Library of References/Articles


Assimakopoulos SF, Marangos M. N-acetyl-cysteine may prevent COVID-19-associated cytokine storm and acute respiratory distress syndrome. Medical Hypotheses. 2020;140:109778. doi:10.1016/j.mehy.2020.109778


Auten RL, Davis JM. Oxygen Toxicity and Reactive Oxygen Species: The Devil Is in the Details. Pediatr Res. 2009;66(2):121-127. doi:10.1203/PDR.0b013e3181a9eafb


Beloqui O, Prieto J, Suárez M, et al. N -Acetyl Cysteine Enhances the Response to Interferon-α in Chronic Hepatitis C: A Pilot Study. Journal of Interferon Research. 1993;13(4):279-282. doi:10.1089/jir.1993.13.279


Bikdeli B, Madhavan MV, Jimenez D, et al. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up. Journal of the American College of Cardiology. Published online April 2020:S0735109720350087. doi:10.1016/j.jacc.2020.04.031


Carpagnano GE, Kharitonov SA, Foschino-Barbaro MP, Resta O, Gramiccioni E, Barnes PJ. Supplementary oxygen in healthy subjects and those with COPD increases oxidative stress and airway inflammation. Thorax. 2004;59(12):1016-1019. doi:10.1136/thx.2003.020768


Casanova T, Garigliany M. N-acetylcysteine: an old drug with variable Anti-influenza properties. Journal of Controversies in Biomedical Research. 2016;2(1):1-8. doi:10.15586/jcbmr.2016.13


Ciriolo MR, Palamara AT, Incerpi S, et al. Loss of GSH, Oxidative Stress, and Decrease of Intracellular pH as Sequential Steps in Viral Infection. J Biol Chem. 1997;272(5):2700-2708. doi:10.1074/jbc.272.5.2700


Craver BM, Ramanathan G, Hoang S, et al. N-acetylcysteine inhibits thrombosis in a murine model of myeloproliferative neoplasm. Blood Adv. 2020;4(2):312-321. doi:10.1182/bloodadvances.2019000967


De Flora S, Grassi C, Carati L. Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment. Eur Respir J. 1997;10(7):1535-1541. doi:10.1183/09031936.97.10071535


Douiev L, Soiferman D, Alban C, Saada A. The Effects of Ascorbate, N-Acetylcysteine, and Resveratrol on Fibroblasts from Patients with Mitochondrial Disorders. JCM. 2016;6(1):1. doi:10.3390/jcm6010001


Ergin B, Guerci P, Zafrani L, et al. Effects of N-acetylcysteine (NAC) supplementation in resuscitation fluids on renal microcirculatory oxygenation, inflammation, and function in a rat model of endotoxemia. Intensive Care Medicine Experimental. 2016;4(1):29. doi:10.1186/s40635-016-0106-1


Fraternale A, Paoletti MF, Casabianca A, et al. GSH and analogs in antiviral therapy. Molecular Aspects of Medicine. 2009;30(1):99-110. doi:10.1016/j.mam.2008.09.001


Fu Y, Fang F, Lu Z, Kuang F, Xu F. N-acetylcysteine protects alveolar epithelial cells from hydrogen peroxide-induced apoptosis through scavenging reactive oxygen species and suppressing c-Jun N-terminal kinase. Exp Lung Res. 2010;36(6):352-361. doi:10.3109/01902141003678582


Geiler J, Michaelis M, Naczk P, et al. N-acetyl-L-cysteine (NAC) inhibits virus replication and expression of pro-inflammatory molecules in A549 cells infected with highly pathogenic H5N1 influenza A virus. Biochem Pharmacol. 2010;79(3):413-420. doi:10.1016/j.bcp.2009.08.025


Hamzeh N, Li L, Barkes B, et al. The effect of an oral anti-oxidant, N-Acetyl-cysteine, on inflammatory and oxidative markers in pulmonary sarcoidosis. Respir Med. 2016;112:106-111. doi:10.1016/j.rmed.2016.01.011


