The effect of N-acetylcysteine supplementation on endothelial function: a systematic review

Background N-acetylcysteine (NAC) as a potent anti-inflammatory and antioxidant compound, has raised scientific interest to affect endothelial function. The present systematic review aimed to summarize the potential therapeutic effects of NAC in different health status. Methods PubMed, Web of Science, Scopus, and Google Scholar were searched up to 2023 to obtain relevant studies. The PRISMA guidelines were employed during all steps. Two reviewers independently extracted the information from the included studies. The studies investigating the effect of oral and intravenous NAC on vascular function were included in the current study. Results A total of 4455 studies were identified. Finally, fifteen studies were included in the present systematic review. Both oral and intravenous NAC administration have been evaluated in eight and seven studies, respectively. Most of included studies, illustrated no significant changes in the markers of vascular function due to NAC supplementation. However, 3 studies showed significant reduction in the Intercellular adhesion molecule-1 (ICAM-1) level based on NAC supplementation. Whereas, there was inconsistent results in term of vascular adhesion molecule-1 (VCAM-1) and NO levels. In general, NAC supplementation had led to an improvement in the markers of vascular function (ET, FMD, SVR, CVR) in a non-significant model. Conclusion It seems that NAC may have favorable effects in vascular dysfunction. However, more studies are needed to confirm these results and clarify the relevant mechanisms.