APLICACIONES DE LA N-ACETILCISTEÍNA EN LA SALUD FEMENINA: UNA REVISIÓN INTEGRADORA
DOI:
https://doi.org/10.66104/b09tb426Palabras clave:
N-acetilcisteína, salud femenina, Endometriosis, síndrome de ovario poliquístico, infertilidadResumen
La N-acetilcisteína es un compuesto conocido por sus propiedades antioxidantes. Considerando sus acciones en enfermedades como la endometriosis, el síndrome de ovarios poliquísticos y la infertilidad, este trabajo tuvo como objetivo revisar las aplicabilidades de la NAC en la salud femenina. Para la realización de esta investigación se verificaron artículos originales de la literatura a partir de las bases de datos Scientific Electronic Library Online (SCIELO), National Library of Medicine (PUBMED) y Biblioteca Virtual en Salud (BVS), en el período de 2014 a 2024. Se seleccionaron 28 artículos para su revisión. La NAC actúa a través de diversos mecanismos que contribuyen a su eficacia y el principal ya descrito en la literatura es el de ser precursor del glutatión. Sin embargo, se han evaluado otros mecanismos, como su potencial para mejorar la viabilidad celular al inhibir la apoptosis, o muerte celular programada. Además de aumentar la actividad de enzimas antioxidantes, como la catalasa y la superóxido dismutasa, lo que resulta en la protección celular contra el daño oxidativo. Los artículos revisados describieron que la NAC puede reducir el dolor y el tamaño de las lesiones endometriales, además de mejorar potencialmente la fertilidad. En el SOP, la NAC ha mostrado eficiencia para restaurar los niveles de ovulación y mejorar la calidad de los óvulos, contribuyendo a mejores tasas de embarazo. Las evidencias sugieren que la NAC puede tener un papel protector contra el estrés oxidativo y la inflamación, condiciones frecuentemente encontradas en enfermedades del sistema reproductor femenino. Los mecanismos descritos y los resultados obtenidos hacen que el suplemento sea prometedor y evidencian la necesidad de la actuación del Nutricionista en su prescripción. Su utilización aliada a una dieta y un estilo de vida equilibrados, son capaces de promover mejores resultados en la salud reproductiva femenina. Así, la NAC se describe como una intervención favorable, pero su aplicación clínica requiere más investigaciones científicas.
Descargas
Referencias
ORGANIZAÇÃO MUNDIAL DE SAÚDE. Estimativas de prevalência de infertilidade, 1990–2021. Geneva: World Health Organization; 2023. Disponível em: https://www.who.int/publications/i/item/978920068315. Acesso em: 12 jan. 2025.
ORGANIZAÇÃO MUNDIAL DE SAÚDE. Infertilidade. WHO News; 2024. Disponível em: https://www.who.int/news-room/fact-sheets/detail/infertility. Acesso em: 12 jan. 2025.
COLLÉE, J. et al. Polycystic ovarian syndrome and infertility: overview and insights of the putative treatments. Gynecological Endocrinology, v. 37, n. 10, p. 869–874, 2 ago. 2021. DOI: 10.1080/09513590.2021.1958310 DOI: https://doi.org/10.1080/09513590.2021.1958310
GIUDICE, L. C. Endometriosis. New England Journal of Medicine, v. 362, n. 25, p. 2389–2398, 24 jun. 2010. DOI: 10.1056/NEJMcp1000274 DOI: https://doi.org/10.1056/NEJMcp1000274
ŁAKOMA, K.; KUKHARUK, O.; ŚLIŻ, D. The Influence of Metabolic Factors and Diet on Fertility. Nutrients, v. 15, n. 5, p. 1180, 27 fev. 2023. DOI: 10.3390/nu15051180 DOI: https://doi.org/10.3390/nu15051180
SILVA , M. P. et al. N-acetilcisteína: múltiplos papéis na terapêutica. Europub Journal of Health Research, [S. l.], v. 3, n. 4 Edição Especial, p. 306–313, 2022. Disponível em: https://ojs.europubpublications.com/ojs/index.php/ejhr/article/view/214. Acesso em: 9 jan. 2025. DOI: https://doi.org/10.54747/ejhrv3n4-ed.esp.003
ANASTASI, E. et al. Efficacy of N-Acetylcysteine on Endometriosis-Related Pain, Size Reduction of Ovarian Endometriomas, and Fertility Outcomes. International Journal of Environmental Research and Public Health, v. 20, n. 6, p. 4686, 1 jan. 2023. DOI: 10.3390/ijerph20064686. DOI: https://doi.org/10.3390/ijerph20064686
Guia Prescrição e Dispensação - CFN. Disponível em: <https://www.cfn.org.br/index.php/destaques/https-www-cfn-org-br-wp-content-uploads-2024-08-documento-em-pdf-sem-sangria-pdf/>. Acesso em: 21 jan. 2025.