Harrison PM, Wendon JA, Gimson AES, Alexander GJM, Williams R. Improvement by Acetylcysteine of Hemodynamics and Oxygen Transport in Fulminant Hepatic Failure. N Engl J Med. 1991;324(26):1852-1857. doi:10.1056/NEJM199106273242604


Hendrickson RG, Howland MA. A3: Antidotes in Depth - N-Acetylcysteine. In: Nelson LS, Howland MA, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS, eds. Goldfrank’s Toxicologic Emergencies. 11th ed. McGraw Hill Education; 2019:492-500.


Horowitz RI, Freeman PR, Bruzzese J. Efficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases. Respiratory Medicine Case Reports. 2020;30:101063. doi:10.1016/j.rmcr.2020.101063


Hou Y, Wang L, Yi D, et al. N-acetylcysteine reduces inflammation in the small intestine by regulating redox, EGF and TLR4 signaling. Amino Acids. 2013;45(3):513-522. doi:10.1007/s00726-012-1295-x


Jain M, Chandel NS. Rethinking antioxidants in the intensive care unit. Am J Respir Crit Care Med. 2013;188(11):1283-1285. doi:10.1164/rccm.201307-1380CP


Jang DH, Weaver MD, Pizon AF. In vitro study of N-acetylcysteine on coagulation factors in plasma samples from healthy subjects. J Med Toxicol. 2013;9(1):49-53. doi:10.1007/s13181-012-0242-2


Kalebic T, Kinter A, Poli G, Anderson ME, Meister A, Fauci AS. Suppression of human immunodeficiency virus expression in chronically infected monocytic cells by glutathione, glutathione ester, and N-acetylcysteine. Proc Natl Acad Sci USA. 1991;88(3):986-990. doi:10.1073/pnas.88.3.986


Kao SJ, Wang D, Lin HI, Chen HI. N-acetylcysteine abrogates acute lung injury induced by endotoxin. Clin Exp Pharmacol Physiol. 2006;33(1-2):33-40. doi:10.1111/j.1440-1681.2006.04320.x


Kuyumcu A, Akyol A, Buyuktuncer Z, Ozmen MM, Besler HT. Improved oxidative status in major abdominal surgery patients after N-acetyl cystein supplementation. Nutr J. 2015;14:4. doi:10.1186/1475-2891-14-4


Lai KY, Ng WY, Osburga Chan PK, Wong KF, Cheng F. High-dose N-acetylcysteine therapy for novel H1N1 influenza pneumonia. Ann Intern Med. 2010;152(10):687-688. doi:10.7326/0003-4819-152-10-201005180-00017


Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. Published online April 6, 2020. doi:10.1007/s00405-020-05965-1


Liu J-Q, Lee T-F, Chen C, Bagim DL, Cheung P-Y. N-Acetylcysteine Improves Hemodynamics and Reduces Oxidative Stress in the Brains of Newborn Piglets with Hypoxia-Reoxygenation Injury. Journal of Neurotrauma. 2010;27(10):1865-1873. doi:10.1089/neu.2010.1325


Liu Q, Zhou Y, Yang Z. The cytokine storm of severe influenza and development of immunomodulatory therapy. Cell Mol Immunol. 2016;13(1):3-10. doi:10.1038/cmi.2015.74


Lythgoe MP, Middleton P. Ongoing Clinical Trials for the Management of the COVID-19 Pandemic. Trends in Pharmacological Sciences. Published online April 2020:S0165614720300705. doi:10.1016/


Mahmoud KM, Ammar AS. Effect of N-acetylcysteine on cardiac injury and oxidative stress after abdominal aortic aneurysm repair: a randomized controlled trial. Acta Anaesthesiol Scand. 2011;55(8):1015-1021. doi:10.1111/j.1399-6576.2011.02492.x


