{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:54:40Z","timestamp":1791568480071,"version":"4.3.4"},"reference-count":178,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Growing interest in drug repurposing and oxidative stress has heightened attention on N\u2011acetylcysteine (NAC). Despite the abundance of reviews across diverse clinical domains, clinical translation remains limited. This review seeks to map the existing evidence, identify critical gaps, and outline priorities for future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five databases were systematically searched to identify relevant reviews based on predetermined inclusion and exclusion criteria. Comprehensive data extraction enabled meaningful evidence mapping. To enhance rigor, critical appraisal was conducted using two validated tools assessing methodological quality and risk of bias, thereby allowing stratification of evidence. Additionally, the corrected covered area (CCA) was calculated to detect potential evidence inflation or redundancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 140 retrieved reviews spanning 17 clinical domains, only 63 were systematic reviews with meta\u2011analysis, representing the highest level of evidence included in this study. Approximately half of these supported NAC repurposing. Beyond its antioxidant, anti\u2011inflammatory, and glutamatergic modulatory roles, which were most frequently reported, several additional mechanisms have been proposed. The number of NAC reviews has increased over time, with most originating from China and the United States. Appraisals revealed a high prevalence of critically low\u2011quality systematic reviews, alongside a notable proportion of reviews with low risk of bias. Finally, CCA analysis demonstrated substantial overlap and redundancy across domains, particularly within subdomains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This novel overview mapped the extensive NAC evidence landscape, highlighting its pleiotropic roles and repurposing potential while revealing possible research waste and critical gaps across domains and evidence levels. Psychiatry, reproductive medicine, nephrology, pulmonology, and toxicology emerged as priority clinical domains for future exploration. However, the overall inconsistency in review certainty remains a barrier to the integration of NAC into clinical guidelines. By delineating research priorities and highlighting new avenues, this review underscores the need for precision medicine approaches to guide future NAC clinical implementation and research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0360434","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:23:17Z","timestamp":1791566597000},"page":"e0360434","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Repurposing landscape of N-acetylcysteine: A scoping review of reviews toward clinical translation"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7169-2273","authenticated-orcid":true,"given":"Mohammed Khaled","family":"Al Alaili","sequence":"first","affiliation":[{"name":"Clinical Pharmacy","place":["Saida, Lebanon"],"department":["Independent Researcher"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"issue":"8","key":"pone.0360434.ref001","doi-asserted-by":"crossref","first-page":"4117","DOI":"10.1016\/j.bbagen.2013.04.016","article-title":"The chemistry and biological activities of N-acetylcysteine","volume":"1830","author":"Y Samuni","year":"2013","journal-title":"Biochim Biophys Acta"},{"key":"pone.0360434.ref002","doi-asserted-by":"crossref","first-page":"107916","DOI":"10.1016\/j.pharmthera.2021.107916","article-title":"The mechanism of action of N-acetylcysteine (NAC): The emerging role of H2S and sulfane sulfur species","volume":"228","author":"B Pedre","year":"2021","journal-title":"Pharmacol Ther"},{"key":"pone.0360434.ref003","author":"U.S. Food and Drug Administration","year":"2025"},{"key":"pone.0360434.ref004","author":"U.S. Food and Drug Administration","year":"2026"},{"key":"pone.0360434.ref005","volume-title":"N-Acetylcysteine","author":"M Ershad","year":"2024"},{"key":"pone.0360434.ref006","doi-asserted-by":"crossref","first-page":"105168","DOI":"10.1016\/j.critrevonc.2026.105168","article-title":"ROS-mediated therapeutic approach through oxidative stress and cell signalling modulation","volume":"220","author":"M Sahu","year":"2026","journal-title":"Crit Rev Oncol Hematol"},{"key":"pone.0360434.ref007","doi-asserted-by":"crossref","first-page":"100177","DOI":"10.1016\/j.arres.2026.100177","article-title":"Oxidative stress in chronic disease: Mechanisms, therapeutic strategies, and future directions","volume":"20","author":"SZ Rahman","year":"2026","journal-title":"Adv Redox Research"},{"key":"pone.0360434.ref008","doi-asserted-by":"crossref","first-page":"1511011","DOI":"10.3389\/fphar.2025.1511011","article-title":"Role of Achyranthes aspera in neurodegenerative diseases: Current evidence and future directions","volume":"16","author":"H Luo","year":"2025","journal-title":"Front Pharmacol"},{"issue":"5","key":"pone.0360434.ref009","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.1039\/D5MD01173F","article-title":"Redefining the role of the thiol-based agent N-acetylcysteine in human health and disease and elucidating potential advantages of its amide derivative","volume":"17","author":"H-Q Qu","year":"2026","journal-title":"RSC Med Chem"},{"key":"pone.0360434.ref010","doi-asserted-by":"crossref","first-page":"173368","DOI":"10.1016\/j.ejphar.2020.173368","article-title":"The effects of N-acetylcysteine on inflammatory and oxidative stress biomarkers: A systematic review and meta-analysis of controlled clinical trials","volume":"884","author":"AH Faghfouri","year":"2020","journal-title":"Eur J Pharmacol"},{"issue":"1","key":"pone.0360434.ref011","doi-asserted-by":"crossref","first-page":"51","DOI":"10.3897\/pharmacia.69.e72548","article-title":"Repurposing \u2013 second life for drugs","volume":"69","author":"P Ayyar","year":"2022","journal-title":"PHAR"},{"issue":"1","key":"pone.0360434.ref012","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1038\/nrd.2018.168","article-title":"Drug repurposing: Progress, challenges and recommendations","volume":"18","author":"S Pushpakom","year":"2019","journal-title":"Nat Rev Drug Discov"},{"issue":"2","key":"pone.0360434.ref013","first-page":"103496","article-title":"Trends in drug repurposing: Advancing cardiovascular disease management in geriatric populations","volume":"73","author":"MK Moka","year":"2025","journal-title":"Curr Res Transl Med"},{"key":"pone.0360434.ref014","doi-asserted-by":"crossref","first-page":"108148","DOI":"10.1016\/j.phrs.2026.108148","article-title":"The crossroads of inflammation and oxidative stress: A review of the interplay between eicosanoids and reactive oxygen species","volume":"226","author":"WH Park","year":"2026","journal-title":"Pharmacol Res"},{"key":"pone.0360434.ref015","doi-asserted-by":"crossref","DOI":"10.34133\/research.0948","article-title":"Chronic psychological stress in oncogenesis: Multisystem crosstalk and multimodal interventions","volume":"8","author":"B Huang","year":"2025","journal-title":"Research"},{"issue":"3","key":"pone.0360434.ref016","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s40264-020-01026-y","article-title":"Safety of N-Acetylcysteine at high doses in chronic respiratory diseases: A review","volume":"44","author":"P Calverley","year":"2021","journal-title":"Drug Saf"},{"issue":"3","key":"pone.0360434.ref017","doi-asserted-by":"crossref","first-page":"676","DOI":"10.3390\/biomedicines12030676","article-title":"The use and potential benefits of N-Acetylcysteine in non-acetaminophen acute liver failure: An etiology-based review","volume":"12","author":"M Popescu","year":"2024","journal-title":"Biomedicines"},{"key":"pone.0360434.ref018","doi-asserted-by":"crossref","DOI":"10.1590\/1414-431x2025e14382","article-title":"Potential of N-acetylcysteine in the management of low back pain: A scoping review of studies in humans and animal models","volume":"58","author":"G Sinigaglia","year":"2025","journal-title":"Braz J Med Biol Res"},{"issue":"5","key":"pone.0360434.ref019","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/acps.12862","article-title":"N-acetylcysteine for major mental disorders: A systematic review and meta-analysis of randomized controlled trials","volume":"137","author":"W Zheng","year":"2018","journal-title":"Acta Psychiatr Scand"},{"issue":"19","key":"pone.0360434.ref020","article-title":"Efficacy of N-Acetylcysteine in idiopathic pulmonary fibrosis: A systematic review and meta-analysis","volume":"95","author":"T Sun","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"11","key":"pone.0360434.ref021","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1080\/15563650.2020.1784428","article-title":"N-acetylcysteine as a treatment for amatoxin poisoning: A systematic review","volume":"58","author":"J Liu","year":"2020","journal-title":"Clin Toxicol (Phila)"},{"key":"pone.0360434.ref022","doi-asserted-by":"crossref","DOI":"10.46658\/JBIMES-24-09","article-title":"Scoping reviews","author":"M Peters","year":"2024","journal-title":"JBI Man Evid Synth"},{"issue":"7","key":"pone.0360434.ref023","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation","volume":"169","author":"AC