Trial reportLiver international : official journal of the International Association for the Study of the Liver2013
Effects of N-acetylcysteine on cytokines in non-acetaminophen acute liver failure: potential mechanism of improvement in transplant-free survival.
Trial report in Liver international : official journal of the International Association for the Study of the Liver, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00518440 (A Multi-Center Trial to Study Acute Liver Failure in Adults), which is not on this map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multi-Center Trial to Study Acute Liver Failure in Adults
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 69 citations in OpenAlex.
- N-Acetylcysteine for the Management of Non-Acetaminophen Drug-Induced Liver Injury in Adults: A Systematic Review.Frontiers in pharmacology · 2022Pooled it
- The Protective Role of L-Cysteine in the Regulation of Blood-Testis Barrier Functions-A Brief Review.Genes · 2024Review
- Review
- Comparative analysis of gene expression between mice and humans in acetaminophen-induced liver injury by integrating bioinformatics analysis.BMC medical genomics · 2024Article
- The Use and Potential Benefits of N-Acetylcysteine in Non-Acetaminophen Acute Liver Failure: An Etiology-Based Review.Biomedicines · 2024Review
- Repurposing N-acetylcysteine for management of non-acetaminophen induced acute liver failure: an evidence scan from a global health perspective.Translational gastroenterology and hepatology · 2024Article
- Advances in the Mechanism of Action of Neutrophil Extracellular Traps in Gastrointestinal Tumors: A Review.International journal of general medicine · 2023Article
- Protective Effects of N-Acetylcysteine on Lipopolysaccharide-Induced Respiratory Inflammation and Oxidative Stress.Antioxidants (Basel, Switzerland) · 2022Article
- Variation in the Care of Acute Liver Failure: A Survey of Intensive Care Professionals.GE Portuguese journal of gastroenterology · 2022Article
- N-acetylcysteine in non-acetaminophen-induced acute liver failure: a systematic review and meta-analysis of prospective studies.Przeglad gastroenterologiczny · 2022Review
- Efficacy and safety of N-acetylcysteine for the treatment of non-acetaminophen-induced acute liver failure: an updated systematic review and meta-analysis.Clinical and experimental hepatology · 2021Article
- Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines.Hepatology international · 2021Article
- Article
- How to manage: acute liver failure.Frontline gastroenterology · 2020Article
- Neutrophils and neutrophil extracellular traps in the liver and gastrointestinal system.Nature reviews. Gastroenterology & hepatology · 2018Review
- Effects of the Usage of l-Cysteine (l-Cys) on Human Health.Molecules (Basel, Switzerland) · 2018Review
- Acute liver failure induced by idiosyncratic reaction to drugs: Challenges in diagnosis and therapy.Liver international : official journal of the International Association for the Study of the Liver · 2018Review
- Functional Implications of the IL-23/IL-17 Immune Axis in Schizophrenia.Molecular neurobiology · 2017Review
- NBAS mutations cause acute liver failure: when acetaminophen is not a culprit.Italian journal of pediatrics · 2017Article
- Oxidative stress mediates an increased formation of vascular endothelial growth factor in human hepatocarcinoma cells exposed to erlotinib.Oncotarget · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundN-Acetylcysteine (NAC) improves transplant-free survival in patients with non-acetaminophen acute liver failure (ALF) when administered in early stages of hepatic encephalopathy. The mechanisms of this benefit are unknown.
aimTo determine whether NAC improves transplant-free survival in ALF by ameliorating the surge of pro-inflammatory cytokines.
methodsSerum samples were obtained from 78 participants of the randomized, ALF Study Group NAC Trial with grade 1 or 2 hepatic encephalopathy on randomization. Concentrations of ten cytokines, chosen to represent a wide array of inflammatory responses, were determined by multiplex enzyme-linked immunosorbent assay ELISA.
resultsIn univariate analysis, predictors of transplant-free survival included NAC administration (P = 0.012), admission bilirubin (P = 0.003), international normalized ratio INR (P = 0.0002), grade 1 vs. grade 2 encephalopathy (P = 0.006) and lower admission interleukin (IL)-17 concentrations (P = 0.011). IL-17 levels were higher in patients with grade 2 vs. grade 1 encephalopathy on randomization (P = 0.007) and in those who progressed to grade 3 or grade 4 encephalopathy over the following 7 days (P ≤ 0.01). Stepwise multivariate logistic regression analysis identified only NAC administration and lower IL-17 concentrations as independent predictors of transplant-free survival. In patients with detectable IL-17 concentrations on admission, 78% of those who received NAC vs. 44% of those who received placebo had undetectable levels by day 3-5 (P = 0.042), and the mean decrease in IL-17 concentrations between admission and late samples was significantly greater in patients who received NAC vs. placebo (P = 0.045).
conclusionsN-acetylcysteine (NAC) may improve transplant-free survival in patients with non-acetaminophen ALF by ameliorating the production of IL-17, which is associated with progression of hepatic encephalopathy and poor outcome.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.