Martinez de Lizarrondo Sara, Gakuba Clément, Herbig Bradley A., et al. Potent Thrombolytic Effect of N-Acetylcysteine on Arterial Thrombi. Circulation. 2017;136(7):646-660. doi:10.1161/CIRCULATIONAHA.117.027290


Matera MG, Calzetta L, Cazzola M. Oxidation pathway and exacerbations in COPD: the role of NAC. Expert Review of Respiratory Medicine. 2016;10(1):89-97. doi:10.1586/17476348.2016.1121105


Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet. 2020;395(10229):1033-1034. doi:10.1016/S0140-6736(20)30628-0


Miller LF, Rumack BH. Clinical safety of high oral doses of acetylcysteine. Semin Oncol. 1983;10(1 Suppl 1):76-85.


Moradi M, Mojtahedzadeh M, Mandegari A, et al. The role of glutathione-S-transferase polymorphisms on clinical outcome of ALI/ARDS patient treated with N-acetylcysteine. Respir Med. 2009;103(3):434-441. doi:10.1016/j.rmed.2008.09.013


Morris AA, Zhao L, Patel RS, et al. Differences in Systemic Oxidative Stress Based on Race and the Metabolic Syndrome: The Morehouse and Emory Team up to Eliminate Health Disparities (META-Health) Study. Metabolic Syndrome and Related Disorders. 2012;10(4):252-259. doi:10.1089/met.2011.0117


Nanda F, Anggiitha GR. Efficacy of N-Acetylcysteine (NAC) in Reducing Acute Exacerbation in Chronic Obstructive Pulmonary Disease (COPD) Patient: An Evidence-Based Case Report. adv sci lett. 2018;24(9):6562-6566. doi:10.1166/asl.2018.12778


Neri S, Ierna D, Antoci S, Campanile E, D’Amico RA, Noto R. Association of alpha-interferon and acetyl cysteine in patients with chronic C hepatitis. Panminerva Med. 2000;42(3):187-192.


Niemi TT, Munsterhjelm E, Pöyhiä R, Hynninen MS, Salmenperä MT. The effect of N-acetylcysteine on blood coagulation and platelet function in patients undergoing open repair of abdominal aortic aneurysm: Blood Coagulation & Fibrinolysis. 2006;17(1):29-34. doi:10.1097/01.mbc.0000195922.26950.89


Olejnik J, Hume AJ, Mühlberger E. Toll-like receptor 4 in acute viral infection: Too much of a good thing. PLoS Pathog. 2018;14(12):e1007390. doi:10.1371/journal.ppat.1007390


Phillips M, Cataneo RN, Greenberg J, Grodman R, Gunawardena R, Naidu A. Effect of oxygen on breath markers of oxidative stress. Eur Respir J. 2003;21(1):48-51. doi:10.1183/09031936.02.00053402


Polonikov A. Endogenous Deficiency of Glutathione as the Most Likely Cause of Serious Manifestations and Death in COVID-19 Patients. ACS Infect Dis. Published online May 28, 2020:acsinfecdis.0c00288. doi:10.1021/acsinfecdis.0c00288


Saddadi F, Alatab S, Pasha F, Ganji MR, Soleimanian T. The effect of treatment with N-acetylcysteine on the serum levels of C-reactive protein and interleukin-6 in patients on hemodialysis. Saudi J Kidney Dis Transpl. 2014;25(1):66-72. doi:10.4103/1319-2442.124489


Sanguinetti CM. N-acetylcysteine in COPD: why, how, and when? Multidiscip Respir Med. 2015;11(1):8. doi:10.1186/s40248-016-0039-2


Santus P, Corsico A, Solidoro P, Braido F, Marco FD, Scichilone N. Oxidative Stress and Respiratory System: Pharmacological and Clinical Reappraisal of N-Acetylcysteine. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2014;11(6):705-717. doi:10.3109/15412555.2014.898040


