Evidence for a Beneficial Effect of Oral N-acetylcysteine on Functional Outcomes and Inflammatory Biomarkers in Patients with Acute Ischemic Stroke

Maryam Sabetghadam,1 Mehrdokht Mazdeh,2 Parnaz Abolfathi,1 Younes Mohammadi,3 Maryam Mehrpooya1 1Department of Clinical Pharmacy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran; 2Department of Neurology, School of Medi...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sabetghadam M, Mazdeh M, Abolfathi P, Mohammadi Y, Mehrpooya M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	ischemic stroke oxidative stress inflammation n-acetylcysteine antioxidant and anti-inflammatory compounds Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/6e13e0801b86482fad40627adfbc075d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:6e13e0801b86482fad40627adfbc075d
record_format	dspace
spelling	oai:doaj.org-article:6e13e0801b86482fad40627adfbc075d2021-12-02T08:05:16ZEvidence for a Beneficial Effect of Oral N-acetylcysteine on Functional Outcomes and Inflammatory Biomarkers in Patients with Acute Ischemic Stroke1178-2021https://doaj.org/article/6e13e0801b86482fad40627adfbc075d2020-05-01T00:00:00Zhttps://www.dovepress.com/evidence-for-a-beneficial-effect-of-oral-n-acetylcysteine-on-functiona-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Maryam Sabetghadam,1 Mehrdokht Mazdeh,2 Parnaz Abolfathi,1 Younes Mohammadi,3 Maryam Mehrpooya1 1Department of Clinical Pharmacy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran; 2Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; 3Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IranCorrespondence: Maryam MehrpooyaDepartment of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Shahid Fahmideh Ave, Hamadan 6517838678, IranTel +9 881 382 1868Fax +98 813 838 1591Email m_mehrpooya2003@yahoo.comPurpose: Numerous preclinical studies have demonstrated the potential neuroprotective effects of N-acetylcysteine (NAC) in the treatment of brain ischemia. Accordingly, the present study aimed to assess the potential therapeutic effects of oral NAC in patients with acute ischemic stroke.Patients and Methods: In a randomized, double-blind, placebo-controlled trial study, 68 patients with acute ischemic stroke with the onset of symptoms less than 24 hours were randomly assigned to either the NAC-treated group or placebo-treated group. NAC and matched placebo were administrated by a 72-hour oral protocol (initially 4 grams loading dose and after on, 4 g in 4 equal divided doses for more 2 days). The primary outcomes were quantification of any neurologic deficit by the use of the National Institute of Health Stroke Scale (NIHSS) score and functional disability by the use of the modified Rankin scale (mRS) at 90 days after stroke. Additionally, serum levels of markers of oxidative stress and inflammation as a main mechanism of its action were assessed at baseline and the end of 3-day treatment protocol.Results: NAC-treated patients in comparison with placebo-treated patients showed a significantly lower mean NIHSS scores at day 90 after stroke. A favorable functional outcome which was defined as an mRS score of 0 or 1, also in favor of NAC compared to placebo was noted on day 90 after stroke (57.6% in the NAC-treated group compared with 28.6% in the placebo-treated group). Further, compared to the placebo, NAC treatment significantly decreased serum levels of proinflammatory biomarkers such as interleukin 6 (IL-6), soluble intercellular cell adhesion molecule-1 (sICAM-1), nitric oxide (NO), malondialdehyde (MDA), and neuron-specific enolase (NSE) and significantly increased serum levels of anti-oxidant biomarkers such as superoxide dismutase (SOD), glutathione peroxidase (GPx), and total thiol groups (TTG).Conclusion: The pattern of results suggests that oral NAC administration early after an acute ischemic stroke is associated with a better outcome profile in terms of acute neurological deficit and disability grade compared to placebo. NAC may improve neurological outcomes of patients with stroke at least in part by its antioxidant and anti-inflammatory effects.Keywords: ischemic stroke, oxidative stress, inflammation, N-acetylcysteine, antioxidant and anti-inflammatory compoundsSabetghadam MMazdeh MAbolfathi PMohammadi YMehrpooya MDove Medical Pressarticleischemic strokeoxidative stressinflammationn-acetylcysteineantioxidant and anti-inflammatory compoundsNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 16, Pp 1265-1278 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	ischemic stroke oxidative stress inflammation n-acetylcysteine antioxidant and anti-inflammatory compounds Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	ischemic stroke oxidative stress inflammation n-acetylcysteine antioxidant and anti-inflammatory compounds Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Sabetghadam M Mazdeh M Abolfathi P Mohammadi Y Mehrpooya M Evidence for a Beneficial Effect of Oral N-acetylcysteine on Functional Outcomes and Inflammatory Biomarkers in Patients with Acute Ischemic Stroke
