NAC N-Acetylcysteine

is about the NAC or n-acetyl cysteine this is an amino acid or it's actually a precursor to an amino acid so let's start talking about that one so I'm going to share my screen and we will talk about it so this is The Situation's 4.4 million people infected in 302 100,000 deaths okay so let's start hey guys have you so thank you very much for joining we are going to start with the n-acetyl cysteine or also called NAC so let's talk about this first of all look at this formula here this formula and look at this formula the basic difference between them is this ty all sorry acetyl group here this has it a group here so basically n-acetylcysteine this guy is a derivative of libro cysteine which is an amino acid and then to me is that we have a an asset I will attach to the end over here good hey guys thank you very much for everyone for joining today's lecture is very important and as it l-cysteine is a very important supplement for inflammation control for proper immune response for proper oxidation-reduction functions for proper control of reactive oxygen species for proper control of the thrombo thrombotic events in the common 19 and other viral diseases or bacterial diseases so this this is a very important topic that we are discussing today and we're talking about the NSD l-cysteine which is a derivative of l-cysteine which is and so l-cysteine this guy is an amino acid now the question is why don't we take the l-cysteine or this guy instead of its derivative that is this one the reason for that is that when we use l-cysteine when we give l-cysteine it goes into cells where the function is not very interesting on the other hand n-acetylcysteine or NAC when we administer that it goes into those cells where it is really useful plus it is more easily permeable into the cells as well this is why as a supplement we administer n-acetylcysteine instead of l-cysteine which is here now else which is of course a form of an acetyl cysteine has a few functions that are interesting so number one to l cysteines bind together through a disulfide bond so if you see here see this see this H over here so this is a reduced form so we release the h we have two of these molecules two of these molecules come together release H that means they get oxidized a disulfide bond and they come together when they are together these guys together are called cysteine as well or cysteine so that is the first important thing actually the second important thing to know that there are true pronounced similarly words one is l-cysteine or cysteine and the other one is also pronounced cysteine but the Spelling's are different one is e I and E and the other one is I and E the difference between them is cysteine I'm just gonna say it cysteine the one that has a IME that is one amino acid and cysteine is two amino acids joined together with the disulfide bonds that is the difference between them now this amino acid is not an essential amino acid our body can manufacture it but still providing supplements can help us the the dimer here this dimer when it is formed it is formed with yourself remember these sulfur bonds here it is formed with those sulfur bonds and there are a couple of benefits of this number one these sulfur bonds here or disulfide bond here it is very easy to become reduced so it takes part so it is this whole molecule here is called a nucleophilic molecule plus it is easy to break as well at the sulfur bonds plus because these sulfur bonds are between the two amino acids it is easy to form tertiary shapes of the proteins so when we have a protein thread so let us say here is a protein thread and we want to make that into a three dimensional globular structure let's say this is a hemoglobins globin this structure formation needs lots of sulfur disulfide bonds that offer the protein to be folded correctly so disulfide bonds are important so once again going back to this one cysteine which are two cysteines bound together with the disulfide bound bond they have two basic functions number one they create mechanical linkages in the within the protein to create 3d shapes of the protein if this was not happening we will all be flat like a paper so this 3d structure is given by two our proteins is given by this this dimer secondly because disulfide bonds are easy to oxidize to reduce that is why these take part in oxidation reduction actions as well inside the cell so with this going back to the discussion here we have this n-acetylcysteine that will make or help make cysteine now cysteine here this guy is also a precursor for a glutathione remember yesterday we talked about glutathione so just a very quick discussion from yesterday we talked about here remember we talked about reactive oxygen species that we have oxygen here oxygen when we reduce it with an electron it becomes superoxide when we further reduce it with another electron it becomes h2 o2 when we further reduce it then it becomes h2o or water water is the most reduced form and the oxygen here is the most oxidized form and then we know that in this process there can be reactive oxygen species or these masters that can be formed which can cause DNA break they can cause