Tricco","year":"2018","journal-title":"Ann Intern Med"},{"key":"pone.0360434.ref024","article-title":"AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"BJ Shea","year":"2017","journal-title":"BMJ"},{"key":"pone.0360434.ref025","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jclinepi.2015.06.005","article-title":"ROBIS: A new tool to assess risk of bias in systematic reviews was developed","volume":"69","author":"P Whiting","year":"2016","journal-title":"J Clin Epidemiol"},{"issue":"4","key":"pone.0360434.ref026","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.jclinepi.2013.11.007","article-title":"Systematic review finds overlapping reviews were not mentioned in every other overview","volume":"67","author":"D Pieper","year":"2014","journal-title":"J Clin Epidemiol"},{"issue":"5","key":"pone.0360434.ref027","article-title":"N-acetylcysteine use among patients undergoing cardiac surgery: A systematic review and meta-analysis of randomized trials","volume":"14","author":"JEG Pereira","year":"2019","journal-title":"PLoS One"},{"issue":"1","key":"pone.0360434.ref028","doi-asserted-by":"crossref","first-page":"22","DOI":"10.58209\/ijbc.15.1.22","article-title":"The effect of Vitamin E and N-acetyl cysteine on oxidative status and hemoglobin level in transfusion-dependent thalassemia patients: A systematic review and meta-analysis","volume":"15","author":"S Haghpanah","year":"2023","journal-title":"Iran J Blood Cancer J"},{"issue":"1","key":"pone.0360434.ref029","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1536\/ihj.20-519","article-title":"The clinical efficacy of N-Acetylcysteine in the treatment of ST segment elevation myocardial infarction","volume":"62","author":"S-J Jiang","year":"2021","journal-title":"Int Heart J"},{"issue":"3","key":"pone.0360434.ref030","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1080\/15563650.2025.2451642","article-title":"The effect of acetylcysteine on the prothrombin time and international normalized ratio: A narrative review","volume":"63","author":"M Nazar","year":"2025","journal-title":"Clin Toxicol (Phila)"},{"issue":"8","key":"pone.0360434.ref031","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1080\/13543784.2018.1501471","article-title":"N-acetyl cysteine in the treatment of alcohol use disorder in patients with liver disease: Rationale for further research","volume":"27","author":"KC Morley","year":"2018","journal-title":"Expert Opin Investig Drugs"},{"issue":"11","key":"pone.0360434.ref032","doi-asserted-by":"crossref","DOI":"10.2146\/ajhp140732","article-title":"Oral acetylcysteine for neuropsychiatric disorders","volume":"72","author":"R Racz","year":"2015","journal-title":"Am J Health Syst Pharm"},{"key":"pone.0360434.ref033","doi-asserted-by":"crossref","first-page":"107283","DOI":"10.1016\/j.addbeh.2022.107283","article-title":"N-acetyl cysteine in the treatment of cannabis use disorder: A systematic review of clinical trials","volume":"129","author":"R Sharma","year":"2022","journal-title":"Addict Behav"},{"key":"pone.0360434.ref034","doi-asserted-by":"crossref","first-page":"1462612","DOI":"10.3389\/fphar.2024.1462612","article-title":"Effect of N-acetylcysteine on craving in substance use disorders (SUD): a meta-analysis of randomized controlled trials","volume":"15","author":"M Cuocina","year":"2024","journal-title":"Front Pharmacol"},{"issue":"4","key":"pone.0360434.ref035","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1007\/s40429-022-00446-3","article-title":"The potential of N-acetyl cysteine in behavioral addictions and related compulsive and impulsive behaviors and disorders: a scoping review","volume":"9","author":"NR Greenberg","year":"2022","journal-title":"Curr Addict Rep"},{"key":"pone.0360434.ref036","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/s40263-022-00907-3","article-title":"The Potential of N \u2011 Acetyl \u2011 L \u2011 Cysteine (NAC) in the Treatment of Psychiatric Disorders","volume":"36","author":"RCJ Bradlow","year":"2022","journal-title":"CNS Drugs"},{"issue":"1","key":"pone.0360434.ref037","doi-asserted-by":"crossref","first-page":"12","DOI":"10.9758\/cpn.2015.13.1.12","article-title":"N-acetyl cysteine in the treatment of obsessive compulsive and related disorders: A systematic review","volume":"13","author":"G Oliver","year":"2015","journal-title":"Clin Psychopharmacol Neurosci"},{"key":"pone.0360434.ref038","first-page":"180","article-title":"N-acetyl cysteine: A potential adjunctive therapy in psychiatric disorders","volume":"5","author":"E Khoja","year":"2024","journal-title":"J Exp Basic Med Sci"},{"issue":"2","key":"pone.0360434.ref039","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/pcn.13502","article-title":"N-acetylcysteine