Evaluating the Effect of Oral N-acetylcysteine as an Adjuvant Treatment on Clinical Outcomes of Patients with Rheumatoid Arthritis: A Randomized, Double Blind Clinical Trial

Batooei, Minoo; Tahamoli-Roudsari, Ahmad; Basiri, Zahra; Yasrebifar, Fatemeh; Shahdoust, Maryam; Eshraghi, Azadeh; Mehrpooya, Maryam; Ataei, Sara

doi:10.2174/1574887113666180307151937

Cited by 43 publications

(48 citation statements)

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“…Oxidative Stress-Rheumatoid Arthritis. Pathophysiologically, RA is still not fully understood [20,28,[35][36][37]. The first references mentioning the term "rheumatoid arthritis" found in the PubMed database come from 1876, represented by two citations [31,38].…”

Section: Back In Time: What History Tells Us About the Binomialmentioning

confidence: 99%

“…When it comes to physiological conditions, the production and clearance of ROS and RNS should be maintained, ideally, in a dynamic balance, once they exert pleiotropic effects on growth, differentiation, chemotaxis, and cell death [15], being also crucial in the defense mechanisms against pathogens [14]. Under pathological conditions, however, such molecules, produced at great rates by articular neutrophils, monocytes, and macrophages [63], are capable of damaging different cell structures, including DNA, carbohydrates, proteins, and lipids [13,14,37,61,64], contributing to the establishment of oxidative stress (Figure 3). In this regard, the [14,16,44,48,50].…”

Section: Back In Time: What History Tells Us About the Binomialmentioning

confidence: 99%

“…Concerning the linkage between proinflammatory cells and oxidative stress mediators, activated macrophages and T cells in the synovium, for example, may induce the production of ROS via tumor necrosis factor (TNF) and interleukin (IL) 1 release [36], this way amplifying synovitis [37]. And what is more, a positive feedback between oxidative stress and inflammation is already recognized (Figure 3), through which both players amplify the damaging action of each other [12,14,65].…”

Section: Oxidative Stress and Localmentioning

confidence: 99%

“…Both experimental models and assessments in patients showed, in addition to elevated ROS and lipid peroxidation formation, a decrease in antioxidant defenses [13,14,60,67]. In this sense, antioxidant therapy may possibly offer novel adjuvant/complementary treatment options aiming at better controlling disease activity [37], as many patients do not achieve remission/low disease activity with the currently available pharmacological treatment [9].…”

Section: Antioxidant Therapy In Rheumatoid Arthritismentioning

confidence: 99%

“…However, when such reactive species reach concentrations above the upper limit of normal range, they damage cellular components [13,14,64]. In this way, therapies that decrease oxidants and/or increase antioxidants are promising in the treatment of various oxidative stressrelated inflammatory diseases [37].…”

Section: Antioxidant Therapy In Rheumatoid Arthritismentioning

confidence: 99%

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Oxidative Stress in Rheumatoid Arthritis: What the Future Might Hold regarding Novel Biomarkers and Add-On Therapies

Fonseca

Nunes-Souza

Goulart

et al. 2019

Oxidative Medicine and Cellular Longevity

167

121

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Numerous rheumatologic autoimmune diseases, among which rheumatoid arthritis, are chronic inflammatory diseases capable of inducing multiple cumulative articular and extra-articular damage, if not properly treated. Nevertheless, benign conditions may, similarly, exhibit arthritis as their major clinical finding, but with short-term duration instead, and evolve to spontaneous resolution in a few days to weeks, without permanent articular damage. Such distinction—self-limited arthritis with no need of immunosuppressive treatment or chronic arthritis at early stages?—represents one of the greatest challenges in clinical practice, once many metabolic, endocrine, neoplastic, granulomatous, infectious diseases and other autoimmune conditions may mimic rheumatoid arthritis. Indeed, the diagnosis of rheumatoid arthritis at early stages is a crucial step to a more effective mitigation of the disease-related damage. As a prototype of chronic inflammatory autoimmune disease, rheumatoid arthritis has been linked to oxidative stress, a condition in which the pool of reactive oxygen species increases over time, either by their augmented production, the reduction in antioxidant defenses, or the combination of both, ultimately implying compromise in the redox signaling. The exact mechanisms through which oxidative stress may contribute to the initiation and perpetuation of local (in the articular milieu) and systemic inflammation in rheumatoid arthritis, particularly at early stages, still remain to be determined. Furthermore, the role of antioxidants as therapeutic adjuvants in the control of disease activity seems to be overlooked, as a little number of short studies addressing this issue is currently found. Thus, the present review focuses on the binomial rheumatoid arthritis-oxidative stress, bringing insights into their pathophysiological relationships, as well as the implications of potential diagnostic oxidative stress biomarkers and therapeutic interventions directed to the oxidative status in patients with rheumatoid arthritis.