lipid break they can cause protein break and when we have viral infections or bacterial infections or external stressors they also help produce reactive oxygens and it is important that we counter them and we saw yesterday that we had NADPH and we had glutathione that helped with that correct so keep that in mind right so daddy says I'm one step daddy says I'm one step ahead of you doctor I order Tennessee and I have it in which to take help me bring it bring up much should I contract absolutely so you should take NSE without even the Cobra 19 NSE is in the world WH O's essential drug lists most safe drug which is an essential drug as well so back here n-acetylcysteine eventually is also important to help make glutathione in the reduced form which is called glutathione as such so gsh now here is the chemical formula for the glutathione and if you see here in this this part is cysteine this part is glycine and then this part is glutamic acid so there are 3-3 amino acids that come together to make loot at ion this is why it is called a tripeptide over three peptides or three amino acids so it's a small it's a small protein please keep that in mind that small protein this being a small protein is an important thing for us to know because this tiny molecular weight of this glutathione will be used up later to react with the reactive oxygen species so this is what is called a scale vendor molecule as well but we saw that yesterday that once we have the glutathione we saw this thing that here are the Masters these are the deities we want to oxidize and reduce them to make them into water to reduce them we have to oxidize something and here is the to GS h 2 GS h which will be oxidized into GS gee so really these are two glutathione molecules or that come together they become oxidized and they become this in that process the reactive oxygen species become reduced and they become water so all good the good thing is many of our molecules that can become oxidized sometimes they become wasted they are oxidized and they are destroyed glutathione can become oxidized and then can become reduced again and become available again so this is a guy who can be punched around by the reactive oxygen species get destroyed then become regenerated like a Phoenix and then get destroyed again so this is the function of glutathione which is very important to fight with the infections and you can imagine this that if a cell has an infection in it and there are reactive oxygen species in it then the glutathione levels have to be high so that we can fight with the reactive oxygen species which is a case a severe case in case of Corbett 19 and for this glutathione to be present in the right amounts we need NSC so NSC would help replenish glutathione this is a very very important thing and I would just very quickly show you a study so this is what is a nested cysteine glutathione here is a study which is very interesting in this study if you see here they have shown two functions of NAC one of the function of the NSC is that when glutathione is used up for example this is tylenol toxicity or Perez de Mol toxicity so this is Paris tamal when it becomes toxic this is its metabolites in the liver and if it is in too much quantities it causes liver cell damage and immune response or inflammation in the liver causing death now this metabolite of peristyle or Tylenol is further reduced or sorry oxidized by gsh but if GH itself is depleted because there is too much of the toxic substance then we we would start getting the toxic effects of the metabolites so what happens is NAC is necessary to produce cystines remember NSE and cysteine are derivatives of each other and these cysteines are necessary to produce glutathione that is what we were just talking about and then glutathione once replenished can take care of the toxicity or toxic metabolites this is why Tylenol or Paris thermal toxicity the antidote is the IV or oral beautify on or sorry NSE similarly we will see here the other function of NSE in a second but I wanted to make sure that we we are aware of how this works okay so now once we have the glutathione available one function of that is taking care of the reactive oxygen species second function we just saw is the for example tylenol toxicity and taking care of that then here is another important function this is also very very important so look here is the situation these are the this monster here this monster are the reactive oxygen species so let's say there is a patient who has gotten covered 19 infection or influenza infection or some other reason to have reactive oxygen species stress once that stress is present please realize this one in our cell there are two types of ways to counter the reactive oxygen species one we have enzymes that can actually convert reactive oxygen species into more reduced form or water they can kind of help us detoxify them so these enzyme examples can be catalyzes peroxidases superoxide dismutase --is these are the enzymes that can make superoxide sorry reactive oxygen species and kind of kill them but these enzymes enough so what do we do we also need something that can become a target of reactive oxygen species