description	Maryam Sabetghadam,1 Mehrdokht Mazdeh,2 Parnaz Abolfathi,1 Younes Mohammadi,3 Maryam Mehrpooya1 1Department of Clinical Pharmacy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran; 2Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; 3Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IranCorrespondence: Maryam MehrpooyaDepartment of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Shahid Fahmideh Ave, Hamadan 6517838678, IranTel +9 881 382 1868Fax +98 813 838 1591Email m_mehrpooya2003@yahoo.comPurpose: Numerous preclinical studies have demonstrated the potential neuroprotective effects of N-acetylcysteine (NAC) in the treatment of brain ischemia. Accordingly, the present study aimed to assess the potential therapeutic effects of oral NAC in patients with acute ischemic stroke.Patients and Methods: In a randomized, double-blind, placebo-controlled trial study, 68 patients with acute ischemic stroke with the onset of symptoms less than 24 hours were randomly assigned to either the NAC-treated group or placebo-treated group. NAC and matched placebo were administrated by a 72-hour oral protocol (initially 4 grams loading dose and after on, 4 g in 4 equal divided doses for more 2 days). The primary outcomes were quantification of any neurologic deficit by the use of the National Institute of Health Stroke Scale (NIHSS) score and functional disability by the use of the modified Rankin scale (mRS) at 90 days after stroke. Additionally, serum levels of markers of oxidative stress and inflammation as a main mechanism of its action were assessed at baseline and the end of 3-day treatment protocol.Results: NAC-treated patients in comparison with placebo-treated patients showed a significantly lower mean NIHSS scores at day 90 after stroke. A favorable functional outcome which was defined as an mRS score of 0 or 1, also in favor of NAC compared to placebo was noted on day 90 after stroke (57.6% in the NAC-treated group compared with 28.6% in the placebo-treated group). Further, compared to the placebo, NAC treatment significantly decreased serum levels of proinflammatory biomarkers such as interleukin 6 (IL-6), soluble intercellular cell adhesion molecule-1 (sICAM-1), nitric oxide (NO), malondialdehyde (MDA), and neuron-specific enolase (NSE) and significantly increased serum levels of anti-oxidant biomarkers such as superoxide dismutase (SOD), glutathione peroxidase (GPx), and total thiol groups (TTG).Conclusion: The pattern of results suggests that oral NAC administration early after an acute ischemic stroke is associated with a better outcome profile in terms of acute neurological deficit and disability grade compared to placebo. NAC may improve neurological outcomes of patients with stroke at least in part by its antioxidant and anti-inflammatory effects.Keywords: ischemic stroke, oxidative stress, inflammation, N-acetylcysteine, antioxidant and anti-inflammatory compounds
format	article
author	Sabetghadam M Mazdeh M Abolfathi P Mohammadi Y Mehrpooya M
author_facet	Sabetghadam M Mazdeh M Abolfathi P Mohammadi Y Mehrpooya M
author_sort	Sabetghadam M
title	Evidence for a Beneficial Effect of Oral N-acetylcysteine on Functional Outcomes and Inflammatory Biomarkers in Patients with Acute Ischemic Stroke
title_short	Evidence for a Beneficial Effect of Oral N-acetylcysteine on Functional Outcomes and Inflammatory Biomarkers in Patients with Acute Ischemic Stroke
title_full	Evidence for a Beneficial Effect of Oral N-acetylcysteine on Functional Outcomes and Inflammatory Biomarkers in Patients with Acute Ischemic Stroke
title_fullStr	Evidence for a Beneficial Effect of Oral N-acetylcysteine on Functional Outcomes and Inflammatory Biomarkers in Patients with Acute Ischemic Stroke
title_full_unstemmed	Evidence for a Beneficial Effect of Oral N-acetylcysteine on Functional Outcomes and Inflammatory Biomarkers in Patients with Acute Ischemic Stroke
title_sort	evidence for a beneficial effect of oral n-acetylcysteine on functional outcomes and inflammatory biomarkers in patients with acute ischemic stroke
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/6e13e0801b86482fad40627adfbc075d
work_keys_str_mv	AT sabetghadamm evidenceforabeneficialeffectoforalnacetylcysteineonfunctionaloutcomesandinflammatorybiomarkersinpatientswithacuteischemicstroke AT mazdehm evidenceforabeneficialeffectoforalnacetylcysteineonfunctionaloutcomesandinflammatorybiomarkersinpatientswithacuteischemicstroke AT abolfathip evidenceforabeneficialeffectoforalnacetylcysteineonfunctionaloutcomesandinflammatorybiomarkersinpatientswithacuteischemicstroke AT mohammadiy evidenceforabeneficialeffectoforalnacetylcysteineonfunctionaloutcomesandinflammatorybiomarkersinpatientswithacuteischemicstroke AT mehrpooyam evidenceforabeneficialeffectoforalnacetylcysteineonfunctionaloutcomesandinflammatorybiomarkersinpatientswithacuteischemicstroke
_version_	1718398666875600896

Evidence for a Beneficial Effect of Oral N-acetylcysteine on Functional Outcomes and Inflammatory Biomarkers in Patients with Acute Ischemic Stroke

Ejemplares similares