Imidazole-Containing Peptidomimetic NACA as a Potent Drug for the Medicinal Treatment of Age-Related Cataract in Humans

Summary: N-alpha-acetylcarnosine probably does good things for cataract patients

Interestingness: 2

Paper by Mark A Babizhayev, Valentina N Yermakova, Anatoly I Deyev and Marie-Christine Seguin. in the Journal of Anti-Aging Medicine, Volume 3, Issue 1, Spring 2000.

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Smallish trial on 49 humans, seeing if N-alpha-acetylcarnosine (NACA) does something for the eyes of cataract patients that are not in bad enough conditiones to go to surgery for it. It seems to do things, good things.

The theory is that the NACA gets converted to L-carnosine in vivo, and this acts as an anti-oxidant preventing or reversing cataracts. Not much more is given, but inhibition of phosphatidylcholine liposomal peroxidation is mentioned. Phosphatidylcholine is a major component of the cell membrane.

They give the NACA in drops to the eyes for two years. All the improvement is seen in the first six months, and after that the levels are maintained. Control subjects deteriorate quite a lot in the period.

This paper has a very long methodology section that probably means something to ophtamologists and optometrists. It also has a lot of decent graphs in the results section.
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The objective of this manuscript is to test the efficacy of Nalpha-acetylcarnosine for the treatment of senile cataract in humans. It was designed as a randomized controlled trial. Forty-nine subjects-volunteers (76 eyes) with an average age of 65.3 ± 7.0 years were enrolled and randomized into two groups at diagnosis of senile cataract. Changes in lens clarity were measured and quantitated over 6 to 24 months thereafter. Patients administered 1% Nalpha-acetylcarnosine (NACA) (26 patients, 41 eyes = Group II), placebo composition (13 patients, 21 eyes) topically (two drops, twice daily) to the conjunctival sac, or were untreated (10 patients, 14 eyes); two latter groups of patients were combined into the control (reference) group I. Patients were evaluated upon entry, at every 2-month (Trial 1) and 6-month (Trial 2) intervals for best corrected visual acuity (b/c VA), by ophthalmoscopy, original techniques of glare test (Trial 1), stereocinematographic slit-image and retro-illumination photography with subsequent interactive digital image analysis and 3D computer graphics of the lens light scattering/absorbing centers. The intra-reader reproducibility of measuring techniques for cataractous changes was good with the overall average of correlation coefficients for image analytical data 0.830 and glare test readings 0.998. Group I of patients demonstrated the variability in densitometric readings of lens cloudings, negative advance in glare sensitivity over 6 months, and gradual deterioration of VA and gross transmissivity of lenses over 24 months comparatively to baseline and the 6-month follow-up examinations. As compared with baseline examination, over 6 months 41.5% of the eyes treated with NACA presented a significant improvement of the gross transmissivity degree of lenses, 90.0% of the eyes showed a gradual improvement in VA to 7-100% and 88.9% of the eyes ranged a 27-100% improvement in glare sensitivity. Topographic study demonstrated less density and corresponding areas of opacification in posterior subcapsular and cortical morphological regions of the lens consistent with VA up to 0.3. The total study period over 24 months revealed that the beneficial effect of NACA is sustainable. No cases resulted in a worsening of VA and image analytical readings of lenses in the NACA-treated group of patients. In most of the patients drug tolerance was good. Statistical analysis revealed the significant differences over 6 and 24 months in cumulative positive changes of overall characteristics of cataracts in the NACA-treated group II from the control group I. The N-acetylated imidazole-containing peptidomimetic NACA is proposed as an effective and physiologically acceptable drug for nonsurgical treatment of age-related and senile cataracts.