NAC, my physician, and published article

NoExcuses

New member
So as most of you know, I visited Warwick in Minnesota and immeditely started oral NAC 600mg QD.

I told my phsycian that I started this treatment, and he informed me that Dr. Moss at Stanford is actually actively conducting a study on NAC. I had no idea.

In case others aren't aware of the study, here is the info I found on PubMed. Phase I trial was just concluded and published, taking a look to see if Dr. Moss' hypothesis of NAC helping to increase glutathione concentrations in neutrophils.

The goal of this study wasn't to look at increases in lung function or decrases in exacerbations or to look at effective doses. The goal simply was ensure that the oral NAC did in fact effect glutathione concentrations in neutrophils.

The next stage will be to examine optimal dosing, safety, as well as to prove that NAC does improve pulmonary function or help avoid exacerbations.

I was pleased to discover that this is being studied and I'm sure you feel the same way!


<b>High-dose oral N-acetylcysteine, a glutathione prodrug, modulates inflammation in cystic fibrosis. </b>


Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA. tirouvan@stanford.edu

Neutrophilic airway inflammation is a hallmark of cystic fibrosis (CF). As high oxidant producers, airway neutrophils contribute largely to the systemic redox imbalance seen in CF. In turn, this chronic and profound imbalance can impact circulating neutrophils before their migration into airways. Indeed, in 18 CF patients with stable disease, blood neutrophils were readily deficient in the pivotal antioxidant glutathione (P = 0.003, compared with 9 healthy controls). In a phase 1 study, this deficiency was improved (P = 0.025) by the glutathione prodrug N-acetylcysteine, given orally in high doses (0.6 to 1.0 g three times daily, for 4 weeks). This treatment was safe and markedly decreased sputum elastase activity (P = 0.006), the strongest predictor of CF pulmonary function. Consistently, neutrophil burden in CF airways was decreased upon treatment (P = 0.003), as was the number of airway neutrophils actively releasing elastase-rich granules (P = 0.005), as measured by flow cytometry. Pulmonary function measures were not improved, as expected with short-term treatment. After excluding data from subjects without baseline airway inflammation, positive treatment effects were more pronounced and included decreased sputum IL-8 levels (P = 0.032). Thus, high-dose oral N-acetylcysteine has the potential to counter the intertwined redox and inflammatory imbalances in CF.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16537378&query_hl=8&itool=pubmed_docsum">http://www.ncbi.nlm.nih.gov/en...=8&itool=pubmed_docsum</a>
 

NoExcuses

New member
So as most of you know, I visited Warwick in Minnesota and immeditely started oral NAC 600mg QD.

I told my phsycian that I started this treatment, and he informed me that Dr. Moss at Stanford is actually actively conducting a study on NAC. I had no idea.

In case others aren't aware of the study, here is the info I found on PubMed. Phase I trial was just concluded and published, taking a look to see if Dr. Moss' hypothesis of NAC helping to increase glutathione concentrations in neutrophils.

The goal of this study wasn't to look at increases in lung function or decrases in exacerbations or to look at effective doses. The goal simply was ensure that the oral NAC did in fact effect glutathione concentrations in neutrophils.

The next stage will be to examine optimal dosing, safety, as well as to prove that NAC does improve pulmonary function or help avoid exacerbations.

I was pleased to discover that this is being studied and I'm sure you feel the same way!


<b>High-dose oral N-acetylcysteine, a glutathione prodrug, modulates inflammation in cystic fibrosis. </b>


Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA. tirouvan@stanford.edu

Neutrophilic airway inflammation is a hallmark of cystic fibrosis (CF). As high oxidant producers, airway neutrophils contribute largely to the systemic redox imbalance seen in CF. In turn, this chronic and profound imbalance can impact circulating neutrophils before their migration into airways. Indeed, in 18 CF patients with stable disease, blood neutrophils were readily deficient in the pivotal antioxidant glutathione (P = 0.003, compared with 9 healthy controls). In a phase 1 study, this deficiency was improved (P = 0.025) by the glutathione prodrug N-acetylcysteine, given orally in high doses (0.6 to 1.0 g three times daily, for 4 weeks). This treatment was safe and markedly decreased sputum elastase activity (P = 0.006), the strongest predictor of CF pulmonary function. Consistently, neutrophil burden in CF airways was decreased upon treatment (P = 0.003), as was the number of airway neutrophils actively releasing elastase-rich granules (P = 0.005), as measured by flow cytometry. Pulmonary function measures were not improved, as expected with short-term treatment. After excluding data from subjects without baseline airway inflammation, positive treatment effects were more pronounced and included decreased sputum IL-8 levels (P = 0.032). Thus, high-dose oral N-acetylcysteine has the potential to counter the intertwined redox and inflammatory imbalances in CF.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16537378&query_hl=8&itool=pubmed_docsum">http://www.ncbi.nlm.nih.gov/en...=8&itool=pubmed_docsum</a>
 

NoExcuses

New member
So as most of you know, I visited Warwick in Minnesota and immeditely started oral NAC 600mg QD.