for schizophrenia: A systematic review and meta-analysis","volume":"77","author":"T Kishi","year":"2023","journal-title":"Psychiatry Clin Neurosci"},{"issue":"3","key":"pone.0360434.ref040","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1080\/17425255.2017.1251580","article-title":"N-acetylcysteine in the treatment of psychiatric disorders: current status and future prospects","volume":"13","author":"A Minarini","year":"2017","journal-title":"Expert Opin Drug Metab Toxicol"},{"key":"pone.0360434.ref041","first-page":"2469486","article-title":"N-Acetylcysteine for the treatment of psychiatric disorders: A review of current evidence","volume":"2018","author":"SL Ooi","year":"2018","journal-title":"Biomed Res Int"},{"issue":"7","key":"pone.0360434.ref042","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1111\/bdi.13039","article-title":"N-acetylcysteine as an adjunctive treatment for bipolar depression: A systematic review and meta-analysis of randomized controlled trials","volume":"23","author":"FG Nery","year":"2021","journal-title":"Bipolar Disord"},{"issue":"5","key":"pone.0360434.ref043","doi-asserted-by":"crossref","DOI":"10.4088\/JCP.22f14664","article-title":"Antipsychotic augmentation with N-Acetylcysteine for patients with schizophrenia","volume":"83","author":"C Andrade","year":"2022","journal-title":"J Clin Psychiatry"},{"issue":"2","key":"pone.0360434.ref044","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1080\/1028415X.2018.1478766","article-title":"Improvement of cognitive function in schizophrenia with N-acetylcysteine: A theoretical review","volume":"23","author":"COB Yolland","year":"2020","journal-title":"Nutr Neurosci"},{"issue":"5","key":"pone.0360434.ref045","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1177\/0004867419893439","article-title":"Meta-analysis of randomised controlled trials with N-acetylcysteine in the treatment of schizophrenia","volume":"54","author":"CO Yolland","year":"2020","journal-title":"Aust N Z J Psychiatry"},{"issue":"11","key":"pone.0360434.ref046","doi-asserted-by":"crossref","DOI":"10.1111\/adb.70001","article-title":"N-acetylcysteine as a treatment for substance use cravings: A meta-analysis","volume":"29","author":"EL Winterlind","year":"2024","journal-title":"Addict Biol"},{"key":"pone.0360434.ref047","doi-asserted-by":"crossref","first-page":"110527","DOI":"10.1016\/j.neuropharm.2025.110527","article-title":"The neuroprotective effects of N-acetylcysteine in psychiatric and neurodegenerative disorders: From modulation of glutamatergic transmission to restoration of synaptic plasticity","volume":"278","author":"S Chakraborty","year":"2025","journal-title":"Neuropharmacology"},{"issue":"3","key":"pone.0360434.ref048","doi-asserted-by":"crossref","first-page":"2538","DOI":"10.1111\/ejn.14130","article-title":"Targeting redox regulation to treat substance use disorder using N\u2010acetylcysteine","volume":"50","author":"JS Womersley","year":"2019","journal-title":"Eur J Neurosci"},{"issue":"5","key":"pone.0360434.ref049","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1007\/s43440-021-00283-7","article-title":"N-acetylcysteine in substance use disorder: A lesson from preclinical and clinical research","volume":"73","author":"I Smaga","year":"2021","journal-title":"Pharmacol Rep"},{"key":"pone.0360434.ref050","doi-asserted-by":"crossref","first-page":"6370","DOI":"10.3390\/ijerph19116370","article-title":"The potential of N -acetylcysteine for treatment of trichotillomania, excoriation disorder, onychophagia, and onychotillomania: An updated literature review","volume":"19","author":"DK Lee","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"11","key":"pone.0360434.ref051","doi-asserted-by":"crossref","first-page":"3481","DOI":"10.1007\/s00213-020-05629-2","article-title":"N-acetylcysteine as an adjunctive treatment for bipolar depression and major depressive disorder: A systematic review and meta-analysis of double-blind, randomized placebo-controlled trials","volume":"237","author":"T Kishi","year":"2020","journal-title":"Psychopharmacology (Berl)"},{"issue":"7","key":"pone.0360434.ref052","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1007\/s00213-021-05789-9","article-title":"The effect of N-acetylcysteine on bipolar depression: A systematic review and meta-analysis of randomized controlled trials","volume":"238","author":"S Pittas","year":"2021","journal-title":"Psychopharmacology (Berl)"},{"issue":"13","key":"pone.0360434.ref053","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1111\/bph.15456","article-title":"N-acetylcysteine as a new prominent approach for treating psychiatric