Effect of N-acetyl-L-cysteine on lymphocyte apoptosis, lymphocyte viability, TNF-alpha and IL-8 in HIV-infected patients undergoing anti-retroviral treatment.
N-acetyl-L-cysteine (NAC) has been proposed as an additional therapeutic agent for AIDS patients because it reduces human immunodeficiency virus type 1 (HIV-1) replication in stimulated CD4+ lymphocytes, and it ameliorates immunological reactivity. In a randomized, 180-day, double-blind, placebo-controlled trial performed with HIV-infected patients classified as A2 and A3 according to the criteria of the Center for Disease Control and Prevention, we investigated the effects of oral administration of NAC on HIV-infected patients undergoing their first anti-retroviral therapy; viral load, CD4+ lymphocyte, lymphocyte viability and apoptosis, and TNF-alpha and IL-8 levels were determined. Sixteen patients who received anti-retroviral therapy plus a placebo formed the control group and the study group consisted of 14 patients who received anti-retroviral therapy and NAC supplementation. A significant decrease was seen in viral load, TNF-alpha and IL-8 levels, and lymphocyte apoptosis, and a significant increase was found in levels of CD4+ lymphocytes and lymphocyte viability in both groups after anti-retroviral treatment, but no measurable benefits of anti-retroviral therapy plus NAC oral supplementation (600 mg/day) were found in relation to anti-retroviral therapy alone, and the baseline levels of cysteine and glutathione in plasma were not recovered by this treatment. In conclusion, the daily doses of NAC necessary for the total recuperation of plasma cysteine and glutathione levels in HIV-infected patients and the additional benefits following the supplementation of NAC in patients submitted to anti-retroviral therapy, need to be studied further.
Treitinger
Aricio
A
Federal University of Santa Catarina, Florianópolis, SC, Brazil. aricio@ccs.ufsc.br
Spada
Celso
C
Masokawa
Ivete Yoshico
IY
Verdi
Júlio César Vidal
JC
Van Der Sander Silveira
Mariette
M
Luis
Magali Chaves
MC
Reis
Marcellus
M
Ferreira
Silvia Inês Alejandra Cordova de Pires
SI
Abdalla
Dulcinéia Saes Parra
DS
D000111:Acetylcysteine / Q000627:therapeutic use*; D000284:Administration, Oral; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects*; D018791:CD4 Lymphocyte Count; D003545:Cysteine / Q000097:blood; D004311:Double-Blind Method; D005978:Glutathione / Q000097:blood; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D016209:Interleukin-8 / Q000097:blood*; D008214:Lymphocytes / Q000187:drug effects*; D008875:Middle Aged; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*; D019562:Viral Load
D019380:Anti-HIV Agents; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D005978:Glutathione; D003545:Cysteine; D000111:Acetylcysteine