Liver disease is highly prevalent in the world. Oxidative stress (OS) and inflammation are the most important pathogenetic events in liver diseases, regardless the different etiology and natural course. N-acetyl-l-cysteine (the active form) (NAC) is being studied in diseases characterized by increased OS or decreased glutathione (GSH) level. NAC acts mainly on the supply of cysteine for GSH synthesis. The objective of this review is to examine experimental and clinical studies that evaluate the antioxidant and anti-inflammatory roles of NAC in attenuating markers of inflammation and OS in hepatic damage. The results related to the supplementation of NAC in any form of administration and type of study are satisfactory in 85.5% (n = 59) of the cases evaluated (n = 69, 100%). Within this percentage, the dosage of NAC utilized in studies in vivo varied from 0.204 up to 2 g/kg/day. A standard experimental design of protection and treatment as well as the choice of the route of administration, with a broader evaluation of OS and inflammation markers in the serum or other biological matrixes, in animal models, are necessary. Clinical studies are urgently required, to have a clear view, so that, the professionals can be sure about the effectiveness and safety of NAC prescription.

Advanced glycation end products (AGEs) are generated spontaneously in cells; however, under conditions of hyperglycemia and lipid peroxidation, their levels are higher than usual, which contribute to the development of diseases such as the nonalcoholic fatty liver disease (NAFLD). NAFLD is associated with oxidative stress (OS), which is linked to the transition of steatosis to steatohepatitis due to lipid peroxidation. The AGE-receptor interaction in hepatic stellate cells leads to an increase in reactive oxygen species and enhances the proliferation and activation of these cells, worsening liver fibrosis and disease progression. In this vicious cycle, there is production of (carboxymethyl)lysine, a biomarker for products of advanced glycation and lipid peroxidation, being a shared component between the two pathways. In this review, we aim to compile evidence to support the basic molecular mechanisms of AGEs and OS generation and their influence, independently or combined, on the evolution of NAFLD. The deeper understanding of the interrelations of AGEs + OS may help to elucidate the pathogenic pathways of NAFLD and to devise rational therapeutic interventions for this disease, with an expected positive impact on quality of life of patients.

Ozone therapy is a technique used in several specialties of equine medicine; however, there are few studies on its use in vaquejada (cowboy competition) athlete horses. This study aims to evaluate the potential effect of ozone gas administered by two different routes on hematological and biochemical values and the oxidative stress marker in vaquejada athlete horses. For this, nine healthy equines that followed a training protocol and underwent two treatments were used with an 8-day wash-out between them. The major ozonated autohemotherapy (MOA) treatment group received a volume of 600ml of the O2-O3 mixture at a concentration of 60 µg/mL, and the rectal insufflation (RI) treatment group received 5mL of gas per kg of body weight at a concentration of 15µg/kg performed every 24h on three consecutive days. Results were significant for RBC, hematocrit, and hemoglobin in the hematological variables, and AST and lactate for biochemical and malondialdehyde variables. No statistically significant differences were found in comparisons between treatment groups. Thus, we can conclude that there is no difference between the two therapies, indicating that the two techniques are effective for the application of ozone therapy in horses competing for vaquejada.

Objective. To compare redox imbalance and inflammation biomarkers in umbilical cords from pregnancies with and without preeclampsia (PE) and to analyse their relationships with perinatal outcomes. Methods. A controlled cross‐sectional study was conducted in Maceió, Alagoas, Brazil, that involved pregnant women with PE and a group of women without the disease, through the application of a standardized questionnaire. After delivery, umbilical cord samples were collected to measure antioxidant defense, products from oxidative damage, and inflammation biomarkers such as myeloperoxidase (MPO), interleukin‐ (IL‐) 6, IL‐8, IL‐10, and tumor necrosis factor‐alpha (TNF‐α). Statistical analyses were performed using Stata version 13.0 software and IBM Statistical Package for the Social Sciences (SPSS) 20.0, adopting a 95% confidence level (α = 0.05), with the chi‐square test, the Wilcoxon–Mann–Whitney test, and the multinomial and Poisson regression tests. Results. One hundred PE pregnant women and 50 women without the disease were studied. The umbilical cords from PE pregnancies showed higher levels of reduced glutathione (GSH) (p ≤ 0.001), glutathione peroxidase (GPx) (p = 0.016), and malondialdehyde (MDA) (p = 0.028) and lower levels of IL‐6 (p = 0.030) and TNF‐α (p ≤ 0.001) than the other group, with some associations among these biomarkers with perinatal outcomes. Conclusion. The higher levels of GSH and GPx, in addition to the lower levels of IL‐6 and TNF‐α, found in the PE umbilical cord, may result from adaptive mechanisms to maintain the oxidative and inflammatory balance; however, despite these changes, the damage to the cell membranes was not minimized, as the MDA level was higher in women with PE than in women without the disease. This implies that a redox imbalance is present, confirming that other physiological and adaptive mechanisms are being activated to preserve foetal health. Therefore, the present work unveils an important role of the umbilical cord in controlling redox imbalance and inflammation in PE pregnancies. Our results reinforce the necessity for continuous research on GSH as a protective compound for the perinatal outcome, especially in PE women.

Background/Objectives: This study aimed to evaluate the effects of oral administration of N-acetylcysteine (NAC) in pregnant women with preeclampsia (PE), using serum markers of redox imbalance and cytokine levels and perinatal outcomes. Methods: A double-blind, randomized, placebo-controlled pilot study was carried out from 2021 to 2023. The study was retrospectively registered with REBEC (Brazilian Clinical Trials Registry). After screening, women were randomized into 2 groups according to the type of supplementation: 600 mg of NAC (NAC group) or capsules containing 2% colloidal silicon dioxide and 98% microcrystalline cellulose (placebo group) until delivery. Blood samples were collected to quantify biomarkers of redox imbalance and cytokine levels. Questionnaires containing socioeconomic, clinical, obstetric, and anthropometric data were applied. Results: A total of 51 pregnant women with PE were included (26 in the placebo group and 25 in the NAC group). The use of NAC was associated with a higher gestational age at birth (GA) of the conceptus (placebo group: 37.39 weeks ± 1.96 SD vs. NAC group: 38.45 weeks ± 1.51 SD; p = 0.044). A moderate effect size was observed for this variable (Cohen’s d = 0.52). However, treatment allocation (NAC vs. control) was not independently associated with gestational age at birth after adjustment for covariates (F(1,28) = 0.144; p = 0.707; η²p = 0.005). The adjusted mean difference between groups was 0.92 weeks (95% CI: −0.16 to 2.00). No other significant effects on redox and inflammatory markers were identified using NAC. Conclusions: NAC supplementation did not impact the mode of delivery between the NAC and placebo groups. As a secondary exploratory finding, a possible trend toward prolonged gestational age was observed in the NAC group; however, this result should be interpreted with caution, given the exploratory nature of the analysis, the neutrality of the primary outcome, and the limited sample size.