Investigation of the effect of N-acetylcysteine on serum levels of oxidative inflammatory biomarkers in patients with stroke

Abstract

Abstract Background N-acetylcysteine (NAC) is a tolerable and safe drug capable of reducing free radicals and other oxidants. We included 74 individuals with ischemic stroke in this randomized, single-blind clinical trial and placed them into intervention (n = 37) and control (n = 37) groups. In the intervention group, in addition to standard treatment for ischemic stroke, they received NAC at a dose of 100 mg/kg bolus and then at a dose of 10 mg/kg/h for 10 h. The control group received only standard stroke treatment. Blood samples were taken before starting NAC and standard stroke treatment and 24 h after receiving the drug to measure the catalase, paraoxonase, malondialdehyde (MDA), neopterin, total antioxidant capacity (TAC), and total oxidant status (TOS) parameters. The National Institutes of Health Stroke Scale (NIHSS) was also calculated before and after 24 h, 2 weeks, 1 month, and 3 months after starting the drug. Results There was no significant difference between the results of parameters before and after standard treatment in control group; however, NAC could significantly reduce TOS (P = 0.02) in the intervention group. Moreover, NAC administration could notably decrease NIHSS calculated at each time point when compared to control group. After subgrouping the intervention group, NAC could increase catalase (P < 0.001), paraoxonase (P < 0.001), and TAC (P < 0.001) while decreased MDA (P < 0.001), neopterin (P = 0.001) and TOS (P < 0.001) significantly in intervention-responding subgroup and decreased NIHSS significantly at each monitored time point. Conclusion NAC can be promising as a complementary drug and a powerful antioxidant in reducing oxidative stress and improving cognitive function in individuals with stroke.

Keywords

• Stroke
• Oxidative stress
• N-acetylcysteine
• Antioxidant biomarkers