I told my phsycian that I started this treatment, and he informed me that Dr. Moss at Stanford is actually actively conducting a study on NAC. I had no idea.

In case others aren't aware of the study, here is the info I found on PubMed. Phase I trial was just concluded and published, taking a look to see if Dr. Moss' hypothesis of NAC helping to increase glutathione concentrations in neutrophils.

The goal of this study wasn't to look at increases in lung function or decrases in exacerbations or to look at effective doses. The goal simply was ensure that the oral NAC did in fact effect glutathione concentrations in neutrophils.

The next stage will be to examine optimal dosing, safety, as well as to prove that NAC does improve pulmonary function or help avoid exacerbations.

I was pleased to discover that this is being studied and I'm sure you feel the same way!


<b>High-dose oral N-acetylcysteine, a glutathione prodrug, modulates inflammation in cystic fibrosis. </b>


Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA. tirouvan@stanford.edu

Neutrophilic airway inflammation is a hallmark of cystic fibrosis (CF). As high oxidant producers, airway neutrophils contribute largely to the systemic redox imbalance seen in CF. In turn, this chronic and profound imbalance can impact circulating neutrophils before their migration into airways. Indeed, in 18 CF patients with stable disease, blood neutrophils were readily deficient in the pivotal antioxidant glutathione (P = 0.003, compared with 9 healthy controls). In a phase 1 study, this deficiency was improved (P = 0.025) by the glutathione prodrug N-acetylcysteine, given orally in high doses (0.6 to 1.0 g three times daily, for 4 weeks). This treatment was safe and markedly decreased sputum elastase activity (P = 0.006), the strongest predictor of CF pulmonary function. Consistently, neutrophil burden in CF airways was decreased upon treatment (P = 0.003), as was the number of airway neutrophils actively releasing elastase-rich granules (P = 0.005), as measured by flow cytometry. Pulmonary function measures were not improved, as expected with short-term treatment. After excluding data from subjects without baseline airway inflammation, positive treatment effects were more pronounced and included decreased sputum IL-8 levels (P = 0.032). Thus, high-dose oral N-acetylcysteine has the potential to counter the intertwined redox and inflammatory imbalances in CF.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16537378&query_hl=8&itool=pubmed_docsum">http://www.ncbi.nlm.nih.gov/en...=8&itool=pubmed_docsum</a>
 

NoExcuses

New member
I wasn't sure how much to take so I was taking 600mg QD as I stated in the post above.

But after reading this study, I think I'll increase to 600mg BID and see how I tolerate it.

One of the side effects of NAC can get low zinc level, which I had my doc test in November after I had been taking NAC for 6 weeks. It takes 6 weeks to get the zinc test back though so I have no idea if I low (I probably am since I got a wammie of a cold a few weeks ago).

It's too bad that these studies take so long to do, but I'm going to continue to experiment because my sputum has become thinner since I took the NAC (it took 3 weeks or so to see effects)
 

NoExcuses

New member
I wasn't sure how much to take so I was taking 600mg QD as I stated in the post above.

But after reading this study, I think I'll increase to 600mg BID and see how I tolerate it.

One of the side effects of NAC can get low zinc level, which I had my doc test in November after I had been taking NAC for 6 weeks. It takes 6 weeks to get the zinc test back though so I have no idea if I low (I probably am since I got a wammie of a cold a few weeks ago).

It's too bad that these studies take so long to do, but I'm going to continue to experiment because my sputum has become thinner since I took the NAC (it took 3 weeks or so to see effects)
 

NoExcuses

New member
I wasn't sure how much to take so I was taking 600mg QD as I stated in the post above.

But after reading this study, I think I'll increase to 600mg BID and see how I tolerate it.

One of the side effects of NAC can get low zinc level, which I had my doc test in November after I had been taking NAC for 6 weeks. It takes 6 weeks to get the zinc test back though so I have no idea if I low (I probably am since I got a wammie of a cold a few weeks ago).

