ALCARvsNAC (N-Acetyl Cysteine)

ALCAR crosses the blood-brain barrier via the organic cation transporter (OCTN2) more effectively than L-carnitine. In neurons, it is hydrolyzed by carnitine acetyltransferase to donate its acetyl group to coenzyme A, forming acetyl-CoA—which can then be used for acetylcholine synthesis via choline acetyltransferase, effectively providing raw material for the memory neurotransmitter. ALCAR also transports long-chain fatty acids across the inner mitochondrial membrane via the carnitine palmitoyltransferase system for beta-oxidation and ATP production. ALCAR activates nerve growth factor (NGF) signaling, possibly through modulation of NGF receptor (TrkA) expression or downstream MAPK/ERK pathways. It has antioxidant properties, reducing lipid peroxidation in mitochondrial membranes and scavenging free radicals. These mechanisms support cognitive function and neuroprotection.

NAC provides cysteine, the rate-limiting substrate for glutathione (GSH) synthesis via gamma-glutamylcysteine ligase (GCLC) and glutathione synthetase (GSS). GSH is the primary intracellular antioxidant, essential for GPx and GST-mediated detoxification of reactive oxygen species in neurons. NAC also modulates glutamate via the cystine-glutamate antiporter (System Xc-, composed of xCT and 4F2hc) — NAC is deacetylated to cysteine, which exchanges for glutamate; the increased extracellular cystine is reduced to cysteine intracellularly, while the exchange increases extrasynaptic glutamate, which activates inhibitory mGlu2/3 autoreceptors on presynaptic terminals, reducing excessive glutamatergic signaling and compulsive behaviors. This glutamate modulation is the basis for psychiatric applications (OCD, addiction). NAC may also directly modulate NMDA receptors via redox sites.