title: N-acetyl-cysteine improves anastomotic wound healing after radiotherapy in rats.
abstract: OBJECTIVE
  This study was designed to determine the effects of intraperitoneally or orally administered N-acetylcysteine (NAC) on anastomotic healing of irradiated rats.
  
  
  METHODS
  Thirty-two male Wistar albino rats were randomized into four groups containing 8 rats each: I; standard resection plus anastomosis, II; radiation plus standard resection plus anastomosis, III; radiation plus standard resection plus anastomosis plus oral NAC, IV; radiation plus standard resection plus anastomosis plus intraperitoneal NAC. Four types of assessment were performed: bursting pressure, hydroxiproline (OHP) content, histopathology, and biochemical evaluation, including serum malondialdehyde (MDA), advanced oxidation protein products (AOPP), reduced glutathione (GSH) and superoxide dismutase (SOD) activities.
  
  
  RESULTS
  Group comparisons demonstrated that bursting pressure was significantly higher in NAC treated rats. The mean tissue OHP concentration in the anastomotic tissue was significantly lower in irradiated rats (group II) than in the other groups. NAC treatment caused increased activity of SOD and GSH. In contrast, MDA levels were found to be decreased in groups III and IV. Histopathological analysis revealed that NAC administration, either orally or intraperitoneally, leads to a better anastomotic healing in terms of reepithelialization, perianastomotic fibrosis, ischemic necrosis, and muscle layer destruction.
  
  
  CONCLUSIONS
  The present study supports the hypothesis that NAC administration alleviates the negative effects of radiotherapy on anastomotic healing. Nevertheless, the underlying mechanisms responsible for this protective effect is unknown today.
authors.affiliation: Department of Health Programmes, Zonguldak Karaelmas University, Ahmet Erdogan Vocational School of Health Services, Zonguldak, Turkey. ebruofluoglu@yahoo.com
authors.forename: Ebru Ofluoglu
authors.initials: EO
authors.lastname: Demir
authors.forename: Guldeniz Karadeniz
authors.initials: GK
authors.lastname: Cakmak
authors.forename: Hakan
authors.initials: H
authors.lastname: Bakkal
authors.forename: Ummuhani Ozel
authors.initials: UO
authors.lastname: Turkcu
authors.forename: Nilufer
authors.initials: N
authors.lastname: Kandemir
authors.forename: Ayse Semra
authors.initials: AS
authors.lastname: Demir
authors.forename: Oge
authors.initials: O
authors.lastname: Tascılar
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage / Q000494:pharmacology*; D000284:Administration, Oral; D000714:Anastomosis, Surgical; D000818:Animals; D003106:Colon / Q000378:metabolism / Q000528:radiation effects* / Q000601:surgery*; D016166:Free Radical Scavengers / Q000008:administration & dosage / Q000494:pharmacology*; D005978:Glutathione / Q000097:blood; D006909:Hydroxyproline / Q000378:metabolism; D007274:Injections, Intraperitoneal; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D023421:Models, Animal; D011878:Radiotherapy; D051381:Rats; D017208:Rats, Wistar; D013482:Superoxide Dismutase / Q000097:blood; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D016166:Free Radical Scavengers; D008315:Malondialdehyde; D013482:Superoxide Dismutase; D005978:Glutathione; D006909:Hydroxyproline; D000111:Acetylcysteine