intentionally this is like a decoy it is we need a small thing remember glutathione is small that can stand in front of this bully the reactive oxygen species and the bully would try to oxidize this thing and then bully would think that I have done a damage to this but that little hero will become alive again by becoming reduced again so who is that we need a small molecule that can go through oxidation reduction repeatedly that is glutathione and who helps us make more glutathione NAC people with the NAC deficiency have more infections and have more inflammation and have more cellular damage and have more lung damage because of the reactive oxygen species and when I said lung damage I want to make sure that we reconsider this there is a study and show you that study there is a study that that says what that has looked at the here if you look at this study this study says repeating glutathione by NAC so using NSE the drug that we are or the supplement we are discussing today by using NSC when we made the gsh it has the effect of reducing pmn into the lung but increases them at the site of infection so somehow NSC administration helps glutathione production which in turn helps balance out the immune response and focuses that respond to the pathogen instead of healthy tissues so this is a very very important concept here so again glutathione I'll go back here replenish replying TSH with NEC so although we are singing praises of gsh over here but this G has such level is maintained by NSE so if we do not have an SI when the SH level is not going to be maintained if we do not have the correct the SH level then B reduction of the reactive oxygen species will not occur that means continuous damage will happen good so far so what we have done so far is a couple of things what we have seen is that n-acetylcysteine gives rise to cysteine dimer which is part of the enzymes and proteins that need to be folded to make a globular protein so that is one function second function is it is an important precursor to make glutathione and then we looked at glutathione in as some brief way as well to see okay if it is a precursor for glutathione helps us make glutathione what is the use of glutathione and we know that glutathione plays a role in antioxidant that is one it also plays a role in the similar way by oxidation of the paracetamol Italian all metabolites and then we also saw that it is necessary we call it a scavenger molecule it is necessary to be a scavenger molecule in our cells for reactive oxygen species and remember it has to be in sufficient quantities the reactive oxygen species can connect with it if we have a million reactive oxygen species in a cell and only hundred thousand-plus earth ions then that is not sufficient if there are million reactive oxygen species we probably need five million glutathione to sit around then another important function of glutathione so we are still singing the praises of glutathione I'm going to go back to NAC in a second the important connection here is NSC helps have the right quantity of glutathione another important thing is that when the virus or any pathogen is taken up by our first responders for example macrophage in this case the inside the cell at that time it is important that lysosome l activity start what does that mean the activity to break down the pathogen that has to start and for that activity for breaking down a pathogen what do we do we normally break disulfide bonds in that pathogen in the proteins of the pathogen and guess who is needed for that glutathione and who is needed for glutathione NAC if I do not have enough NAC then I do not have enough glutathione if I do not have enough glutathione then I do not have enough glutathione to break the pathogens that are in our immune cells so immune cell function is also helped by glutathione which is helped by NSE so hopefully this much is clear we have seen a bunch of effects of NAC through glutathione plus we have seen that NSE helps make proteins now let's look at some direct effect of NSC as well so here NSE was used in the past as a mucolytic in respiratory infections or respiratory diseases for example cystic fibrosis what happens is that here if you look at it and this is a study as well that study is yeah here so I'm I've kind of free drawn this picture so this is a study in this study what they're saying is that imagine this green and black they are two strands of mucus these are glycoproteins right so these are 2 glycoprotein strands Y will become thick and elastic and sticky is because they developed disulfide bonds between them because the developed disulfide bond between them those fibers those glycoproteins those mucus threads they fuse with each other they bind with each other and they become plugs and they become sticky now to break them we give NSE so we're not talking about glutathione anymore now we are singing the praises of Hennessy itself the NS even given would attack these disulfide bonds and would cause beer reduction so see here this is one thread this is the other thread on one thread the sulfur is now reduced on the others thread sulfur now has NSE attached to it and then there is one more attack and then