Synopsis

Source of validity: Scientific
Rating (out of 5): 2

N-acetylcysteine (NAC) is an antioxidant and precursor of glutathione, and its use in colitis is supported by a modest body of scientific research, mostly in preclinical models. Several animal studies have demonstrated that NAC administration can reduce colonic inflammation, oxidative stress, and tissue injury in chemically induced models of colitis, such as those using dextran sulfate sodium (DSS) or trinitrobenzene sulfonic acid (TNBS). These effects are attributed to NAC’s ability to scavenge reactive oxygen species and modulate inflammatory cytokine production, thereby preserving mucosal integrity and reducing disease severity.

Limited human data are available. Some small pilot studies and case reports suggest potential benefit in inflammatory bowel disease (IBD), including ulcerative colitis, when NAC is used as an adjunct to standard therapy. For example, a 2010 pilot study found that oral NAC in combination with mesalazine improved clinical and endoscopic outcomes in patients with ulcerative colitis compared to mesalazine alone. However, these findings have not been widely replicated in larger, well-controlled clinical trials, and NAC is not established as a standard therapy for colitis in clinical guidelines.

In summary, while there is scientific rationale and encouraging preclinical data, clinical evidence for the use of NAC in colitis is limited and of low quality. Further research is needed to determine its efficacy and safety in this context.

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