SHAHVEGHAR ASL, Z.; PARASTOUEI, K.; ESKANDARI, E. The effects of N-acetylcysteine on ovulation and sex hormones profile in women with polycystic ovary syndrome: a systematic review and meta-analysis. British Journal of Nutrition, v. 130, p. 202-2010, 2023. DOI: 10.1017/S0007114522003270 DOI: https://doi.org/10.1017/S0007114522003270
SANDHU, A.; KALRA, S.; KALRA, B. Oxidative Stress in Polycystic Ovarian Syndrome and the Effect of Antioxidant N-Acetylcysteine on Ovulation and Pregnancy Rate. Cureus, v. 13, n. 9, e17887, 2021. DOI: 10.7759/cureus.17887. DOI: https://doi.org/10.7759/cureus.17887
Dymanowska-Dyjak, I; Frankowska, K; Abramiuk, M; Polak, G. Oxidative Imbalance in Endometriosis-Related Infertility - The Therapeutic Role of Antioxidants. International Journal of Molecular Sciences, v. 25, n. 12, p. 6298, 7 jun. 2024. DOI: 10.3390/ijms25126298 DOI: https://doi.org/10.3390/ijms25126298
FAN, L. et al. N-Acetylcysteine improves oocyte quality through modulating the Nrf2 signaling pathway to ameliorate oxidative stress caused by repeated controlled ovarian hyperstimulation. Reproduction, Fertility and Development, v. 34, n. 10, p. 736–750, 6 maio 2022. DOI: 10.1071/RD22020. DOI: https://doi.org/10.1071/RD22020
WANG, R. et al. BMI1 Deficiency Results in Female Infertility by Activating p16/p19 Signaling and Increasing Oxidative Stress. International Journal of Biological Sciences, v. 15, n. 4, p. 870–881, 1 jan. 2019. DOI: 10.7150/ijbs.30488. DOI: https://doi.org/10.7150/ijbs.30488
FANG, Y. et al. N-acetylcysteine supplementation improves endocrine-metabolism profiles and ovulation induction efficacy in polycystic ovary syndrome. Journal of Ovarian Research, v. 17, n. 1, 16 out. 2024. DOI: 0.1186/s13048-024-01528-8 DOI: https://doi.org/10.1186/s13048-024-01528-8
GIORGI, Vanessa Silvestre Innocenti; FERRIANI, Rui Alberto; NAVARRO, Paula Andrea. Follicular fluid from infertile women with mild endometriosis impairs in vitro bovine embryo development: potential role of oxidative stress. Revista Brasileira de Ginecologia e Obstetrícia, v. 43, n. 2, p. 119-125, 2021. DOI: 10.1055/s-0040-1718443. DOI: https://doi.org/10.1055/s-0040-1718443
SCHWALFENBERG, Gerry K. N-acetylcysteine: a review of clinical usefulness (an old drug with new tricks). Journal of Nutrition and Metabolism, v. 2021, p. 1-13, 2021. DOI: 10.1155/2021/9949453. DOI: https://doi.org/10.1155/2021/9949453
YIFU, Pu. A review of antioxidant N-acetylcysteine in addressing polycystic ovary syndrome. Gynecological Endocrinology, v. 40, n. 1, p. 2381498, 2024. DOI: 10.1080/09513590.2024.2381498. DOI: https://doi.org/10.1080/09513590.2024.2381498
CAI, J. et al. N-acetylcysteine alleviates D-galactose-induced injury of ovarian granulosa cells in female rabbits by regulating the PI3K/Akt/mTOR signaling pathway. Antioxidants, v. 13, n. 384, 2024. DOI: 10.3390/antiox13040384. DOI: https://doi.org/10.3390/antiox13040384
AGOSTINIS, C. et al. The combination of N-acetyl cysteine, alpha-lipoic acid, and bromelain shows high anti-inflammatory properties in novel in vivo and in vitro models of endometriosis. Mediators of Inflammation, v. 2015, p. 918089, 2015. DOI: 10.1155/2015/918089 DOI: https://doi.org/10.1155/2015/918089