Siddiqi HK, Mehra MR. COVID-19 Illness in Native and Immunosuppressed States: A Clinical-Therapeutic Staging Proposal. The Journal of Heart and Lung Transplantation. Published online March 2020:S105324982031473X. doi:10.1016/j.healun.2020.03.012


Soltan-Sharifi MS, Mojtahedzadeh M, Najafi A, et al. Improvement by N-acetylcysteine of acute respiratory distress syndrome through increasing intracellular glutathione, and extracellular thiol molecules and anti-oxidant power: evidence for underlying toxicological mechanisms. Hum Exp Toxicol. 2007;26(9):697-703. doi:10.1177/0960327107083452


Song Q, Lin L, Chen L, Cheng L, Zhong W. Co-administration of N-acetylcysteine and dexmedetomidine plays a synergistic effect on protection of LPS-induced acute lung injury via correcting Th1/Th2/Th17 cytokines imbalance. Clin Exp Pharmacol Physiol. 2020;47(2):294-301. doi:10.1111/1440-1681.13196


Sun J, Song P, Wang Y, Chen Y. Clinical efficacy of acetylcysteine combined with tetrandrine tablets in the treatment of silicosis and the effect on serum IL-6 and TNF-α. Exp Ther Med. Published online August 30, 2019. doi:10.3892/etm.2019.7966


Tangül SU, Çakmak AM, Çağlayan O, Bozdoğan Ö. Prevention of the harmful effects of free oxygen radicals by using N-acetylcysteine in testicular torsion. Journal of Pediatric Urology. 2020;16(1):42.e1-42.e8. doi:10.1016/j.jpurol.2019.10.028


Thibaut HJ, Linden L van der, Jiang P, et al. Binding of Glutathione to Enterovirus Capsids Is Essential for Virion Morphogenesis. PLOS Pathogens. 2014;10(4):e1004039. doi:10.1371/journal.ppat.1004039


Tisoncik JR, Korth MJ, Simmons CP, Farrar J, Martin TR, Katze MG. Into the Eye of the Cytokine Storm. Microbiology and Molecular Biology Reviews. 2012;76(1):16-32. doi:10.1128/MMBR.05015-11


Tse HN, Tseng C-Z. Update on the pathological processes, molecular biology, and clinical utility of N-acetylcysteine in chronic obstructive pulmonary disease. COPD. Published online August 2014:825. doi:10.2147/COPD.S51057


Wang B, Yee Aw T, Stokes KY. N-acetylcysteine attenuates systemic platelet activation and cerebral vessel thrombosis in diabetes. Redox Biol. 2018;14:218-228. doi:10.1016/j.redox.2017.09.005


Wasyanto T, Yasa’ A, Jalaludinsyah A. Effect of Oral N-Acetylcysteine Supplementation on the Immunity System in Patients with Acute Myocardial Infarction. Acta Med Indones. 2019;51(4):311-317.


Yao H, Cai Z-Y, Sheng Z-X. NAC attenuates adriamycin-induced nephrotic syndrome in rats through regulating TLR4 signaling pathway. Eur Rev Med Pharmacol Sci. 2017;21(8):1938-1943.


Yu L-M, Zhang W-H, Han X-X, et al. Hypoxia-Induced ROS Contribute to Myoblast Pyroptosis during Obstructive Sleep Apnea via the NF-κB/HIF-1α Signaling Pathway. Oxid Med Cell Longev. 2019;2019:4596368. doi:10.1155/2019/4596368


Zhang Q, Ju Y, Ma Y, Wang T. N-acetylcysteine improves oxidative stress and inflammatory response in patients with community acquired pneumonia: A randomized controlled trial. Medicine (Baltimore). 2018;97(45):e13087. doi:10.1097/MD.0000000000013087


Zhang Y, Ding S, Li C, Wang Y, Chen Z, Wang Z. Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis. Exp Ther Med. 2017;14(4):2863-2868. doi:10.3892/etm.2017.4891


An Introduction to Reactive Oxygen Species - Measurement of ROS in Cells | January 26, 2014. Accessed May 11, 2020.