医学中N-乙酰半胱氨酸（NAC）的治疗应用

English | PDF,EPUB | 2018 (2019 Edition) | 392 Pages | ISBN : 9811053103 | 13.16 MB

Focusing on the practical use of N-Acetyl-Cysteine (NAC) in medicine, this book provides a comprehensive review of the basic biological and clinical studies documenting its benefits in treating medical disease. NAC is perhaps best known as an antidote for acetaminophen, but its therapeutic effect in a wide range of medical diseases has recently been realized. In addition to its well recognized use in radiological contrast prophylaxis for renal disease and pulmonary disorders, studies have suggested significant promise in psychiatric and neurological disorders such as addiction, Alzheimer’s disease, ataxia, autism, bipolar disorder, depression, epilepsy, neuropathy, obsessive-compulsive disorder, schizophrenia, traumatic brain injury and trichotillomania in addition to promising studies in audiology, cardiology, exercise physiology, gastroenterology, hematology, infectious disease, infertility and ophthalmology. Given the promising studies for a wide range of medical conditions, coupled with a excellent safety profile, the potential for NAC in the treatment of human disease appears considerable.Dr Leonore A Herzenberg from Stanford University, a pioneer of redox physiology and the use of NAC, provides a succinct history of the development of the therapeutic use of NAC for medical disease. This is followed by a series of basic science chapters outlining the role of NAC in important physiological processes, including modulation of dopamine and glutamate neurotransmitter systems, redox and mitochondrial metabolism, apoptosis and inflammation.

The last section of the book is dedicated to clinically oriented chapters that comprehensively review the literature on medical disorders in which NAC has been found to be effective, including toxicity and cardiovascular, gastrointestinal, neurological, psychiatric, pulmonary and renal disorders. Each chapter reviews the theoretical biological mechanisms of NAC for the specific diseases reviewed, rates the clinical studies using a standardized criteria in order to provide an objective level of evidence and grade of recommendation for the use of NAC for specific medical conditions and outlines the ongoing clinical trials examining NAC for the treatment of specific diseases. Final chapters review the clinical evidence verifying that specific theoretical biological mechanisms are actually being targeted by NAC in medical disease. Studies on the pharmacology, formulation and potential adverse effects of NAC are also reviewed. A final chapter synthesizes the clinical studies to suggest that the effectiveness of NAC may signal a new basic physiological disorder, glutathione deficiency, which may be an important pathophysiological mechanism of many diseases.

专注于N-乙酰半胱氨酸（NAC）在医学中的实际应用，本书提供了全面的关于这种化合物对治疗医学疾病的基本生物学和临床研究综述。NAC 也许最著名的是作为阿司匹林中毒的解毒剂，但最近发现其在多种医疗疾病的疗效。除了用于肾病和肺部疾病放射学对比预防方面的广泛应用外，研究表明它在包括成瘾、阿尔茨海默病、共济失调、自闭症、双相情感障碍、抑郁症、癫痫、周围神经病变、强迫性障碍、精神分裂症、脑创伤以及拔毛障碍在内的许多精神和神经系统疾病的治疗方面具有显著的潜力。鉴于对多种医疗状况研究的积极结果，加上良好的安全性特征，NAC在人类疾病治疗中的潜在用途似乎很可观。斯坦福大学的先驱 Leonore A. Herzenberg 教授提供了关于 NAC 用于医学疾病的疗法开发的历史概述。这之后是一系列基本科学章节，详细阐述了 NAC 在重要生理过程中的作用，包括多巴胺和谷氨酸神经递质系统的调节、氧化还原和线粒体代谢、凋亡及炎症。 本书的最后一部分是针对具体医疗状况临床研究的章节，全面回顾了在这些疾病中发现NAC有效的文献。其中包括毒性及其心血管系统、胃肠系统、神经系统、精神健康、肺部和肾病。每一章都会详细审查 NAC 在特定疾病的理论生物学机制，并使用标准化的标准来评估临床试验的结果，从而为 NAC 在特定医疗状况下使用的客观证据水平和推荐等级提供依据，并概述了针对特定疾病进行的NAC临床试验。最后的章节将回顾临床数据，以表明 NAC 可能正在靶向医学疾病中的特定理论生物学机制。对 NAC 的药理学、配方及潜在副作用的研究也进行了综述。最后一章综合临床研究结果，提出 NAC 的有效性可能预示着一种新的基本生理紊乱——谷胱甘肽缺乏症，这可能是许多疾病的病理生理机制的重要因素。

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