YAHIA, Z.; YAHIA, A.; ABDELAZIZ, T. N-acetylcysteine Clinical Applications. Cureus, 24 out. 2024. DOI: 10.7759/cureus.72252. DOI: https://doi.org/10.7759/cureus.72252
LU, H. et al. The inhibition of reactive oxygen species (ROS) by antioxidants inhibits the release of an autophagy marker in ectopic endometrial cells. Taiwanese Journal of Obstetrics and Gynecology, v. 59, n. 2, p. 256–261, 2020. DOI: 10.1016/j.tjog.2020.01.014. DOI: https://doi.org/10.1016/j.tjog.2020.01.014
ZHOU, L.-H. et al. Metformin inhibits ovarian granular cell pyroptosis through the miR-670-3p/NOX2/ROS pathway. Aging, v. 15, n. 10, p. 4429–4443, 2023. DOI: 10.18632/aging.204745 DOI: https://doi.org/10.18632/aging.204745
YAO, Q. et al. Oxidative Stress as a Contributor to Insulin Resistance in the Skeletal Muscles of Mice with Polycystic Ovary Syndrome. International Journal of Molecular Sciences, v. 23, n. 19, p. 11384–11384, 27 set. 2022. DOI: 10.3390/ijms231911384. DOI: https://doi.org/10.3390/ijms231911384
ZHANG, Y. et al. Hyperandrogenism and insulin resistance‐induced fetal loss: evidence for placental mitochondrial abnormalities and elevated reactive oxygen species production in pregnant rats that mimic the clinical features of polycystic ovary syndrome. The Journal of Physiology, v. 597, n. 15, p. 3927–3950, 3 jul. 2019. DOI: 10.1113/JP277879. DOI: https://doi.org/10.1113/JP277879
HU, M. et al. Suppression of uterine and placental ferroptosis by N-acetylcysteine in a rat model of polycystic ovary syndrome. Molecular human reproduction, v. 27, n. 12, 24 nov. 2021. DOI: 10.1093/molehr/gaab067. DOI: https://doi.org/10.1093/molehr/gaab067
RAFIEE, B. et al. Effects of N-acetylcysteine and metformin treatment on the stereopathological characteristics of uterus and ovary. European Journal of Translational Myology, v. 32, n. 2, 9 maio 2022. DOI: https://doi.org/10.4081/ejtm.2022.10409
EL SHARKWY, I. A.; ABD EL AZIZ, W. M. Randomized controlled trial of N ‐acetylcysteine versus l‐carnitine among women with clomiphene‐citrate‐resistant polycystic ovary syndrome. International Journal of Gynecology & Obstetrics, 17 jul. 2019. DOI: 10.1002/ijgo.12902 DOI: https://doi.org/10.1002/ijgo.12902
CHANDIL, N. et al. Comparison of Metformin and N Acetylcysteine on Clinical, Metabolic Parameter and Hormonal Profile in Women with Polycystic Ovarian Syndrome. Journal of obstetrics and gynaecology of India, v. 69, n. 1, p. 77–81, 2019. DOI: 10.1007/s13224-018-1135-3. DOI: https://doi.org/10.1007/s13224-018-1135-3
MOSTAJERAN, F.; GHASEMI TEHRANI, H.; RAHBARY, B. N-Acetylcysteine as an Adjuvant to Letrozole for Induction of Ovulation in Infertile Patients with Polycystic Ovary Syndrome. Advanced Biomedical Research, v. 7, n. 1, p. 100, 2018. DOI: 10.4103/abr.abr_157_17. DOI: https://doi.org/10.4103/abr.abr_157_17
CHERAGHI, E. et al. N-Acetylcysteine Compared to Metformin, Improves The Expression Profile of Growth Differentiation Factor-9 and Receptor Tyrosine Kinase c-Kit in The Oocytes of Patients with Polycystic Ovarian Syndrome. International Journal of Fertility & Sterility, v. 11, n. 4, p. 270–278, 2018. DOI: 10.22074/ijfs.2018.5142.