disorders","volume":"178","author":"I Smaga","year":"2021","journal-title":"Br J Pharmacol"},{"key":"pone.0360434.ref054","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.pnpbp.2018.06.005","article-title":"Oral N-acetylcysteine in the treatment of obsessive-compulsive disorder: A systematic review of the clinical evidence","volume":"86","author":"JP Couto","year":"2018","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"pone.0360434.ref055","article-title":"A review of N-acetylcysteine in the treatment of grooming disorders","author":"TL Braun","year":"2019","journal-title":"Int J Dermatol"},{"key":"pone.0360434.ref056","article-title":"Exploring the potential link between \u0394FosB and N-acetylcysteine in craving\/relapse dynamics: Can N-acetylcysteine stand out as a possible treatment candidate?","volume":"37","author":"S Arjmand","year":"2024","journal-title":"Acta Neuropsychiatr"},{"key":"pone.0360434.ref057","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.psychres.2017.02.024","article-title":"N-acetylcysteine for treating cocaine addiction - A systematic review","volume":"251","author":"MA Nocito Echevarria","year":"2017","journal-title":"Psychiatry Res"},{"issue":"6","key":"pone.0360434.ref058","doi-asserted-by":"crossref","first-page":"2657","DOI":"10.3390\/ijms26062657","article-title":"N-Acetylcysteine in the treatment of acute lung injury: perspectives and limitations","volume":"26","author":"D Mokra","year":"2025","journal-title":"Int J Mol Sci"},{"issue":"6","key":"pone.0360434.ref059","doi-asserted-by":"crossref","first-page":"6564","DOI":"10.21037\/apm-21-1138","article-title":"Systematic review and meta-analysis of the efficacy of N-acetylcysteine in the treatment of acute exacerbation of chronic obstructive pulmonary disease","volume":"10","author":"C Jiang","year":"2021","journal-title":"Ann Palliat Med"},{"key":"pone.0360434.ref060","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1089\/ars.2020.8247","article-title":"N-Acetylcysteine and Hydrogen Sulfide in Coronavirus Disease 2019","volume":"35","author":"AR Bourgonje","year":"2021","journal-title":"Antioxidants Redox Signal"},{"issue":"12","key":"pone.0360434.ref061","doi-asserted-by":"crossref","first-page":"3356","DOI":"10.1007\/s12325-019-01111-4","article-title":"Effect of orally administered N-acetylcysteine on chronic bronchitis: a meta-analysis","volume":"36","author":"J Wei","year":"2019","journal-title":"Adv Ther"},{"issue":"137","key":"pone.0360434.ref062","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1183\/16000617.00002215","article-title":"Influence of N-acetylcysteine on chronic bronchitis or COPD exacerbations: A meta-analysis","volume":"24","author":"M Cazzola","year":"2015","journal-title":"Eur Respir Rev"},{"issue":"2","key":"pone.0360434.ref063","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.hrtlng.2016.12.004","article-title":"The effect of N-acetylcysteine on exacerbations of chronic obstructive pulmonary disease: A meta-analysis and systematic review","volume":"46","author":"K Fowdar","year":"2017","journal-title":"Heart & Lung"},{"issue":"3","key":"pone.0360434.ref064","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0265006","article-title":"Clinical efficacy of Chinese herbs for supplementing qi and activating blood circulation combined with N-acetylcysteine in the treatment of idiopathic pulmonary fibrosis: A systematic review and network meta-analysis","volume":"17","author":"Q Pang","year":"2022","journal-title":"PLoS One"},{"key":"pone.0360434.ref065","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.pupt.2016.07.009","article-title":"Pirfenidone, nintedanib and N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis: A systematic review and meta-analysis","volume":"40","author":"P Rogliani","year":"2016","journal-title":"Pulm Pharmacol Ther"},{"issue":"1","key":"pone.0360434.ref066","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1186\/s12890-023-02778-w","article-title":"Efficacy of N-acetylcysteine plus pirfenidone in the treatment of idiopathic pulmonary fibrosis: a systematic review and meta-analysis","volume":"23","author":"X-L Zhang","year":"2023","journal-title":"BMC Pulm Med"},{"key":"pone.0360434.ref067","doi-asserted-by":"crossref","DOI":"10.1177\/17534666231158563","article-title":"The efficacy of N-acetylcysteine in chronic obstructive pulmonary disease patients: a meta-analysis","volume":"17","author":"C Huang","year":"2023","journal-title":"Ther Adv Respir Dis"},{"issue":"15","key":"pone.0360434.ref068","doi-asserted-by":"crossref","first-page":"8238","DOI":"10.3390\/ijms22158238","article-title":"The 3,4-Quinones of Estrone and Estradiol are