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Abstract

N-Acetylcysteine, commonly referred to as NAC, is the N-acetylated form of the amino acid cysteine. When ingested, it is rapidly deacetylated during first-pass metabolism to the essential amino acid cysteine and then stored by the liver, which uses and releases it as needed. It is also stored, utilized, and/or released into the bloodstream as glutathione (GSH), a cysteine-containing tripeptide that serves as a detoxifying agent, a coenzyme for multiple enzymes, and a key component of the electron transport system.

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Notes

  1. 1.

    Pronounced either as the homophone for the word “knack” or spelled out as the letters “N-A-C”

  2. 2.

    Disclaimer: In accord with our university policy, we have cooperated with BioAdvantex in the development of several patents for NAC use in HIV and other diseases and have worked on clinical trials with both Zambon and BioAdvantex. Some of these patents have been issued; none have as yet secured FDA approval for clinical (or other) uses. Other groups conducting studies discussed in this volume have worked, I believe, with other NAC sources

  3. 3.

    In accord with our university policy, we have been joined by this company (BioAdvantex) in the development of several patents for NAC use in HIV and other diseases. However, neither we nor BioAdvantex have secured FDA approval for any clinical (or other) uses.

References

  • Atkuri KR, Mantovani JJ, Herzenberg LA, Herzenberg LA (2007) N-acetylcysteine-a safe antidote for cysteine/glutathione deficiency. Curr Opin Pharmacol 7(4):355–359

    Article  CAS  Google Scholar 

  • Conrad C, Lymp J, Thompson V, Dunn C, Davies Z, Chatfield B, Nichols D, Clancy J, Vender R, Egan ME, Quittell L, Michelson P, Antony V, Spahr J, Rubenstein RC, Moss RB, Herzenberg LA, Goss CH, Tirouvanziam R (2015) Long-term treatment with oral N-acetylcysteine: affects lung function but not sputum inflammation in cystic fibrosis subjects. A phase II randomized placebo-controlled trial. J Cyst Fibros 14(2):219–227. https://doi.org/10.1016/j.jcf.2014.08.008

    Article  CAS  PubMed  Google Scholar 

  • De Rosa SC, Zaretsky MD, Dubs JG, Roederer M, Anderson M, Green A, Mitra D, Watanabe N, Nakamura H, Tjioe I, Deresinski SC, Moore WA, Ela SW, Parks D, Herzenberg LA, Herzenberg LA (2000) N-acetylcysteine (NAC) replenishes glutathione in HIV infection. Eur J Clin Investig 30(10):841–856

    Article  Google Scholar 

  • Green JL, Heard KJ, Reynolds KM, Albert D (2013) Oral and intravenous acetylcysteine for treatment of acetaminophen toxicity: a systematic review and meta-analysis. West J Emerg Med 14(3):218–226. https://doi.org/10.5811/westjem.2012.4.6885

    Article  PubMed  PubMed Central  Google Scholar 

  • Hardan AY, Fung LK, Libove RA, Obukhanych TV, Nair S, Herzenberg LA, Frazier TW, Tirouvanziam R (2012) A randomized controlled pilot trial of oral N-acetylcysteine in children with autism. Biol Psychiatry 71(11):956–961. https://doi.org/10.1016/j.biopsych.2012.01.014

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Herzenberg LA, De Rosa SC, Dubs JG, Roederer M, Anderson MT, Ela SW, Deresinski SC (1997) Glutathione deficiency is associated with impaired survival in HIV disease. Proc Natl Acad Sci U S A 94(5):1967–1972

    Article  CAS  Google Scholar 

  • Herzenberg LA, De Rosa SC, Herzenberg LA (1998) Low glutathione levels in CD4 T cells predict poor survival in AIDS; N-acetylcysteine may improve survival. In: Monatagnier LOR, Pasquier C (eds) Oxidative stress in cancer, AIDS and neurodegenerative diseases, vol 1. Marcel Dekker, Inc., Stanford, pp 379–387

    Google Scholar 

  • Nolan GP, Fiering S, Nicolas JF, Herzenberg LA (1988) Fluorescence-activated cell analysis and sorting of viable mammalian cells based on beta-D-galactosidase activity after transduction of Escherichia coli lacZ. Proc Natl Acad Sci U S A 85(8):2603–2607

    Article  CAS  Google Scholar 

  • Staal FJ, Roederer M, Herzenberg LA, Herzenberg LA (1990) Intracellular thiols regulate activation of nuclear factor kappa B and transcription of human immunodeficiency virus. Proc Natl Acad Sci U S A 87(24):9943–9947

    Article  CAS  Google Scholar 

  • Tirouvanziam R, Conrad CK, Bottiglieri T, Herzenberg LA, Moss RB (2006) High-dose oral N-acetylcysteine, a glutathione prodrug, modulates inflammation in cystic fibrosis. Proc Natl Acad Sci U S A 103(12):4628–4633. https://doi.org/10.1073/pnas.0511304103

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tirouvanziam R, Obukhanych TV, Laval J, Aronov PA, Libove R, Banerjee AG, Parker KJ, O'Hara R, Herzenberg LA, Herzenberg LA, Hardan AY (2012) Distinct plasma profile of polar neutral amino acids, leucine, and glutamate in children with autism Spectrum disorders. J Autism Dev Disord 42(5):827–836. https://doi.org/10.1007/s10803-011-1314-x

    Article  PubMed  Google Scholar 

  • Weisbord SD, Gallagher M, Jneid H, Garcia S, Cass A, Thwin S-S, Conner TA, Chertow GM, Bhatt DL, Shunk K, Parikh CR, McFalls EO, Brophy M, Ferguson R, Hongsheng W, Androsenko M, Myles J, Kaufman J, Palevsky PM (2018) Outcomes after angiography with sodium bicarbonate and acetylcysteine. N Engl J Med 378(7):603–614

    Article  CAS  Google Scholar 

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Correspondence to Leonore A. Herzenberg .

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Herzenberg, L.A. (2019). History of N-Acetylcysteine. In: Frye, R., Berk, M. (eds) The Therapeutic Use of N-Acetylcysteine (NAC) in Medicine. Adis, Singapore. https://doi.org/10.1007/978-981-10-5311-5_1

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  • DOI: https://doi.org/10.1007/978-981-10-5311-5_1

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  • Publisher Name: Adis, Singapore

  • Print ISBN: 978-981-10-5310-8

  • Online ISBN: 978-981-10-5311-5

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