谷胱甘肽口服、舌下含服、NAC对照实验
藥物形式:
| 服用形式 | 藥物形式 | 服用頻次 | 
| PO(口服) | L-谷胱甘肽 |   150mg/片, 3次/天  | 
| NAC |   200mg/片 1次/天  | |
|   subligual (舌下含服)?  | 
3周隨機交叉實驗、20個人
V1、V2、V3表示定期隨診
wash-out表示消除前面一種藥物對后面的影響。(這樣的好處是實驗都發生于同一群樣本身上)
P1、P2、P3中的P表示period?
本篇博客解釋論文【1】
Cysteine is the limiting factor for GSH synthesis and its represents 33.6% of the GSH molecule [24]. Providing 200 mg of cysteine (commercial dosage) would be suffificient for the body to theoretically synthetize de novo up to 600 mg of GSH(200mg的半胱氨酸可以合成600mg的谷胱甘肽) Each product was administered successively during three periods (P1, P2 and P3) of 21 days each. A wash-out period of 14 days was observed between each product. Six combinations of administration were possible: [NAC-PO-SL]; [NAC-SL-PO]; [PO-SL-NAC]; [PO-NAC-SL]; [SL-PO-NAC]; [SL-NAC-PO] (PO?oral form of GSH; SL? sublingual form). Each combination was randomly assigned to volunteers at the inclusion, by respecting a minimum of three subjects per combination. Each period included three visits: V1; V2 (V1t1072 days) and V3 (V2t1072 days). In total, each volunteer received two preliminary visits (pre-inclusion and inclusion) and nine visits during the protocol. PO、NAC、sublingual排列組合(3*2*1=6種),每種組合隨機分配至少3個志愿者。 Blood tests were realized at the beginning (visit 1, before takingtreatment), at the middle (visit 2) and at the end (visit 3) of every
period, for all the volunteers. At each visit, the following parameters were measured. (服藥前,就診一次,治療中期,就診一次,治療結束后,就診一次) The secondary outcomes contributed to estimate the oxidative stress status of the volunteers: plasma reduced thiols, vitamin E,Total Cholesterol, HDL-C, LDL-C and plasma triglycerides were also measured.(次要結果有助于評估氧化損傷志愿者的應激狀態:血漿還原硫醇、維生素E、總膽固醇、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇和血漿甘油三酯) Carryover effect?延滯效應 wash-out 洗脫期 wash-out是因為交叉實驗設計的時候會有前面一段時間的Carryover effect?,所以需要消除影響。 The comparative analysis of bioavailability between oral GSH and the sublingual form is summarized in Tables 3 and 4.(表3和表4總結了口服和舌下含服兩種形式) (NAC, oral GSH or sublingual GSH)?is reported in Table 5.
下面這段是分析
A comparative analysis was performed: first by taking NAC as reference (comparison NAC vs oral GSH and NAC vs sublingual GSH) and second by comparing the oral GSH to the sublingual GSH form.
 In the oral GSH group, the GSH/GSSG ratio was low at each time and significantly different at V3 (p?0.03) compared to the NAC group.
 In the sublingual GSH group, this ratio tended to be high at each time and was statistically significant at V2 (p?0.03) compared to the NAC group.
 Compared to the oral GSH group, the sublingual group exhibited a higher GSH/GSSG ratio, in particular at V3 (p?0.02).?
表6. 還原硫醇
表7 血漿中的維生素E
表8 脂質狀態
這三張表用來表示志愿者的應激狀態?
3.2.3. Adverse effects Values of the plasma levels of CRPus and liver function markers at each visit for each treatment arm were reported in Table 9. Whatever the marker (hepatic status or ultra-sensitive CRP), no signifificant changes were reported. For all the markers monitored, values were always within the range of normality. All the dosage forms were very well tolerated and no adverse events were reported by the participants, whatever the treatment used.(沒有重大不良副作用) High levels of GSSG are indicative of periods of oxidative stress. The ratio GSH/GSSG is an important marker of redox status In our study, the GSH/GSSG ratios in the NAC and sublingual GSH arms are significantly higher than oral GSH one. It seems that the sublingual GSH form is more useful than the oral form to improve this balance.(服用NAC和舌下模式的GSH/GSSG顯著高于口服方式,很明顯舌下方式明顯好于口服) High levels of GSSG are indicative of periods of oxidative stress. The ratio GSH/GSSG is animportant marker of redox status(GSSG的高水平表明存在氧化應激期。GSH/GSSG的比率為氧化還原狀態的重要標志) In our study, the GSH/GSSG ratios in the NAC and sublingual GSH arms are significantly higher than oral GSH one. It seems that the sublingual GSH form is more useful than the oral form to improve this balance. One possible explanation of these results is that oral GSH undergoes partial hydrolysis and oxidation during the digestive process. Therefore, the liver has to synthetize de novo GSH from
precursors.
(在我們研究發現,NAC和舌下GSH含服的GSH/GSSG比率明顯高于口服GSH。在改善這一點上,舌下含服GSH形式似乎比口服形式更有用對這些結果的一種可能解釋是,口服GSH在消化過程中忍受部分水解和氧化過程因此,肝臟必須從肝臟中重新合成GSH前體。)
Reference:
【1】Effects of N-acetylcysteine, oral glutathione (GSH) and a novel sublingual form of GSH on oxidative stress markers: A comparative crossover study.
總結
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