The chemistry and biological activities of N-acetylcysteine
Open accessAbstract
Background N-acetylcysteine (NAC) has been in clinical practice for several decades. It has been used as a mucolytic agent and for the treatment of numerous disorders including paracetamol intoxication, doxorubicin cardiotoxicity, ischemia-reperfusion cardiac injury, acute respiratory distress syndrome, bronchitis, chemotherapy-induced toxicity, HIV/AIDS, heavy metal toxicity and psychiatric disorders.Scope of review The mechanisms underlying the therapeutic and clinical applications of NAC are complex and still unclear. The present review is focused on the chemistry of NAC and its interactions and functions at the organ, tissue and cellular levels in an attempt to bridge the gap between its recognized biological activities and chemistry.Major conclusions The antioxidative activity of NAC as of other thiols can be attributed to its fast reactions with OH, NO2, CO3(-) and thiyl radicals as well as to restitution of impaired targets in vital cellular components. NAC reacts relatively slowly with superoxide, hydrogen-peroxide and peroxynitrite, which cast some doubt on the importance of these reactions under physiological conditions. The uniqueness of NAC is most probably due to efficient reduction of disulfide bonds in proteins thus altering their structures and disrupting their ligand bonding, competition with larger reducing molecules in sterically less accessible spaces, and serving as a precursor of cysteine for GSH synthesis.General significance The outlined reactions only partially explain the diverse biological effects of NAC, and further studies are required for determining its ability to cross the cell membrane and the blood-brain barrier as well as elucidating its reactions with components of cell signaling pathways.
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N-acetylcysteine acts as a modulator of synaptic glutamate through the cysteine-glutamate exchanger, increases glutathione and oxidative defenses, enhances neurogenesis and mitochondrial function, decreases pro-inflammatory cytokines, and regulates apoptosis.
“NAC acts as a modulator of synaptic glutamate through the cysteine-glutamate exchanger, increases glutathione and oxidative defenses, enhances neurogenesis and mitochondrial function, decreases pro-inflammatory cytokines, and regulates apoptosis [156].”
From Cognitive remission: a novel objective for the treatment of major depression? (2016) · cites this paper as [156]
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The Potential of N-Acetyl-L-Cysteine (NAC) in the Treatment of Psychiatric Disorders
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Self-citationFrança, K., Kumar, A., Castillo, D., Jafferany, M., Hyczy da Costa Neto, M., Damevska, K., Wollina, U., & Lotti, T. (2019) · Dermatologic Therapy · doi:10.1111/dth.12622 · Cited by 51 · see citing works
Composition, Properties and Reactions of Coconut Water
Rethinam, P., & Krishnakumar, V. (2022) · Coconut Water · doi:10.1007/978-3-031-10713-9_4 · Cited by 9 · see citing works
Bakadlag, R., Limniatis, G., Georges, G., & Georges, E. (2023) · BMC Cancer · doi:10.1186/s12885-022-10474-x · Cited by 9 · see citing works
- Authors
- Samuni, Y., Goldstein, S., Dean, O. M., & Berk, M.
- Affiliations
- Barwon Health (AU)
- Hebrew University of Jerusalem (IL)
- The Royal Melbourne Hospital (AU)
- Corresponding author
- Goldstein, Sara
- Venue
- Biochimica et Biophysica Acta (BBA) - General Subjects
- Publisher
- Elsevier BV
- Published
- 2013-08
- Volume
- 1830
- Issue
- 8
- Pages
- 4117-4129
- ISSN
- 0304-4165 (ISSN-L)
- OpenAlex
- W2119624946
- Cited by
- 876
- References
- 264
- Citations by year
- 2026: 57 · 2025: 66 · 2024: 67 · 2023: 80 · 2022: 79 · 2021: 74 · 2020: 70 · 2019: 77 · 2018: 73 · 2017: 61 · 2016: 61 · 2015: 53 · 2014: 46 · 2013: 10
- FWCI
- 5.23
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Biochimica et Biophysica Acta (BBA) - General Subjects (publishedVersion)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- National Health and Medical Research Council of Australia
- Simons Autism Foundation
- CRC for Mental Health
- Rotary Health
- Alfred Deakin Postdoctoral Research Fellowship
- Israel Science Foundation (1477)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Sulfur Compounds in Biology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Redox biology and oxidative stress
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Keywords
- N-acetylcysteine, antioxidant activity, thiols, disulfide bond reduction, glutathione synthesis, cysteine precursor, reactive oxygen species, peroxynitrite, superoxide, hydrogen peroxide, hydroxyl radicals, nitrite, heavy metal toxicity, doxorubicin cardiotoxicity, ischemia-reperfusion injury, acute respiratory distress syndrome, bronchitis, chemotherapy toxicity, HIV/AIDS, blood-brain barrier, signal transduction
- MeSH terms
- Acetylcysteine, Animals, Mental Disorders, Blood-Brain Barrier, Cell Cycle, Cell Membrane, Humans, Signal Transduction, Apoptosis
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