title: N-acetylcysteine improves microcirculatory flow during smoking: new effects of an old drug with possible benefits for smokers.
abstract: BACKGROUND
  Cigarette smoking provokes marked acute changes in the microcirculatory vasculature, including a reduced blood flow velocity. In accordance with the hypothesis that the reduced blood flow is due to an imbalance between pro-oxidants and oxidants, we recently showed that most of the reduction could be reversed by a high dose of vitamin C.
  
  
  OBJECTIVE
  In the present work we tested the hypothesis that N-acetylcysteine, a mucolyticum and an antioxidant, may have an effect on the smoking-induced changes observed by vital capillary microscopy of the nailfold.
  
  
  METHODS
  In all, 37 healthy volunteers of both genders and with varied smoking habits were treated with N-acetylcysteine 200 mg t.i.d. for 2 weeks. In vivo investigation of the microcirculation by capillaroscopy was performed before and after treatment.
  
  
  RESULTS
  Treatment with N-acetylcysteine significantly reduced the smoking-induced relative decrease in capillary blood flow velocity in a group of volunteers with varied smoking habits (p = 0.0016). The preventive effect was clearly significant in smokers (p = 0.003).
  
  
  CONCLUSIONS
  Treatment with N-acetylcysteine has a positive impact on microcirculatory flow during smoking, particularly in habitual smokers.
authors.affiliation: Department of Medicine, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
authors.forename: Q
authors.initials: Q
authors.lastname: Lu
authors.forename: I
authors.initials: I
authors.lastname: Björkhem
authors.forename: R J
authors.initials: RJ
authors.lastname: Xiu
authors.forename: P
authors.initials: P
authors.lastname: Henriksson
authors.forename: A
authors.initials: A
authors.lastname: Freyschuss
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology*; D000328:Adult; D000975:Antioxidants / Q000494:pharmacology*; D001783:Blood Flow Velocity / Q000187:drug effects; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D020678:Microscopic Angioscopy; D012907:Smoking / Q000503:physiopathology*
chemical_list: D000975:Antioxidants; D000111:Acetylcysteine