Singh Mona, Kim Alina, Young Amelie, Nguyen Deanna, Monroe Cynthia L, Ding Tiffany, Gray Dennis, Venketaraman Vishwanath
College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA.
College of Medicine, California Northstate University, Elk Grove, CA 95757, USA.
Life (Basel). 2024 Oct 23;14(11):1361. doi: 10.3390/life14111361.
N-acetylcysteine (NAC) has established use as an antidote for acetaminophen overdose and treatment for pulmonary conditions and nephropathy. It plays a role in regulating oxidative stress and interacting with various cytokines including IL-1β, TNFα, IL-8, IL-6, IL-10, and NF-κB p65. The overexpression of reactive oxygen species (ROS) is believed to contribute to chronic pain states by inducing inflammation and accelerating disease progression, favoring pain persistence in neuropathic and musculoskeletal pain conditions. Through a comprehensive review, we aim to explore the mechanisms and inflammatory pathways through which NAC may manage neuropathic and musculoskeletal pain. Evidence suggests NAC can attenuate neuropathic and musculoskeletal pain through mechanisms such as inhibiting matrix metalloproteinases (MMPs), reducing reactive oxygen species (ROS), and enhancing glutamate transport. Additionally, NAC may synergize with opioids and other pain medications, potentially reducing opioid consumption and enhancing overall pain management. Further research is needed to fully elucidate its therapeutic potential and optimize its use in pain management. As an adjuvant therapy, NAC shows potential for chronic pain management, offering significant benefits for public health.
N-乙酰半胱氨酸（NAC）已被确立为对乙酰氨基酚过量的解毒剂以及用于治疗肺部疾病和肾病。它在调节氧化应激以及与包括白细胞介素-1β（IL-1β）、肿瘤坏死因子α（TNFα）、白细胞介素-8（IL-8）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）和核因子κB p65（NF-κB p65）在内的多种细胞因子相互作用中发挥作用。据信活性氧（ROS）的过表达通过诱导炎症和加速疾病进展而导致慢性疼痛状态，有利于神经病理性和肌肉骨骼疼痛状况下的疼痛持续存在。通过全面综述，我们旨在探索NAC可能用于管理神经病理性和肌肉骨骼疼痛的机制及炎症途径。有证据表明，NAC可通过抑制基质金属蛋白酶（MMPs）、减少活性氧（ROS）以及增强谷氨酸转运等机制减轻神经病理性和肌肉骨骼疼痛。此外，NAC可能与阿片类药物及其他止痛药协同作用， potentially reducing opioid consumption and enhancing overall pain management. 还需要进一步研究以充分阐明其治疗潜力并优化其在疼痛管理中的应用。作为一种辅助疗法，NAC在慢性疼痛管理方面显示出潜力，为公共卫生带来显著益处。