those both of those are going to become reduced the point is the NSE can attack directly the disulfide bonds and break them now keep this in mind this is not only for necessary for mucolytic this is also going to be necessary to break the bond between a platelet and one Willebrand factor which is a thrombotic outcome of Corbett 19 remember we have been talking about it for days now that what happens is when the curve in 19 is in our in fact sir endothelial cells through the s2 then the endothelial cells become damaged plus they released the what is that 1 billion factor from their wibble plot a body is plus a sub endothelial von Willebrand factor is released plus the von Willebrand factor that was present inside the plasma which is stabilizer for factor eight that becomes stressed out as well and when that becomes stressed out that those want von Willebrand factors they show disulfide bonds that start connecting together and then start connecting with the platelet that is how platelet aggregation starts and this guy NSE breaks disulfide bonds so imagine the importance of Hennessy by to reduce the thrombotic activity of kovat 19 and thrombotic activity in general so this is one example here mucus plug is broken down into D into singles so normally what happens is that we have the NSE we have a protein that has disulfide bonds in it and NSE comes in in the first goal and it breaks this disulfide bond then if you do it again so see this got reduced if you put NSE again on this guy then even this bond would get reduced to SH so there's a two attacks that it does but eventually it graves a disulfide bond when it breaks the disulfide bond that breaks breaks aggregates good now with this all in mind just now look and cysteine this is the last part and connected to covert 19 as well and connected to any other infection as well so first of all we just talked about it it's a gsh precursor through the GS h it will do antioxidant activity and a very important thing against covert nineteen or other diseases which are infective or which cause reactive oxygen species stress that is one very important second reduces platelet aggregation so we just talked about it let's look at it once more I've been drawing this diagram for some days now I think now you would know this diagram by heart so there are the this is a blood vessel this is a blood vessel these are endothelial cells and then under the endothelial cell are the one really brain factors inside the endothelial cell and the Gribble cloudy body are also 1 million factors and then inside the plasma are like sailing like ships are also 1 billion factors which are which are stabilizing factor 8 now when the Co bit 19 when this asked of 2 comes into our body and it connects with the s2 that is 2 connection eventually would cause local inflammation correct which would then cause destruction of the local endothelial cells so when they are destroyed what happens is collagen is exposed we we almost make this diagram daily so I'm not spending too much time on it the one Willebrand factor is exposed then this ship like von Willebrand factor that is running around in the plasma it is called high molecular weight one Willebrand factor the one that is under the endothelium is called low molecular weight one Willebrand factor the one that is running around in the plasma is called high molecular weight von Willebrand factor this high molecular weight von Willebrand factor is a very sensitive protein it is very very sensitive it is very moody small shear small stress to it causes it to start creating disulfide bonds so as soon as the the corporate 19 is present and there is stress in the blood vessel through which this ship was passing then what happens is that B's one really brain factors all of them they start showing disulfide they start opening up their disulfide areas and they start bonding now this also starts bonding with platelet these disulfide bonds also allow platelets to start bonding there as well and that is the start of the platelet aggregation or thrombosis the NSE has a speciality of cutting the disulfide bonds this is its direct action we are now talking about two glutathione it has a direct action on cutting the disulfide bond which would release the platelets and which would also cause less platelet aggregation which would cause less inflammation less from vs. less hypercoagulable 'ti in the patient of cord 19 so imagine just like vitamin B is crucial now there are so many studies out that say that if anybody who is deficient in vitamin D has a higher chance of developing severe COBIT 19 and even dying from it similarly NSC is another supplement which is really important to reduce the hypercoagulability and to fight with the reactive oxygen species anybody who asked you how does it fight B Roz you say through the glutathione and how does it fight the hypercoagulability your answer is going to be it reduces the thrombotic plaques by attacking the disulfide bonds in the world Willebrand factor which will reduce the coagulation so that then going back here so this is a platelet aggregation we just talked about where as the molten or toxicity management we already talked about it