Effect of intravenous N-acetylcysteine infusion on haemostatic parameters in healthy subjects

Knudsen, T. T.; Thorsen, S.; Jensen, S. A.; Dalhoff, K.; Schmidt, L. E.; Becker, U.; Bendtsen, F.
April 2005
Gut;Apr2005, Vol. 54 Issue 4, p515
Academic Journal
Background and aim: N-acetylcysteine is used to treat paracetamol overdose but depresses the activity of plasma coagulation factors II, VII, and X, which are often used to assess liver injury. The aim of this study was to investigate the effect of N-acetylcysteine on haemostasis in normal volunteers. Methods: Haemostatic parameters in 10 healthy subjects were analysed before and following intravenous infusion of therapeutic doses of N-acetylcysteine, as well as in vitro. Results: N-acetylcysteine induced significant decreases in plasma levels of vitamin K dependent haemostatic proteins in vivo, being maximal at one hour following the start of infusion, with maximal decreases from 1.00 to 0.73 (0.67-0.79) (mean (95% confidence interval), 0.66 (0.58-0.73), 0.81 (0.73-0.90), 0.64 (0.57-0.70), 0.74 (0.65-0.82), and 0.61 (0.54-0.67) for factor II, VII, IX, and X activities, protein C activity, and free protein S reactivity, respectively. These data suggest that N-acetylcysteine induces protein modfications affecting activity. Five subjects developed an adverse reaction to infusion of N-acetylcysteine and these were associated with a rapid increase in levels of factor 2.71), respectively, which suggests that the allergic reaction induced release of vWF from endothelial cells. N-acetylcysteine and these were associated with a rapid increase in levels of factor VIII and its carrier protein von Willebrand factor (vWf) from 1.0 to 1.85 (1.85-2.62) and 1.77 (0.83-2.71), respectively, which suggests that the allergic reaction induced release of vWf from endothelial cells. N-acetylcysteine did not affect factor VIII or vWf in subjects without adverse reactions, and nor did it affect factor V or antithrombin in any of the subjects. Conclusion: Therapeutic doses of N-acetylcysteine cause abnormal haemostatic activity, and this should be taken into account when using haemostatic function tests as an indicator of hepatic injury.


Related Articles

  • HT Defix.  // Royal Society of Medicine: Medicines;2002, p285 

    The article presents information on HT Defix, a proprietary, prescription-only preparation of factor IX dried, which is prepared from human blood plasma. It can be used in treating patients with a deficiency in factor IX, and is available in a form for intravenous infusion.

  • Crystal structure of the human a-thrombin-haemadin complex: an exosite II-binding inhibitor. Richardson, John L.; Kröger, Burkhard; Hoeffken, Wolfgang; Sadler, J. Evan; Pereira, Pedro; Huber, Robert; Bode, Wolfram; Fuentes-Prior, Pablo // EMBO Journal;11/1/2000, Vol. 19 Issue 21, p5650 

    The serine proteinase α-thrombin plays a pivotal role in the regulation of blood fluidity, and therefore constitutes a primary target in the treatment of various haemostatic disorders. Haemadin is a slow tight-binding thrombin inhibitor from the land-living leech Haemadipsa sylvestris. Here...

  • Acyclic Identification of Aptamers for Human alpha-Thrombin Using Over-Represented Libraries and Deep Sequencing. Kupakuwana, Gillian V.; Crill II, James E.; McPike, Mark P.; Borer, Philip N. // PLoS ONE;2011, Vol. 6 Issue 5, p1 

    Background: Aptamers are oligonucleotides that bind proteins and other targets with high affinity and selectivity. Twenty years ago elements of natural selection were adapted to in vitro selection in order to distinguish aptamers among randomized sequence libraries. The primary bottleneck in...

  • Phosphodiesterase 10A Upregulation Contributes to Pulmonary Vascular Remodeling. Xia Tian; Vroom, Christina; Ghofrani, Hossein Ardeschir; Weissmann, Norbert; Bieniek, Ewa; Grimminger, Friedrich; Seeger, Werner; Schermuly, Ralph Theo; Pullamsetti, Soni Savai // PLoS ONE;2011, Vol. 6 Issue 4, p1 

    Phosphodiesterases (PDEs) modulate the cellular proliferation involved in the pathophysiology of pulmonary hypertension (PH) by hydrolyzing cAMP and cGMP. The present study was designed to determine whether any of the recently identified PDEs (PDE7-PDE11) contribute to progressive pulmonary...

  • Recombinant activated factor VIIa treatment for refractory hemorrhage in infants. Dang, C. N.; Katakam, L. I.; Smith, P. B.; Cotten, C. M.; Goldberg, R. N.; Chandler, N.; Thornburg, C. D.; Bidegain, M. // Journal of Perinatology;Mar2011, Vol. 31 Issue 3, p188 

    Objective:Report clinical response to recombinant factor VIIa in a cohort of critically ill infants.Study Design:We identified all infants who received factor VIIa in the Duke Neonatal Intensive Care Unit between January 2005 and July 2008. Hematological data and volume of blood transfusions...

  • PRELIMINARY STUDIES ON IN VITRO AND IN VIVO EFFECTS OF 50% HYPAQUE ON COAGULATION IN MAN. Chandra, Ramesh; Abraham, Jacob // Angiology;Apr1973, Vol. 24 Issue 4, p199 

    A preliminary study of in Vitro and in Vivo changes in the various factors of coagulation by 50% Hypaque in man is reported. Significant inhibition of all the stages of clotting and increased fibrinolytic activity were demonstrated by various special laboratory tests. Persistence of such...

  • Tromboelastografía: nuevos conceptos en la fisiología de la hemostasia y su correlación con la coagulopatía asociada al trauma. Galvez, Kenny; Cortes, Claudia // Colombian Journal of Anesthesiology / Revista Colombiana de Anes;ago-oct2012, Vol. 40 Issue 3, p224 

    Initial interpretation of the process of coagulation refers to two pathways: (1) the extrinsic pathway, consisting of tissue factor (TF) and factor VII, and (2) the intrinsic pathway, in which factors XII, XI, IX, VIII and V are involved. Currently, this concept has changed and it is accepted...

  • The Role of Tissue Factor in Thrombosis and Hemostasis. Malý, M. A.; Tomašov, P.; Hájek, P.; Blaško, P.; Hrachovinová, I.; Salaj, P.; Veselka, J. // Physiological Research;2007, Vol. 56 Issue 6, p685 

    The tissue factor (TF) is one of the most important regulators of arterial thrombosis. Because arterial thrombosis is the pathophysiologic background of acute coronary syndrome, the possible impact of blocking the arterial thrombosis on its onset is a challenging problem. The investigations of...

  • The Involvement of Blood Coagulation Factor XIII in Fibrinolysis and Thrombosis. Muszbek, L.; Bagoly, Z.; Bereczky, Z.; Katona, É. // Cardiovascular & Hematological Agents in Medicinal Chemistry;2008, Vol. 6 Issue 3, p190 

    It has been known for a long time that blood coagulation factor XIII (FXIII) is essential for maintaining haemostasis, its deficiency leads to severe bleeding complication. Biochemical studies have revealed that FXIII is a key regulator of fibrinolysis and, in addition to its role in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics