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Prolonged N-acetylcysteine therapy in late acetaminophen poisoning associated with acute liver failure – a need to be more cautious?

Since the 1970s, N-acetylcysteine (NAC) has shown proven efficacy as an antidote for acetaminophen (APAP) poisoning and APAP-induced liver failure for early presenters. The current evidence of benefits of NAC for late presenters is controversial because of the poor understanding of the mechanism of...

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Detalles Bibliográficos
Autores principales: Athuraliya, T Nimmi C, Jones, Alison L
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2717416/
https://www.ncbi.nlm.nih.gov/pubmed/19490595
http://dx.doi.org/10.1186/cc7800
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author Athuraliya, T Nimmi C
Jones, Alison L
author_facet Athuraliya, T Nimmi C
Jones, Alison L
author_sort Athuraliya, T Nimmi C
collection PubMed
description Since the 1970s, N-acetylcysteine (NAC) has shown proven efficacy as an antidote for acetaminophen (APAP) poisoning and APAP-induced liver failure for early presenters. The current evidence of benefits of NAC for late presenters is controversial because of the poor understanding of the mechanism of late toxicity. In the previous issue of Critical Care, Yang and colleagues use a mouse model to demonstrate that NAC in doses similar to those used therapeutically to treat APAP poisoning in humans impairs liver regenerative capacity and that the effect is more pronounced when administered for a longer duration. Studies based on cell cultures support this evidence. Cytokine and growth factor signalling pathways are recognised to be involved in the process of liver regeneration and apoptosis. This research paper generates several issues related to the future management of APAP-induced liver failure and research into the mechanism of toxicity, especially of late toxicity.
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spelling pubmed-27174162010-05-14 Prolonged N-acetylcysteine therapy in late acetaminophen poisoning associated with acute liver failure – a need to be more cautious? Athuraliya, T Nimmi C Jones, Alison L Crit Care Commentary Since the 1970s, N-acetylcysteine (NAC) has shown proven efficacy as an antidote for acetaminophen (APAP) poisoning and APAP-induced liver failure for early presenters. The current evidence of benefits of NAC for late presenters is controversial because of the poor understanding of the mechanism of late toxicity. In the previous issue of Critical Care, Yang and colleagues use a mouse model to demonstrate that NAC in doses similar to those used therapeutically to treat APAP poisoning in humans impairs liver regenerative capacity and that the effect is more pronounced when administered for a longer duration. Studies based on cell cultures support this evidence. Cytokine and growth factor signalling pathways are recognised to be involved in the process of liver regeneration and apoptosis. This research paper generates several issues related to the future management of APAP-induced liver failure and research into the mechanism of toxicity, especially of late toxicity. BioMed Central 2009 2009-05-14 /pmc/articles/PMC2717416/ /pubmed/19490595 http://dx.doi.org/10.1186/cc7800 Text en Copyright © 2009 BioMed Central Ltd
spellingShingle Commentary
Athuraliya, T Nimmi C
Jones, Alison L
Prolonged N-acetylcysteine therapy in late acetaminophen poisoning associated with acute liver failure – a need to be more cautious?
title Prolonged N-acetylcysteine therapy in late acetaminophen poisoning associated with acute liver failure – a need to be more cautious?
title_full Prolonged N-acetylcysteine therapy in late acetaminophen poisoning associated with acute liver failure – a need to be more cautious?
title_fullStr Prolonged N-acetylcysteine therapy in late acetaminophen poisoning associated with acute liver failure – a need to be more cautious?
title_full_unstemmed Prolonged N-acetylcysteine therapy in late acetaminophen poisoning associated with acute liver failure – a need to be more cautious?
title_short Prolonged N-acetylcysteine therapy in late acetaminophen poisoning associated with acute liver failure – a need to be more cautious?
title_sort prolonged n-acetylcysteine therapy in late acetaminophen poisoning associated with acute liver failure – a need to be more cautious?
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2717416/
https://www.ncbi.nlm.nih.gov/pubmed/19490595
http://dx.doi.org/10.1186/cc7800
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