Mukolitik ve nefroprotektif bir ajan olan N-asetilsistein, yaygın olarak asetaminofen toksisitesinde antidot olarak kullanılır. Bir sistein donörü olarak hareket ederek, antioksidan, antiinflamatuar ve antiproliferatif etkileri oluşturur. Nörotransmitter düzeylerinde de değişikliğe yol açar. Fibroblastların ve keratinositlerin çoğalmasını engeller, vazodilatasyona neden olur. Bu özellikleriyle nöroloji, psikiyatri, nefroloji, maligniteler, çeşitli vasküler bozukluklar ve akciğer hastalıklarına kadar çok çeşitli tıbbi alanlarda potansiyel kullanım alanı bulmuştur. Dermatoloji alanındaki kullanımları, sistemik ve topikal formda olmak üzere küçük çaplı çalışmalar ve olgu sunumları, vaka serileri şeklinde literatürde bildirilmiştir. Burada sırasıyla ilaç reaksiyonları (toksik epidermal nekroliz ve ilaç hipersensitivite sendromu); trikotillomani, trikoteiromani, onikotillomani gibi deri yolma bozukluklarını içeren psikodermatozlar; iktiyozlar, kontakt dermatit ve atopik dermatit gibi epidermal bariyer/keratinizasyon bozuklukları olan hastalıklar; kseroderma pigmentozum, melazma, psödoporfiri gibi fotodermatozlar; sistemik skleroz ve lupus eritematozus gibi konnektif doku hastalıkları; yara iyileşmesi ve büllöz morfea; polikistik over sendromu, hiperandrojenizm, akne ve alopesideki kullanım alanlarına değinilecektir. Her ne kadar ilacın temini kolay ve güvenlik profili iyi olsa da daha geniş çapta kullanım için kanıt düzeyinin daha yüksek olması gerekli görülmektedir. Bu derlemede, N-asetilsisteinin dermatoloji alanındaki mevcut çeşitli kullanım alanları ve etki mekanizmaları gözden geçirilerek, günlük dermatoloji pratiğinde göz ardı edilen potansiyel kullanım alanlarına dikkat çekilmesi hedeflenmiştir. Dermatolojik hastalıklar için güvenli ve umut veren bir seçenek olabileceği düşünülmektedir.
Anahtar Kelimeler: N-asetilsistein; antioksidan; antiinflamatuar; nörotransmitter
N-acetylcysteine, a mucolytic and nephroprotective agent, is frequently used as an antidote to acetaminophen toxicity. Acting as a cysteine donor, it has antioxidant, anti-inflammatory and antiproliferative effects. It also causes changes in neurotransmitter levels. It prevents the proliferation of fibroblasts and keratinocytes, generates vasodilation. With these properties, it has found potential use in a wide variety of medical fields, from neurology, psychiatry, nephrology, malignancies, various vascular disorders to lung diseases. Their use in dermatology has been reported in the literature in the form of small-scale studies, case reports, case series, in systemic and topical forms. Here, respectively; the usage areas in drug reactions (toxic epidermal necrolysis and drug hypersensitivity syndrome); psychodermatoses including skin picking disorders such as trichotillomania, trichotillomania, onychotillomania; diseases with epidermal barrier/keratinization disorders such as ichthyoses, contact dermatitis and atopic dermatitis; photodermatoses such as xeroderma pigmentosum, melasma, pseudoporphyria; connective tissue diseases such as systemic sclerosis and lupus erythematosus; wound healing and bullous morphea; polycystic ovary syndrome, hyperandrogenism, acne and alopecia will be mentioned. Although the drug is easy to obtain and has a good safety profile, a higher level of evidence is required for wider use. In this review, the current usage areas and mechanisms of action of N-acetylcysteine in dermatology are reviewed and it is aimed to draw attention to the potential usage areas that are overlooked in daily dermatology practice. It is considered to be a safe and promising option for dermatological diseases.
Keywords: N-acetylcysteine; antioxidant; anti-inflammatory; neurotransmitter
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