mucolytic so cystic fibrosis and COPD patients used to use them because it breaks the mucus plugs we just talked about that as well then it direct of reducing the function of coagulation factor to seven nine and ten that is also its direct evidence based observation I do not know the exact mechanism for how does it do it I would suspect it does the same way as by attacking the disulfide bonds but I'm not sure so it reduces the clotting by reducing the factors activity as well so look how many ways it is reducing the clotting number one platelet aggregation reduction number two blood clotting factor reduction number three disulfide bond in the van Willebrand factor so all of those are very very important for inflammation and reduction and control so this is what is n-acetylcysteine function I hope it is clear I hope you you enjoyed that the nsel cysteine is such a beautiful product it is in the WHI list of the essential drugs it is in that list and it is the most safe drug it is safe in pregnancy as well as far as I have studied but if somebody is pregnant they should not take anything unless they talk with their doctor so I don't want to put you or your baby at risk so do not listen to me there so this is what we have how does what are the three functions or four functions of NSE may it is a precursor to make dimer cysteine dimers which make proteins that gives the and those dimers are in the proteins to make tertiary proteins or globular proteins like hemoglobin is globin secondly it is a precursor to make glutathione which helps in the oxidation reductions plus glutathione is a scavenger Thyle molecule as well helps the macrophages kill the pathogens as well plus glutathione is also participant in the prevention or the as an antidote for toxicity in glutathione has many other functions and then so that is 2/3 NAC can directly be antithrombotic by reducing the platelet function or aggregation by reducing the function of some blood clotting factors by reducing the disulfide bond in von Willebrand factor so that they do not connect with platelets so by reducing the platelet aggregation initiation and then this is the basic function so I hope that this is a third after this who would consider that NSC should be something that should be needed as well and what I try to do was I did not go to the supplements and because everyone who's selling a supplement tries to just you know talk praises of it I went into scientific papers to see that what are the mechanisms that are important so yes it is found in the natural food our body can make it as well so I'm looking at a comment there and then we can take supplements to again when you take supplements we take n-acetylcysteine instead of cysteine because NS tell cysteine is easily permeable and can be taken orally and goes to the right cells so this is what we have tell me what would you like to do tomorrow and for today I would beg leave we will talk again tomorrow please like subscribe to my channel and share this and also how about today I show you that I also have a website which I have never ever tried to show the team the website because I did not want to appear commercial when I'm doing these for a noble cause however since YouTube has started taking down our lectures I want you to show you that at least be aware that dr. Beane calm is the site where all of these videos are eventually going and I'm putting them there so for example if I go to the video library the these videos I am uploading them here so if they are not available on YouTube they will be available here but again the point is not this that I'm trying to be salesy I think after 2 months for the first time I brought it up just so that if people are looking for these videos we'll put them there I hope YouTube stops doing what they're doing but meanwhile we have a backup so thank you very much tell me about topic would you like tomorrow is it pregnancy and hope it 19 I have a bunch of topics that students had asked for for example NSAIDs and Kobe 19 pregnancy and probit 19 alcohol and COBIT 19 then mortality in various ethnic populations we have done that vascular endothelial growth factor as a final common pathway for the goodnight you elderly people and what happens I think I've done healed fatigue syndrome then cardiovascular diseases we've done so there are a bunch of topics I can either pick up one of these or please share a topic here that she would like me to talk about so for today thank you and see you tomorrow please share this thank you very much bye-bye

Channel: Drbeen Medical Lectures

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Keywords: drbeen, medicine, nursing, med school, microbiology, sars-cov-2, covid-19, coronavirus, usmle, mbbs, nclex, Health (Industry), Medicine (Field of Study), Pathology (Medical Specialty), what is, nursing (field of study), why are?, n-acetylcysteine, acetylcisteine, cystine, glutathione, reactive oxygen speices, g6pd, glucose 6 phosphate dehydrogenase, gluose, glucose 6 phosphate, thiol, acetyl, platelet aggregation, hypercoagulability, von willebrand factor, vwf, factor VIII, redox

Id: K8kKWgsGIU8

Length: 35min 30sec (2130 seconds)

Published: Thu May 14 2020