Evoluzione delle esigenze cliniche nella terapia delle flogosi croniche bronchiali con N-acetilcisteina (NAC): Dalle evidenze dell'attività mucolitica a quelle delle proprietà antiossidanti con alte dosi

Translated title of the contribution: Evolution of the clinical needs in the treatment of chronic bronchial inflammations with N-acetylcysteine (NAC): From mucolytic evidences to antioxidant properties with high-doses

L. Allegra, C. Baldessari, V. Valenti

Research output: Contribution to journalArticle

Abstract

Beginning several decades ago, N-acetylcysteine (NAC) has shown its mucolytic properties, thank to which it has been, and still is, the mucoactive reference drug. Mucolytic properties are already present at relatively low dosages, 600 mg/day p.o. being considered optimal for this indication. In this sense the literature is rich of observations and, for further evidence, three clear meta-analises confirmed such activity as well as NAC positive clinical and functional consequences. More recently, particularly in the last 25 years, evidences have accumulated on a different NAC property, the antioxidant one, a property but more and more clearly demonstrable for higher, (but anyhow well tolerated), dosages than those necessary to show mucolytic activity (>600 mg, but specially 1.200/1.800 mg day). Such property (antagonization of free oxygen radicals and consequent protection of the human organism from the damages they can induce) has been demonstrated in chronic and degenerative respiratory diseases such as COPD and, quite recently, diffuse interstitial fibrosis, as well as in several non-respiratory diseases interesting other organs, and specially in life-threatening conditions due to severe poisoning (where the successful dosage has exceptionally been in the order of dozens of mg!). In conclusion, for all these utilisations too, whose evidence in the literature the present paper detailed takes in consideration, the clinical success is attributed to the antioxidant NAC activity.

Original languageItalian
Pages (from-to)123-132
Number of pages10
JournalGIMT - Giornale Italiano delle Malattie del Torace
Volume60
Issue number2
Publication statusPublished - 2006

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Expectorants
Acetylcysteine
Antioxidants
Inflammation
Poisoning
Chronic Obstructive Pulmonary Disease
Free Radicals
Reactive Oxygen Species
Fibrosis
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

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title = "Evoluzione delle esigenze cliniche nella terapia delle flogosi croniche bronchiali con N-acetilcisteina (NAC): Dalle evidenze dell'attivit{\`a} mucolitica a quelle delle propriet{\`a} antiossidanti con alte dosi",
abstract = "Beginning several decades ago, N-acetylcysteine (NAC) has shown its mucolytic properties, thank to which it has been, and still is, the mucoactive reference drug. Mucolytic properties are already present at relatively low dosages, 600 mg/day p.o. being considered optimal for this indication. In this sense the literature is rich of observations and, for further evidence, three clear meta-analises confirmed such activity as well as NAC positive clinical and functional consequences. More recently, particularly in the last 25 years, evidences have accumulated on a different NAC property, the antioxidant one, a property but more and more clearly demonstrable for higher, (but anyhow well tolerated), dosages than those necessary to show mucolytic activity (>600 mg, but specially 1.200/1.800 mg day). Such property (antagonization of free oxygen radicals and consequent protection of the human organism from the damages they can induce) has been demonstrated in chronic and degenerative respiratory diseases such as COPD and, quite recently, diffuse interstitial fibrosis, as well as in several non-respiratory diseases interesting other organs, and specially in life-threatening conditions due to severe poisoning (where the successful dosage has exceptionally been in the order of dozens of mg!). In conclusion, for all these utilisations too, whose evidence in the literature the present paper detailed takes in consideration, the clinical success is attributed to the antioxidant NAC activity.",
keywords = "COPD, Interstitial diffuse fibrosis, Mucolytic activity, NAC, Non-respiratory diseases",
author = "L. Allegra and C. Baldessari and V. Valenti",
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AU - Baldessari, C.

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N2 - Beginning several decades ago, N-acetylcysteine (NAC) has shown its mucolytic properties, thank to which it has been, and still is, the mucoactive reference drug. Mucolytic properties are already present at relatively low dosages, 600 mg/day p.o. being considered optimal for this indication. In this sense the literature is rich of observations and, for further evidence, three clear meta-analises confirmed such activity as well as NAC positive clinical and functional consequences. More recently, particularly in the last 25 years, evidences have accumulated on a different NAC property, the antioxidant one, a property but more and more clearly demonstrable for higher, (but anyhow well tolerated), dosages than those necessary to show mucolytic activity (>600 mg, but specially 1.200/1.800 mg day). Such property (antagonization of free oxygen radicals and consequent protection of the human organism from the damages they can induce) has been demonstrated in chronic and degenerative respiratory diseases such as COPD and, quite recently, diffuse interstitial fibrosis, as well as in several non-respiratory diseases interesting other organs, and specially in life-threatening conditions due to severe poisoning (where the successful dosage has exceptionally been in the order of dozens of mg!). In conclusion, for all these utilisations too, whose evidence in the literature the present paper detailed takes in consideration, the clinical success is attributed to the antioxidant NAC activity.

AB - Beginning several decades ago, N-acetylcysteine (NAC) has shown its mucolytic properties, thank to which it has been, and still is, the mucoactive reference drug. Mucolytic properties are already present at relatively low dosages, 600 mg/day p.o. being considered optimal for this indication. In this sense the literature is rich of observations and, for further evidence, three clear meta-analises confirmed such activity as well as NAC positive clinical and functional consequences. More recently, particularly in the last 25 years, evidences have accumulated on a different NAC property, the antioxidant one, a property but more and more clearly demonstrable for higher, (but anyhow well tolerated), dosages than those necessary to show mucolytic activity (>600 mg, but specially 1.200/1.800 mg day). Such property (antagonization of free oxygen radicals and consequent protection of the human organism from the damages they can induce) has been demonstrated in chronic and degenerative respiratory diseases such as COPD and, quite recently, diffuse interstitial fibrosis, as well as in several non-respiratory diseases interesting other organs, and specially in life-threatening conditions due to severe poisoning (where the successful dosage has exceptionally been in the order of dozens of mg!). In conclusion, for all these utilisations too, whose evidence in the literature the present paper detailed takes in consideration, the clinical success is attributed to the antioxidant NAC activity.

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