CHERAGHI, E. et al. Co-Administration of Metformin and N-Acetyl Cysteine Fails to Improve Clinical Manifestations in PCOS Individual Undergoing ICSI. International Journal of Fertility & Sterility, v. 8, n. 2, p. 119, 8 jul. 2014. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC4107684/. Acesso em: 28 nov. 2024.
PALOMAR, A. et al. Antioxidant Supplementation Alleviates Mercury-Induced Cytotoxicity and Restores the Implantation-Related Functions of Primary Human Endometrial Cells. International journal of molecular sciences, v. 24, n. 10, p. 8799, Autumn 2023. DOI: 10.3390/ijms24108799 DOI: https://doi.org/10.3390/ijms24108799
ZHANG, S. et al. Chemotherapy impairs ovarian function through excessive ROS-induced ferroptosis. Cell Death and Disease, v. 14, n. 5, 24 maio 2023. DOI: 10.1038/s41419-023-05859-0. DOI: https://doi.org/10.1038/s41419-023-05859-0
GAO, W. et al. Oxidative damage of DNA induced by X-irradiation decreases the uterine endometrial receptivity which involves mitochondrial and lysosomal dysfunction. International journal of clinical and experimental medicine, v. 8, n. 3, p. 3401–10, Autumn 2015. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC4443064/. Acesso em: 21 nov. 2024.
LIM, J. et al. Antioxidant supplementation partially rescues accelerated ovarian follicle loss, but not oocyte quality, of glutathione-deficient mice†. Biology of reproduction, v. 102, n. 5, p. 1065–1079, Winter 2020. DOI: 10.1093/biolre/ioaa009 DOI: https://doi.org/10.1093/biolre/ioaa009
MENDES, K. D. S.; SILVEIRA, R. C. DE C. P.; GALVÃO, C. M. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto - Enfermagem, v. 17, n. 4, p. 758–764, dez. 2008. DOI: https://doi.org/10.1590/S0104-07072008000400018
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2026 Clara Oliveira de Vasconcelos, Beatriz Pardal de Matos, Marcela Gemeliano Valverde, Arthur Venâncio da Silva, Larissa Cristina Ramos Laurentino, Natália Christinne Ferreira de Oliveira, Clara Mockdece Neves, Ana Paula Boroni Moreira
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Authors who publish in this journal agree to the following terms:
Authors retain copyright and grant the journal the right of first publication, with the work simultaneously licensed under the Creative Commons Attribution License, which permits the sharing of the work with proper acknowledgment of authorship and initial publication in this journal;
Authors are authorized to enter into separate, additional agreements for the non-exclusive distribution of the version of the work published in this journal (e.g., posting in an institutional repository or publishing it as a book chapter), provided that authorship and initial publication in this journal are properly acknowledged, and that the work is adapted to the template of the respective repository;
Authors are permitted and encouraged to post and distribute their work online (e.g., in institutional repositories or on their personal websites) at any point before or during the editorial process, as this may lead to productive exchanges and increase the impact and citation of the published work (see The Effect of Open Access);
Authors are responsible for correctly providing their personal information, including name, keywords, abstracts, and other relevant data, thereby defining how they wish to be cited. The journal’s editorial board is not responsible for any errors or inconsistencies in these records.
PRIVACY POLICY
The names and email addresses provided to this journal will be used exclusively for the purposes of this publication and will not be made available for any other purpose or to third parties.
Note: All content of the work is the sole responsibility of the author and the advisor.
