NAC helps to reduce liver function abnormalities - N-acetylcysteine - Brief Article

Nutrition Health Review, Fall, 2002

Patients who have had a recent heart attack, ulcerative colitis, or adult respiratory distress syndrome may be deficient in glutathione (GSH), an important protector of liver cells, red blood cells, and lymphocytes.

Lower glutathione levels in plasma and lung fluid have also been seen in patients with human immunodeficiency virus (HIV) infection. It is thought that low glutathione levels speed up the development of emphysema in HIV-positive patients, especially if they have a history of smoking. Patients who are co-infected with HIV and hepatitis C (HCV) have even further diminished levels of glutathione.

A new study by De Rosa and colleagues, published in the European Journal of Clinical Investigation, investigated the use of N-acetylcysteine (NAC), a mucolytic agent used to reduce the viscosity of mucus and to build up glutathione levels in HIV-positive patients. In an 8-week test, 31 patients received NAC and 30 received a placebo. Both groups began the study with low glutathione levels.

Results showed that the patients who received NAC had near-normal glutathione levels, whereas levels in the placebo group remained the same. No side effects were reported, although occasional dose reduction was necessary to diminish gastrointestinal effects.

Anti-HIV protease inhibitors are known to be toxic to the liver, especially in patients with both HIV and hepatitis, and the NAC results are therefore significant. In a study of 24 patients, interferon and NAC treatment reduced liver abnormalities better than interferon alone.