Supplementation

Although methionine is the only sulfur-containing essential amino acid, it has not been considered as part of supplementation regimes. Since cysteine easily oxidizes to cystine, which has a poor solubility, it is generally supplemented in the form of n-acetylcysteine (NAC). Both directly and indirectly, as a precursor for glutathione, NAC has attracted attention as a potentially protective agent against oxidative injury in numerous conditions including endurance exercise, ischemia reperfusion injury, adult respiratory distress syndrome (ARDS), and cystic fibrosis. In addition, NAC has mucolytic properties in chronic obstructive pulmonary disease (COPD) patients by reducing disulfide bonds of polymers in mucus, blocking their reactivity. Currently, only robust evidence exists for the usefulness of NAC supplementation in the protection against nephropathy, induced by administration of iodine-containing contrast agents for radiological imaging in patients with chronic renal failure, in the reduction of the number of exacerbations and disability in COPD patients, and in the treatment of liver injury induced by acetaminophen intoxication. On the other hand it has been suggested that glutathione depletion by buthionine sulfoximine administration potentiates the effect of radiotherapy by increasing the susceptibility of tumor cells to radiation-induced oxidative injury.

In a few studies it has been demonstrated that taurine supplementation improves retinal development in premature babies receiving parenteral nutrition. Human data on the efficacy of taurine supplementation in so-called energy drinks are very limited. In the absence of taurine supplementation in children taurine concentrations drop, suggesting its conditional indispensability also in the postneonatal period. This has led to the addition of taurine to standard feeding formulas for infants and growing children.

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