The Therapeutic Use of N-Acetylcysteine (NAC) in Medicine

Description

Focusing on the practical use of N-Acetyl-Cysteine (NAC) in medicine, this book provides a comprehensive review of the basic biological and clinical studies documenting its benefits in treating medical disease. NAC is perhaps best known as an antidote for acetaminophen, but its therapeutic effect in a wide range of medical diseases has recently been realized. In addition to its well recognized use in radiological contrast prophylaxis for renal disease and pulmonary disorders, studies have suggested significant promise in psychiatric and neurological disorders such as addiction, Alzheimer’s disease, ataxia, autism, bipolar disorder, depression, epilepsy, neuropathy, obsessive-compulsive disorder, schizophrenia, traumatic brain injury and trichotillomania in addition to promising studies in audiology, cardiology, exercise physiology, gastroenterology, hematology, infectious disease, infertility and ophthalmology. Given the promising studies for a wide range of medical conditions, coupled with a excellent safety profile, the potential for NAC in the treatment of human disease appears considerable. Dr Leonore A Herzenberg from Stanford University, a pioneer of redox physiology and the use of NAC, provides a succinct history of the development of the therapeutic use of NAC for medical disease. This is followed by a series of basic science chapters outlining the role of NAC in important physiological processes, including modulation of dopamine and glutamate neurotransmitter systems, redox and mitochondrial metabolism, apoptosis and inflammation. The last section of the book is dedicated to clinically oriented chapters that comprehensively review the literature on medical disorders in which NAC has been found to be effective, including toxicity and cardiovascular, gastrointestinal, neurological, psychiatric, pulmonary and renal disorders. Each chapter reviews the theoretical biological mechanisms of NAC for the specific diseases reviewed, rates the clinical studies using a standardized criteria in order to provide an objective level of evidence and grade of recommendation for the use of NAC for specific medical conditions and outlines the ongoing clinical trials examining NAC for the treatment of specific diseases. Final chapters review the clinical evidence verifying that specific theoretical biological mechanisms are actually being targeted by NAC in medical disease. Studies on the pharmacology, formulation and potential adverse effects of NAC are also reviewed. A final chapter synthesizes the clinical studies to suggest that the effectiveness of NAC may signal a new basic physiological disorder, glutathione deficiency, which may be an important pathophysiological mechanism of many diseases. Front Matter ....Pages i-xii Front Matter ....Pages 1-1 History of N-Acetylcysteine (Leonore A. Herzenberg)....Pages 3-15 Front Matter ....Pages 17-17 Neurotransmitter Systems: Glutamate (M. Foster Olive, Gregory Powell, Erin McClure, Cassandra D. Gipson)....Pages 19-28 Neurotransmitter Systems: Dopamine (Nihit Kumar)....Pages 29-51 Oxidative Stress in Psychiatric Disorders (Lawrence Fung, Antonio Hardan)....Pages 53-72 Mitochondrial Metabolism (Shannon Rose, Sirish C. Bennuri)....Pages 73-103 Apoptosis (Sirish C. Bennuri, Shannon Rose, Richard Eugene Frye)....Pages 105-121 Inflammation (Rabindra Tirouvanziam)....Pages 123-135 Front Matter ....Pages 137-137 Clinical Trials on N-Acetylcysteine (Richard Eugene Frye)....Pages 139-146 N-Acetylcysteine in the Poisoned Patient (Angela L. Chiew, Geoffrey K. Isbister)....Pages 147-168 The Use of N-Acetylcysteine as a Chelator for Metal Toxicity (Daniel A. Rossignol)....Pages 169-179 Application of N-Acetylcysteine in Neurological Disorders (Reza Bavrsad Shahripour, Ana Hossein Zadeh Maleki, Andrei V. Alexandrov)....Pages 181-202 Application of N-Acetylcysteine in Psychiatric Disorders (John Slattery, Richard Eugene Frye)....Pages 203-218 Clinical Treatment of Addictive Disorders with N-Acetylcysteine (Gregory Powell, Erin A. McClure, M. Foster Olive, Cassandra D. Gipson)....Pages 219-233 The Clinical Use of N-Acetylcysteine for the Treatment and Protection Against Renal Disease (Richard Eugene Frye)....Pages 235-253 Application of N-Acetylcysteine in Pulmonary Disorders (Carol Conrad)....Pages 255-276 The Clinical Use of N-Acetylcysteine in Cardiology (John P. Marenco, Richard Eugene Frye)....Pages 277-287 The Clinical Use of N-Acetylcysteine in Gastrointestinal Disorders (Richard Eugene Frye)....Pages 289-299 The Clinical Use of N-Acetylcysteine in Other Medical Disorders (Richard Eugene Frye)....Pages 301-330 The Physiological Effects of N-Acetylcysteine in Clinical Studies (Richard Eugene Frye)....Pages 331-348 Cysteine/Glutathione Deficiency: A Significant and Treatable Corollary of Disease (Pietro Ghezzi, Kevin V. Lemley, James P. Andrus, Stephen C. De Rosa, Arne Holmgren, Dean Jones et al.)....Pages 349-386 Pharmacology, Formulations, and Adverse Effects (Richard Eugene Frye, James P. Andrus, Kevin V. Lemley, Stephen C. De Rosa, Pietro Ghezzi, Arne Holmgren et al.)....Pages 387-394