Effect of N-Acetylcysteine on Cisplatin Toxicity: A Review of the Literature

Abstract

Angeles Citlali Zavala-Valencia,1,2 Liliana Velasco-Hidalgo,3 Armando Martínez-Avalos,3 Manuel Castillejos-López,4 Luz-María Torres-Espíndola1 1Laboratory of Pharmacology, National Institute of Pediatrics, Mexico City, Mexico; 2Iztacala Faculty of Higher Studies, Tlalnepantla, México; 3Oncology Service, National Institute of Pediatrics, Mexico City, México; 4Hospital Epidemiology and Infectology Unit, National Institute of Respiratory Diseases Ismael Cosío Villegas, Mexico City, MexicoCorrespondence: Luz-María Torres-Espíndola; Manuel Castillejos-López, Email [email protected]; [email protected]: N-acetylcysteine (NAC) is a membrane-permeable cysteine precursor capable of enhancing the intracellular cysteine pool, enhancing cellular glutathione (GSH) synthesis, and thus potentiating the endogenous antioxidant mechanism. Late administration of NAC after cisplatin has been shown in different in vivo studies to reduce the side effects caused by various toxicities at different levels without affecting the antitumor efficacy of platinum, improving total and enzymatic antioxidant capacity and decreasing oxidative stress markers. These characteristics provide NAC with a rationale as a potentially effective chemo protectant in cisplatin-based therapeutic cycles. NAC represents a potential candidate as a chemoprotective agent to decrease toxicities secondary to cisplatin treatment. It suggests that it could be used in clinical trials, whereby the effective dose, timing, and route should be adjusted to optimize chemoprotection. This review provides an overview of the effect of NAC on cisplatin toxicity, a drug widely used in the clinic in adults and children.Keywords: cisplatin, toxicity, chemo protectant, oxidative stress, antioxidant

Keywords

• cisplatin
• toxicity
• chemo protectant
• oxidative stress
• antioxidant.