant of excessive mucus and also to counteract the toxicity of certain components such as doxorubicin, paracetamol, acute respiratory distress syndrome.

It is included in many dietary supplement formulas for its proven antioxidant and anti-inflammatory role with the ability to penetrate the blood-brain barrier and cell membrane.

It can be considered of great value in therapies to counter neurodegenerative and mental health diseases. Furthermore, this compound has been evaluated for its neuroprotective potential in the prevention of cognitive ageing dementia (1).

N-acetylcysteine is a sulfur-containing amino acid compound that has been tested for its protective potential in cardiac ischemia-reperfusion injury (2).

Overall N-acetylcysteine is easily absorbed into the human body and it is safe at doses of up to 300mg per kg body weight (3) however, there are documented risks if administered intravenously (4).

N-acetylcysteine insights

Typical optimal characteristics of the commercial product N-acetylcysteine

• Molecular Formula : C₅H₉NO₃S
• Linear Formula HSCH₂CH(NHCOCH₃)CO₂H
• Molecular Weight: 163.2 g/mol
• CAS: 616-91-1
• EC Number: 210-498-3
• UNII WYQ7N0BPYC
• InChI=1S/C5H9NO3S/c1-3(7)6-4(2-10)5(8)9/h4,10H,2H2,1H3,(H,6,7)(H,8,9)/t4-/m0/s1
• InChl Key      PWKSKIMOESPYIA-BYPYZUCNSA-N
• SMILES    CC(=O)NC(CS)C(=O)O
• IUPAC   (2R)-2-acetamido-3-sulfanylpropanoic acid
• ChEBI 28939
• DSSTox Substance ID: DTXSID5020021
• MDL number  MFCD00004880 
• PubChem Substance ID  329748885
• NACRES NA.24

Synonyms: 

• (2R)-2-acetamido-3-sulfanylpropanoic acid
• NAC
• LAC
• acetylcysteine

References_________________________________________________________

(1) Tardiolo G, Bramanti P, Mazzon E. Overview on the Effects of N-Acetylcysteine in Neurodegenerative Diseases. Molecules. 2018;23(12):3305. Published 2018 Dec 13. doi:10.3390/molecules23123305

(2) Bartekova M, Barancik M, Ferenczyova K, Dhalla NS. Beneficial Effects of N-acetylcysteine and N-mercaptopropionylglycine on Ischemia Reperfusion Injury in the Heart. Curr Med Chem. 2018;25(3):355–366. doi:10.2174/0929867324666170608111917

(3) Hołyńska-Iwan I, Wróblewski M, Olszewska-Słonina D, Tyrakowski T. Zastosowanie N-acetylocysteiny do optymalizacji specyficznych terapii farmakologicznych [The application of N-acetylcysteine in optimization of specific pharmacological therapies]. Pol Merkur Lekarski.

(4) Dodd S, Dean O, Copolov DL, Malhi GS, Berk M. N-acetylcysteine for antioxidant therapy: pharmacology and clinical utility. Expert Opin Biol Ther. 2008;8(12):1955–1962. doi:10.1517/14728220802517901