Acetylcysteine as Adjuvant Therapy for Vasculitis Associated with Antineutrophil Cytoplasmic Antibody

Fernández–Fernández, Francisco José; Sesma, Pascual

doi:10.3899/jrheum.101159

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…Antioxidant effect of N-acetylcystein published by Fernández-Fernández and Sesma[65] in one patient with WG and also our unpublished experience suggests clinical improvement of systemic inflammation. Administration of NAC is based on two significant studies: the IFIGENIA trial in 2005[66] (Idiopathic Pulmonary Fibrosis International Group Exploring Nacetylcysteine I Annual study) and the study by Guilpain et al[42].…”

supporting

confidence: 63%

Immunological Mechanisms and Clinical Aspects in Pulmonary- Renal Syndrome: A Review

Lukan¹

2013

Updates in the Diagnosis and Treatment of Vasculitis

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supporting

confidence: 63%

Immunological Mechanisms and Clinical Aspects in Pulmonary- Renal Syndrome: A Review

Lukan¹

2013

Updates in the Diagnosis and Treatment of Vasculitis

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“…This is a novel finding that, if confirmed in a larger study, could point not only to depleted GSH as a contributory factor in heightened platelet activation in type 2 diabetes, but also to the usefulness of intracellular GSH screening before NAC therapy. A critical role for intracellular GSH in determining the extent of NAC benefit might also explain the lack of consistency in results from studies in a range of clinical conditions [15–21], where intracellular GSH has not been a consideration.…”

Section: Discussionmentioning

confidence: 99%

“…N -acetylcysteine (NAC), is a well-recognised intravenous therapy used to redress acute GSH depletion in overdosage with paracetamol (known as acetaminophen in the USA and Canada) [14]. NAC is currently under investigation for its antioxidant benefits in a range of clinical conditions [15–20], although there are some doubts about its efficacy, particularly in contrast-induced nephropathy [21]. …”

Section: Introductionmentioning

confidence: 99%

N-Acetylcysteine inhibits platelet–monocyte conjugation in patients with type 2 diabetes with depleted intraplatelet glutathione: a randomised controlled trial

et al. 2012

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Aims/hypothesisThe aim of this study was to determine whether oral dosing with N-acetylcysteine (NAC) increases intraplatelet levels of the antioxidant, glutathione (GSH), and reduces platelet–monocyte conjugation in blood from patients with type 2 diabetes.MethodsIn this placebo-controlled randomised crossover study, the effect of oral NAC dosing on platelet–monocyte conjugation and intraplatelet GSH was investigated in patients with type 2 diabetes (eligibility criteria: men or post-menopausal women with well-controlled diabetes (HbA1c < 10%), not on aspirin or statins). Patients (n = 14; age range 43–79 years, HbA1c = 6.9 ± 0.9% [52.3 ± 10.3 mmol/mol]) visited the Highland Clinical Research Facility, Inverness, UK on day 0 and day 7 for each arm of the study. Blood was sampled before and 2 h after oral administration of placebo or NAC (1,200 mg) on day 0 and day 7. Patients received placebo or NAC capsules for once-daily dosing on the intervening days. The order of administration of NAC and placebo was allocated by a central office and all patients and research staff involved in the study were blinded to the allocation until after the study was complete and the data fully analysed. The primary outcome for the study was platelet–monocyte conjugation.ResultsOral NAC reduced platelet–monocyte conjugation (from 53.1 ± 4.5% to 42.5 ± 3.9%) at 2 h after administration and the effect was maintained after 7 days of dosing. Intraplatelet GSH was raised in individuals with depleted GSH and there was a negative correlation between baseline intraplatelet GSH and platelet–monocyte conjugation. There were no adverse events.Conclusions/interpretationThe NAC-induced normalisation of intraplatelet GSH, coupled with a reduction in platelet–monocyte conjugation, suggests that NAC might help to reduce atherothrombotic risk in type 2 diabetes.Funding:Chief Scientist Office (CZB/4/622), Scottish Funding Council, Highlands & Islands Enterprise and European Regional Development Fund.Trial registration:isrctn.org ISRCTN89304265Electronic supplementary materialThe online version of this article (doi:10.1007/s00125-012-2685-z) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

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Beneficial Effect of N-acetylcysteine on Antineutrophil Cytoplasmic Antibody-associated Vasculitis

Park¹,

Pai²,

Kim³

et al. 2012

J Rheumatol

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Acetylcysteine as Adjuvant Therapy for Vasculitis Associated with Antineutrophil Cytoplasmic Antibody

Cited by 4 publications

References 8 publications

Immunological Mechanisms and Clinical Aspects in Pulmonary- Renal Syndrome: A Review

Immunological Mechanisms and Clinical Aspects in Pulmonary- Renal Syndrome: A Review

N-Acetylcysteine inhibits platelet–monocyte conjugation in patients with type 2 diabetes with depleted intraplatelet glutathione: a randomised controlled trial

Beneficial Effect of N-acetylcysteine on Antineutrophil Cytoplasmic Antibody-associated Vasculitis

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