the initiators of cancer whereas resveratrol and N-acetylcysteine are the preventers","volume":"22","author":"E Cavalieri","year":"2021","journal-title":"Int J Mol Sci"},{"issue":"7","key":"pone.0360434.ref069","first-page":"169","article-title":"N-Acetyl Cysteine and Glutathione in health and cancer-pharmacogenomics, research, and clinical practice: Hypothesis and review","volume":"28","author":"RH Morales-Borges","year":"2022","journal-title":"Altern Ther Health Med"},{"issue":"2","key":"pone.0360434.ref070","article-title":"N-Acetyl Cysteine as a promising therapeutic approach in ovarian cancer: Potential and perspectives","volume":"2","author":"EA Kindlon","year":"2025","journal-title":"Acad Oncol"},{"issue":"1","key":"pone.0360434.ref071","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s43043-022-00104-8","article-title":"N-acetyl cysteine as a potential regulator of SARS-CoV-2-induced male reproductive disruptions","volume":"27","author":"P Sengupta","year":"2022","journal-title":"Middle East Fertil Soc J"},{"key":"pone.0360434.ref072","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.repbre.2025.02.002","article-title":"Therapeutic potential of carnitine and N-acetyl-cysteine supplementation on sperm parameters and pregnancy outcomes in idiopathic male infertility: A systematic review and meta-analysis of randomized control trials","volume":"5","author":"Y Ranneh","year":"2025","journal-title":"Reprod Breed"},{"issue":"1","key":"pone.0360434.ref073","doi-asserted-by":"crossref","first-page":"2381498","DOI":"10.1080\/09513590.2024.2381498","article-title":"A review of antioxidant N-acetylcysteine in addressing polycystic ovary syndrome","volume":"40","author":"P Yifu","year":"2024","journal-title":"Gynecol Endocrinol"},{"issue":"2","key":"pone.0360434.ref074","doi-asserted-by":"crossref","DOI":"10.1111\/and.13953","article-title":"The role of N-acetyl-cysteine (NAC) orally daily on the sperm parameters and serum hormones in idiopathic infertile men: A systematic review and meta-analysis of randomised controlled trials","volume":"53","author":"Z Zhou","year":"2021","journal-title":"Andrologia"},{"issue":"5","key":"pone.0360434.ref075","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1515\/jbcpp-2020-0107","article-title":"N-acetyl-cysteine as adjuvant therapy in female infertility: A systematic review and meta-analysis","volume":"32","author":"N Devi","year":"2020","journal-title":"J Basic Clin Physiol Pharmacol"},{"issue":"1","key":"pone.0360434.ref076","doi-asserted-by":"crossref","DOI":"10.1111\/and.13898","article-title":"Antioxidant effects of N-acetylcysteine on the male reproductive system: A systematic review","volume":"53","author":"A Ghafarizadeh","year":"2021","journal-title":"Andrologia"},{"issue":"1","key":"pone.0360434.ref077","first-page":"1","article-title":"Meta-analysis of the efficacy and safety of L-carnitine and N-acetylcysteine monotherapy for male idiopathic infertility","volume":"23","author":"X Ma","year":"2025","journal-title":"Rev Int Androl"},{"issue":"2","key":"pone.0360434.ref078","article-title":"A Meta-Analysis of the Efficacy of L-Carnitine\/L-Acetyl-Carnitine or N-Acetyl-Cysteine in men with idiopathic asthenozoospermia","volume":"15","author":"G Wei","year":"2021","journal-title":"Am J Mens Health"},{"issue":"2","key":"pone.0360434.ref079","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1017\/S0007114522003270","article-title":"The effects of N-acetylcysteine on ovulation and sex hormones profile in women with polycystic ovary syndrome: A systematic review and meta-analysis","volume":"130","author":"Z Shahveghar Asl","year":"2023","journal-title":"Br J Nutr"},{"issue":"2","key":"pone.0360434.ref080","doi-asserted-by":"crossref","first-page":"284","DOI":"10.3390\/nu17020284","article-title":"Efficacy of N-Acetylcysteine in polycystic ovary syndrome: systematic review and meta-analysis","volume":"17","author":"I Vi\u00f1a","year":"2025","journal-title":"Nutrients"},{"key":"pone.0360434.ref081","article-title":"Comparison of the efficacy between NAC and metformin in treating PCOS patients: A meta-analysis","author":"Y Song","year":"2019","journal-title":"Gynecol Endocrinol"},{"issue":"1","key":"pone.0360434.ref082","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s40360-023-00699-2","article-title":"Efficacy of intravenous N acetylcysteine as an adjuvant therapy in the treatment of acute aluminum phosphide Poisoning: A systematic review and meta-analysis","volume":"24","author":"HO Shaker","year":"2023","journal-title":"BMC Pharmacol Toxicol"},{"key":"pone.0360434.ref083","first-page":"1109","article-title":"Role of n-acetyl cysteine in rodenticide poisoning - a systematic review and meta-analysis","volume":"32","author":"S Valliappan","year":"2025","journal-title":"TPM"},{"key":"pone.0360434.ref084","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.freeradbiomed.2020.09.020","article-title":"N-Acetylcysteine as a treatment for sulphur mustard poisoning","volume":"161","author":"TW Sawyer","year":"2020","journal-title":"Free Radic Biol Med"},{"issue":"6","key":"pone.0360434.ref085","first-page":"1535","article-title":"Effect of N-acetyl-cysteine in prevention of noise-induced hearing loss: a systematic review and meta-analysis of randomized controlled trials","volume":"18","author":"P-H Chang","year":"2021","journal-title":"Arch Med Sci"},{"issue":"1","key":"pone.0360434.ref086","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s40360-024-00829-4","article-title":"Intratympanic N-acetylcysteine in the prevention of cisplatin-induced ototoxicity: A systematic review and meta-analysis of randomized controlled trials","volume":"26","author":"M Tawalbeh","year":"2025","journal-title":"BMC Pharmacol Toxicol"},{"issue":"3","key":"pone.0360434.ref087","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.wjorl.2021.01.005","article-title":"Effect of N-acetyl-cysteine treatment on sensorineural hearing loss: a meta-analysis","volume":"8","author":"X Bai","year":"2022","journal-title":"World J Otorhinolaryngol Head Neck Surg"},{"issue":"11","key":"pone.0360434.ref088","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1136\/thoraxjnl-2015-207245","article-title":"A systematic review and meta-analysis of the efficacy and safety of N-acetylcysteine in preventing aminoglycoside-induced ototoxicity: implications for the treatment of multidrug-resistant TB","volume":"70","author":"K Kranzer","year":"2015","journal-title":"Thorax"},{"issue":"1","key":"pone.0360434.ref089","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1186\/s12876-025-04382-0","article-title":"Efficacy of N-Acetylcysteine in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and meta-analysis","volume":"25","author":"A Hormati","year":"2025","journal-title":"BMC Gastroenterol"},{"issue":"12","key":"pone.0360434.ref090","article-title":"N-acetylcysteine for non-paracetamol (acetaminophen)-related acute liver failure","volume":"12","author":"JT Siu","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"pone.0360434.ref091","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1111\/bcp.12880","article-title":"N-acetylcysteine for non-paracetamol drug-induced liver injury: A systematic review","volume":"81","author":"MF Chughlay","year":"2016","journal-title":"Br J Clin Pharmacol"},{"issue":"6","key":"pone.0360434.ref092","doi-asserted-by":"crossref","DOI":"10.1111\/ans.14295","article-title":"Current evidence for the use of N-acetylcysteine following liver resection","volume":"88","author":"R Kemp","year":"2018","journal-title":"ANZ J Surg"},{"issue":"4","key":"pone.0360434.ref093","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1177\/00494755231176317","article-title":"Role of N-acetylcysteine in liver injury due to dengue fever","volume":"53","author":"M Gupta","year":"2023","journal-title":"Trop Doct"},{"issue":"5","key":"pone.0360434.ref094","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.clinre.2015.01.003","article-title":"Efficacy and safety of acetylcysteine in \u201cnon-acetaminophen\u201d acute liver failure: A meta-analysis of prospective clinical trials","volume":"39","author":"J Hu","year":"2015","journal-title":"Clin Res Hepatol Gastroenterol"},{"issue":"12","key":"pone.0360434.ref095","doi-asserted-by":"crossref","first-page":"30269","DOI":"10.3390\/ijms161226225","article-title":"Oxidative stress and inflammation in hepatic diseases: therapeutic possibilities of N-Acetylcysteine","volume":"16","author":"KQ de Andrade","year":"2015","journal-title":"Int J Mol Sci"},{"key":"pone.0360434.ref096","doi-asserted-by":"crossref","first-page":"3320325","DOI":"10.1155\/2021\/3320325","article-title":"Drug-induced liver injury: clinical evidence of N-acetyl cysteine protective effects","volume":"2021","author":"Y Ntamo","year":"2021","journal-title":"Oxid Med Cell Longev"},{"issue":"12","key":"pone.0360434.ref097","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.3390\/antiox9121283","article-title":"N-Acetyl cysteine targets hepatic lipid accumulation to curb oxidative stress and inflammation in NAFLD: A comprehensive analysis of the literature","volume":"9","author":"PV Dludla","year":"2020","journal-title":"Antioxidants (Basel)"},{"key":"pone.0360434.ref098","doi-asserted-by":"crossref","first-page":"100340","DOI":"10.1016\/j.aohep.2021.100340","article-title":"N-acetyl