However, the use of NAC for immunomodulation in HIV patients has not yet undergone prospective randomised controlled trials and therefore cannot be recommended as routine therapy in HIV infected, or other immune deficient, patients. N-acetylcysteine would also appear to enhance T cell function in HIV infected patients. It is also possible that NAC may confer benefit in reducing the risks of radiographic contrast nephropathy, although the study suggesting this was probably insufficiently powered to review all patient subsets (e.g. It may also be of use in ameliorating nitrate tolerance. There is also conflicting evidence for the use of NAC in sepsis or ARDS and while there is some evidence to suggest that NAC may be of benefit in acute myocardial infarction, the patient numbers are small. For example, in hepatic failure, there are few studies in man showing improved outcome following NAC therapy. While there is evidence for its effectiveness as an antidote to paracetamol poisoning, its use in other disorders has only experimental or anecdotal support. It also causes vasodilation by increasing cyclic guanosine monophosphate levels, inhibits platelet aggregation, acts as a sulphydryl donor to regenerate endothelial-derived relaxing factor and reduces IL-8 and TNF-alpha production. It acts as an antioxidant, both directly as a glutathione substitute and indirectly as a precursor for glutathione. N-acetylcysteine (NAC) is an amino acid with a MW of 163.2. Evidence-based medicine for Chemical Defense - including efficacy and safety A. Treatment of chemical induced lung injury and respiratory toxicity including exposure to nerve agents, sulfur mustard gas, chlorine, phosgene. Chemical Defense therapeutic area(s) - including key possible uses Name of Chemical Defense therapeutic agent/device
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