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Human & Experimental Toxicology
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Improvement by N-acetylcysteine of acute respiratory distress syndrome through increasing intracellular glutathione, and extracellular thiol molecules and anti-oxidant power: evidence for underlying toxicological mechanisms

Mohammad Sadegh Soltan-Sharifi

Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran, mohammad.abdollahi{at}utoronto.ca

Mojtaba Mojtahedzadeh

Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran

Atabak Najafi

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Mohammad Reza Khajavi

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Mohammad Reza Rouini

Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran

Mandana Moradi

Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran

Azadeh Mohammadirad

Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran

Mohammad Abdollahi

Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran

In acute respiratory distress syndrome (ARDS), there is extensive overproduction of free radicals to the extent that endogenous anti-oxidants are overwhelmed, permitting oxidative cell damage. The present study examined the benefit of the anti-oxidant compound N-acetylcysteine (NAC) in the management of ARDS by measuring patient's intracellular glutathione (inside red blood cells) and extracellular (plasma) anti-oxidant defense biomarkers and outcome. Twenty-seven ARDS patients were recruited from the intensive care unit of a teaching Hospital and randomly divided into two groups. Both groups were managed similarly by regular treatments but 17 patients received NAC 150 mg/kg at the first day that followed by 50 mg/kg/day for three days and 10 patients did not receive NAC. Treatment by NAC increased extracellular total anti-oxidant power and total thiol molecules and also improved intracellular glutathione and the outcome of the patients. In conclusion, patients with ARDS are in a deficient oxidant—anti-oxidant balance that can get a significant benefit if supplemented with NAC. Human & Experimental Toxicology (2007) 26, 697—703

Key Words: ARDS • glutathione • N-acetylcysteine • oxidative stress

Human & Experimental Toxicology, Vol. 26, No. 9, 697-703 (2007)
DOI: 10.1177/0960327107083452
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