Researchers from the Department of Biochemistry and Molecular Biology at the Univesidad de Alcalá (UAH), confirm that N-acetyl-L-cysteine (NAC) combined with mesalamine produces a significant improvement in patients suffering from ulcerative colitis.
The team headed by Luis González Guijarro, biochemistry and molecular biology professor at the UAH, in collaboration with the pharmaceutical firm Farmasierra S.L., has developed a pilot study of the effects of N-acetyl-L-cysteine on patients suffering from moderate or mild ulcerative colitis. The conclusion reached in this study, and published in the World Journal of Gastroenterology, is that the association of N-acetyl-L-cysteine and mesalamine, reduces the symptoms of patients affected with this condition. Previous to now, these patients were treated solely with mesalamine.
Professor González Guijarro explains that ulcerative colitis is a form of inflammatory bowel disease that specifically affects the colon, producing free radicals and hydrogen peroxide. The cells of our immune system protect the body from infections using several weapons and neutrophils, the most abundant type of white blood cell in our organism, destroying microorganisms and producing hydrogen peroxide. Hydrogen peroxide is unstable and breaks down into hydroxyl radicals that cause damage to the delicate tissues. Professor González Guijarro states that the intention of the co-administration of NAC and mesalamine was to eliminate the hydrogen peroxide and reduce the number of free radicals using N-acetyl-L-cysteine. N-acetyl-L-cysteine is a precursor to glutathione, a molecule that along with glutathione peroxidase, eliminates hydrogen peroxide.
The study carried out in collaboration with the Gregorio Marañón hospital and the Princesa hospital, is the first step in the long process that has to take place before any drug reaches drugstores. Work must begin on the association of mesalamine and NAC into a single product; since the study was carried out by administering one drug as a pill and the other as a soluble compound.
The professor of biochemistry and molecular biology insists that the clinical and biochemical effects have to be continuously recorded in order to corroborate the preliminary indications. For example, that this association does not produce any adverse side effects, and that N-acetyl-L-cysteine can be significant in the quimioprevention of colon cancer.
Another objective of the team of the UAH is to direct the molecule to the inflamed colon, using an enteric coating that should degrade at a certain pH. This way when the patient ingests the pill, the drug will pass through the stomach and intestine and will only be released in the colon.
N-acetyl-L-cysteine, is a drug normally used for the treatment of chronic obstructive pulmonary disease (COPD) and to minimize the effects of cold and flu. Its hepatic protective properties also make this drug a useful tool in paracetamol intoxications.
The research team at Alcalá University has been studying the new therapeutic properties of NAC for years, producing results such as an in vitro study where N-acetyl-L-cysteine reduced the negative effects caused by azathioprine, a immunosuppressant of clinical use, on the liver. Currently many research groups are working on the application of NAC in the treatment of diverse pathologies, such as diabetes, alcohol and cocaine dependence syndromes.
Every advance in the treatment of ulcerative colitis is of great relevance because the disease causes many discomforts in the patient while conditioning their life. In the early stages the symptoms are mainly diarrhea, weight loss, and intestinal bleeding, but once it aggravates, intestinal fistulas appear. “Nowadays new extremely powerful drugs are being developed; so-called biological drugs, like anti-TNF antibodies, that even manage to cure the fistulas but cause negative side effects and are very expensive. Every improvement in the application of classic drugs with enteric coatings, combinations of drugs, etc… represent less risk for the patient and savings for the social security” states González Guijarro.
“The future in treating diseases is customized treatments. In order for a drug to work, the weight and age of the patient must be considered, but their genetic information will also provide the key to evaluate whether a certain molecule would be effective for the particular patient” concludes the Professor of the UAH.
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