It's too bad that these studies take so long to do, but I'm going to continue to experiment because my sputum has become thinner since I took the NAC (it took 3 weeks or so to see effects)
 
2

2perfectboys

Guest
Studies take so long, because safety is the top priority. It's about time they did research on GSH/NAC. I would never put my son on it because it was not approved, and the when I asked his doctor about testing his GSH levels, he seemed dumbfounded on how to do this. There is a lab that wll do the GSH levels, but until they find that it is first of all safe and secondly that oral dosage can be delivered effectively to increase GSH, I think it is not a good ideal to experiment of your own. There is a doage by weight for GSH, but I think this dosage could just add up to money down the drain, if there is no benefit from it. Can't wait to see what the studies conclude
 
2

2perfectboys

Guest
Studies take so long, because safety is the top priority. It's about time they did research on GSH/NAC. I would never put my son on it because it was not approved, and the when I asked his doctor about testing his GSH levels, he seemed dumbfounded on how to do this. There is a lab that wll do the GSH levels, but until they find that it is first of all safe and secondly that oral dosage can be delivered effectively to increase GSH, I think it is not a good ideal to experiment of your own. There is a doage by weight for GSH, but I think this dosage could just add up to money down the drain, if there is no benefit from it. Can't wait to see what the studies conclude
 
2

2perfectboys

Guest
Studies take so long, because safety is the top priority. It's about time they did research on GSH/NAC. I would never put my son on it because it was not approved, and the when I asked his doctor about testing his GSH levels, he seemed dumbfounded on how to do this. There is a lab that wll do the GSH levels, but until they find that it is first of all safe and secondly that oral dosage can be delivered effectively to increase GSH, I think it is not a good ideal to experiment of your own. There is a doage by weight for GSH, but I think this dosage could just add up to money down the drain, if there is no benefit from it. Can't wait to see what the studies conclude
 
M

mneville

Guest
Amy- Warwick also told me about NAC which I have put on my list of questions for our CF visit next week. I have no idea how much a two year old would take?

On another post, you mentioned the 97.9 number of the Minnesota Center and how great it was. It really is compared to our center in the low 80's for lung function between 6-17. But after visiting Warwick for five hours, the only difference I really notice is their strict adherence of an hour of the VEST daily. We have been doing this diligently since our son has been 19 months old. There is nothing else I can figure out that they do to make their numbers so high?? Have you? Besides MucoMyst...Whatever it is, I want to do it.

Overall Minnesota (CF or not) has the second highest life expectancy age in the USA. It must be good air? Megan
 
M

mneville

Guest
Amy- Warwick also told me about NAC which I have put on my list of questions for our CF visit next week. I have no idea how much a two year old would take?

On another post, you mentioned the 97.9 number of the Minnesota Center and how great it was. It really is compared to our center in the low 80's for lung function between 6-17. But after visiting Warwick for five hours, the only difference I really notice is their strict adherence of an hour of the VEST daily. We have been doing this diligently since our son has been 19 months old. There is nothing else I can figure out that they do to make their numbers so high?? Have you? Besides MucoMyst...Whatever it is, I want to do it.

Overall Minnesota (CF or not) has the second highest life expectancy age in the USA. It must be good air? Megan
 
M

mneville

Guest
Amy- Warwick also told me about NAC which I have put on my list of questions for our CF visit next week. I have no idea how much a two year old would take?

On another post, you mentioned the 97.9 number of the Minnesota Center and how great it was. It really is compared to our center in the low 80's for lung function between 6-17. But after visiting Warwick for five hours, the only difference I really notice is their strict adherence of an hour of the VEST daily. We have been doing this diligently since our son has been 19 months old. There is nothing else I can figure out that they do to make their numbers so high?? Have you? Besides MucoMyst...Whatever it is, I want to do it.

Overall Minnesota (CF or not) has the second highest life expectancy age in the USA. It must be good air? Megan
 

zoe4life

New member
Amy,
Thanks again for all of your knowledge & research! You are such an inspiration to me and Zoe! Please keep us informed, you "trying" out these doses etc...thank you!!
Love,
Jada
Zoe's mom
 

zoe4life

New member
Amy,
Thanks again for all of your knowledge & research! You are such an inspiration to me and Zoe! Please keep us informed, you "trying" out these doses etc...thank you!!
Love,
Jada
Zoe's mom
 

zoe4life

New member
Amy,
Thanks again for all of your knowledge & research! You are such an inspiration to me and Zoe! Please keep us informed, you "trying" out these doses etc...thank you!!
Love,
Jada
Zoe's mom
 
2

2perfectboys

Guest
Louisville tops Minnesota!!! 98.1 mean for FEV1 for under 18. Minnesoata's guideline for care are actually sad. I can't believe that a clinic that is suppose to be so proactive is only reaching their required visits of peds and adults at 65% and 58%, sounds like a lot of non-compliance especially compared to Cinti clinic that had a peds rae of almost 75%. Too me, theses new #s are not really that useful and don't tell the whole story or else it just goes to show u, there is more than one way of CF treatment
 
2

2perfectboys

Guest
Louisville tops Minnesota!!! 98.1 mean for FEV1 for under 18. Minnesoata's guideline for care are actually sad. I can't believe that a clinic that is suppose to be so proactive is only reaching their required visits of peds and adults at 65% and 58%, sounds like a lot of non-compliance especially compared to Cinti clinic that had a peds rae of almost 75%. Too me, theses new #s are not really that useful and don't tell the whole story or else it just goes to show u, there is more than one way of CF treatment
 
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