title: Effect of N-acetyl-L-cysteine on lymphocyte apoptosis, lymphocyte viability, TNF-alpha and IL-8 in HIV-infected patients undergoing anti-retroviral treatment.
abstract: 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.
authors.affiliation: Federal University of Santa Catarina, Florianópolis, SC, Brazil. aricio@ccs.ufsc.br
authors.forename: Aricio
authors.initials: A
authors.lastname: Treitinger
authors.forename: Celso
authors.initials: C
authors.lastname: Spada
authors.forename: Ivete Yoshico
authors.initials: IY
authors.lastname: Masokawa
authors.forename: Júlio César Vidal
authors.initials: JC
authors.lastname: Verdi
authors.forename: Mariette
authors.initials: M
authors.lastname: Van Der Sander Silveira
authors.forename: Magali Chaves
authors.initials: MC
authors.lastname: Luis
authors.forename: Marcellus
authors.initials: M
authors.lastname: Reis
authors.forename: Silvia Inês Alejandra Cordova de Pires
authors.initials: SI
authors.lastname: Ferreira
authors.forename: Dulcinéia Saes Parra
authors.initials: DS
authors.lastname: Abdalla
mesh_terms: 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
chemical_list: D019380:Anti-HIV Agents; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D005978:Glutathione; D003545:Cysteine; D000111:Acetylcysteine