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Section: Back In Time: What History Tells Us About the Binomialmentioning

confidence: 99%

Section: Back In Time: What History Tells Us About the Binomialmentioning

confidence: 99%

Section: Oxidative Stress and Localmentioning

confidence: 99%

Section: Antioxidant Therapy In Rheumatoid Arthritismentioning

confidence: 99%

Section: Antioxidant Therapy In Rheumatoid Arthritismentioning

confidence: 99%

See 3 more Smart Citations

Oxidative Stress in Rheumatoid Arthritis: What the Future Might Hold regarding Novel Biomarkers and Add-On Therapies

Fonseca

Nunes-Souza

Goulart

et al. 2019

Oxidative Medicine and Cellular Longevity

167

121

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Investigation of the Effect of Oral Selenium on the Reduction of Clinical Symptoms and Joint Pain in Patients With Rheumatoid Arthritis in the Iranian Population

Mehrpooya,

Majmasanaye,

Faramarzi

et al. 2023

The Journal of Clinical Pharma

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Rheumatoid arthritis (RA) is a common inflammatory joint disease. Because inflammation and nitrosative stress play an important role in the pathogenesis of RA, drugs that have antioxidant and anti‐inflammatory effects can be effective as adjuvant treatment in these patients. Selenium is a compound that has been shown in recent studies to have anti‐inflammatory and antioxidant effects. Therefore, the aim of this study was to investigate the effect of oral selenium on the reduction of clinical symptoms and joint pain in patients with RA. Fifty‐one patients with moderate and severe RA were randomly divided into selenium and placebo groups. The first group of patients received selenium at a dose of 200 μg twice a day for 12 weeks along with standard RA interventions and treatments, and the second group received standard treatments of RA along with a placebo. Clinical symptoms were evaluated with standard indicators to evaluate disease activity before and after the intervention in the 12th week. Examination of clinical symptoms at the end of the study showed that in the selenium group and after 12 weeks, a reduction in clinical symptoms and joint pain were observed, which was statistically significant compared with before the study began. Meanwhile, no significant changes were observed in the patients of the placebo group in terms of reducing symptoms and joint pains. A dose of 200 μg of oral selenium twice a day for 12 weeks can significantly reduce clinical symptoms and joint pain in patients with RA.

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Effects of N-acetylcysteine supplementation on disease activity, oxidative stress, and inflammatory and metabolic parameters in rheumatoid arthritis patients: a randomized double-blind placebo-controlled trial

et al. 2022

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Evaluating the Effect of Oral N-acetylcysteine as an Adjuvant Treatment on Clinical Outcomes of Patients with Rheumatoid Arthritis: A Randomized, Double Blind Clinical Trial

Cited by 43 publications

References 0 publications

Oxidative Stress in Rheumatoid Arthritis: What the Future Might Hold regarding Novel Biomarkers and Add-On Therapies

Oxidative Stress in Rheumatoid Arthritis: What the Future Might Hold regarding Novel Biomarkers and Add-On Therapies

Investigation of the Effect of Oral Selenium on the Reduction of Clinical Symptoms and Joint Pain in Patients With Rheumatoid Arthritis in the Iranian Population

Effects of N-acetylcysteine supplementation on disease activity, oxidative stress, and inflammatory and metabolic parameters in rheumatoid arthritis patients: a randomized double-blind placebo-controlled trial

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