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      Medical and Dietary Uses of N-Acetylcysteine

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          Abstract

          N-acetylcysteine (NAC), a plant antioxidant naturally found in onion, is a precursor to glutathione. It has been used as a drug since the 1960s and is listed on the World Health Organization (WHO) Model List of Essential Medicines as an antidote in poisonings. There are numerous other uses or proposed uses in medicine that are still in preclinical and clinical investigations. NAC is also used in food supplements and cosmetics. Despite its abundant use, there are projections that the NAC global market will grow in the next five years; therefore, the purpose of this work is to provide a balanced view of further uses of NAC as a dietary supplement. Although NAC is considered a safe substance, the results among clinical trials are sometimes controversial or incomplete, like for many other antioxidants. More clinical trials are underway that will improve our understanding of NAC applicability.

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          Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine

          Intravenous sodium bicarbonate and oral acetylcysteine are widely used to prevent acute kidney injury and associated adverse outcomes after angiography without definitive evidence of their efficacy.
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            Structural, chemical and biological aspects of antioxidants for strategies against metal and metalloid exposure

            Oxidative stress contributes to the pathophysiology of exposure to heavy metals/metalloid. Beneficial renal effects of some medications, such as chelation therapy depend at least partially on the ability to alleviate oxidative stress. The administration of various natural or synthetic antioxidants has been shown to be of benefit in the prevention and attenuation of metal induced biochemical alterations. These include vitamins, N-acetylcysteine, α-lipoic acid, melatonin, dietary flavonoids and many others. Human studies are limited in this regard. Under certain conditions, surprisingly, the antioxidant supplements may exhibit pro-oxidant properties and even worsen metal induced toxic damage. To date, the evidence is insufficient to recommend antioxidant supplements in subject with exposure to metals. Prospective, controlled clinical trials on safety and effectiveness of different therapeutic antioxidant strategies either individually or in combination with chelating agent are indispensable. The present review focuses on structural, chemical and biological aspects of antioxidants particularly related to their chelating properties.
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              Oxidants, antioxidants and the current incurability of metastatic cancers

              Jim Watson (2013)
              The vast majority of all agents used to directly kill cancer cells (ionizing radiation, most chemotherapeutic agents and some targeted therapies) work through either directly or indirectly generating reactive oxygen species that block key steps in the cell cycle. As mesenchymal cancers evolve from their epithelial cell progenitors, they almost inevitably possess much-heightened amounts of antioxidants that effectively block otherwise highly effective oxidant therapies. Also key to better understanding is why and how the anti-diabetic drug metformin (the world's most prescribed pharmaceutical product) preferentially kills oxidant-deficient mesenchymal p53− −cells. A much faster timetable should be adopted towards developing more new drugs effective against p53− − cancers.
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                Author and article information

                Journal
                Antioxidants (Basel)
                Antioxidants (Basel)
                antioxidants
                Antioxidants
                MDPI
                2076-3921
                28 April 2019
                May 2019
                : 8
                : 5
                : 111
                Affiliations
                [1 ]Center for human molecular genetics and pharmacogenomics, Faculty of Medicine, University of Maribor, SI-2000 Maribor, Slovenia; spela.salamon@ 123456gmail.com
                [2 ]Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška 4, SI-1000 Ljubljana, Slovenia; barbara.kramar@ 123456mf.uni-lj.si (B.K.); tinkara.pircmarolt@ 123456mf.uni-lj.si (T.P.M.)
                [3 ]University of Ljubljana, Faculty of Health Sciences, Laboratory of Oxidative Stress Research, Zdravstvena pot 5, SI-1000 Ljubljana, Slovenia; borut.poljsak@ 123456zf.uni-lj.si
                Author notes
                Author information
                https://orcid.org/0000-0001-8646-5754
                https://orcid.org/0000-0002-6948-7238
                Article
                antioxidants-08-00111
                10.3390/antiox8050111
                6562654
                31035402
                5ea6f4e4-505f-4a78-9573-97fb067dc2de
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 08 March 2019
                : 23 April 2019
                Categories
                Review

                n-acetylcysteine,acetylcysteine,pharmacology,physiology,dietary supplements,aging,sports

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