cysteine versus standard of care for non-acetaminophen induced acute liver injury: A systematic review and meta-analysis","volume":"24","author":"DB Shrestha","year":"2021","journal-title":"Ann Hepatol"},{"issue":"1","key":"pone.0360434.ref099","article-title":"Use of N-acetyl-cysteine in the perioperative period of liver transplantation: A scoping review","volume":"27","author":"FAM dos Santos","year":"2024","journal-title":"BJT"},{"issue":"9","key":"pone.0360434.ref100","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1097\/TP.0000000000004597","article-title":"N-acetylcysteine in the donor, recipient, or both donor and recipient in liver transplantation: A systematic review with meta-analysis and trial sequential analysis","volume":"107","author":"D Jia","year":"2023","journal-title":"Transplantation"},{"issue":"3","key":"pone.0360434.ref101","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1097\/TME.0000000000000116","article-title":"N-Acetylcysteine use in non-acetaminophen-induced acute liver failure","volume":"38","author":"CM McPheeters","year":"2016","journal-title":"Adv Emerg Nurs J"},{"key":"pone.0360434.ref102","doi-asserted-by":"crossref","first-page":"112638","DOI":"10.1016\/j.biopha.2022.112638","article-title":"Clinical use of N-acetyl cysteine during liver transplantation: Implications of oxidative stress and inflammation as therapeutic targets","volume":"147","author":"Y Ntamo","year":"2022","journal-title":"Biomed Pharmacother"},{"issue":"2","key":"pone.0360434.ref103","doi-asserted-by":"crossref","first-page":"85","DOI":"10.4103\/sjg.sjg_406_21","article-title":"N-acetylcysteine for non-acetaminophen induced acute liver failure: A review","volume":"28","author":"SX Jiang","year":"2022","journal-title":"Saudi J Gastroenterol"},{"issue":"3","key":"pone.0360434.ref104","doi-asserted-by":"crossref","DOI":"10.1111\/dth.14915","article-title":"A systematic review of N-acetylcysteine for treatment of acne vulgaris and acne-related associations and consequences: Focus on clinical studies","volume":"34","author":"N Mardani","year":"2021","journal-title":"Dermatol Ther"},{"issue":"12","key":"pone.0360434.ref105","doi-asserted-by":"crossref","first-page":"2896","DOI":"10.1093\/pm\/pnab042","article-title":"Efficacy and safety of N-acetylcysteine for the management of chronic pain in adults: A systematic review and meta-analysis","volume":"22","author":"M Mohiuddin","year":"2021","journal-title":"Pain Med"},{"issue":"7","key":"pone.0360434.ref106","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1080\/17581869.2024.2388504","article-title":"Perioperative N-acetylcysteine: Evidence and indications","volume":"14","author":"PR Wilson","year":"2024","journal-title":"Pain Manag"},{"issue":"2","key":"pone.0360434.ref107","first-page":"455","article-title":"Role of N-Acetyl Cysteine in the management of diabetic peripheral neuropathy: a systematic review","volume":"8","author":"M Emara sherien","year":"2024","journal-title":"Arch Pharm Sci Ain Shams Univ"},{"issue":"1","key":"pone.0360434.ref108","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s12929-017-0377-1","article-title":"Repositioning drugs for traumatic brain injury - N-acetyl cysteine and Phenserine","volume":"24","author":"BJ Hoffer","year":"2017","journal-title":"J Biomed Sci"},{"issue":"2","key":"pone.0360434.ref109","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1177\/0004867420952540","article-title":"Effectiveness of N-acetylcysteine in autism spectrum disorders: A meta-analysis of randomized controlled trials","volume":"55","author":"T-M Lee","year":"2021","journal-title":"Aust N Z J Psychiatry"},{"issue":"2","key":"pone.0360434.ref110","doi-asserted-by":"crossref","first-page":"416","DOI":"10.3390\/antiox11020416","article-title":"N-Acetyl-Cysteine: Modulating the cysteine redox proteome in neurodegenerative diseases","volume":"11","author":"M Martinez-Banaclocha","year":"2022","journal-title":"Antioxidants"},{"issue":"12","key":"pone.0360434.ref111","doi-asserted-by":"crossref","first-page":"3305","DOI":"10.3390\/molecules23123305","article-title":"Overview on the effects of N-acetylcysteine in neurodegenerative diseases","volume":"23","author":"G Tardiolo","year":"2018","journal-title":"Molecules"},{"key":"pone.0360434.ref112","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.neubiorev.2017.04.013","article-title":"The effect of N-acetylcysteine (NAC) on human cognition - A systematic review","volume":"78","author":"DR Skvarc","year":"2017","journal-title":"Neurosci Biobehav Rev"},{"issue":"6","key":"pone.0360434.ref113","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1007\/s13311-023-01422-z","article-title":"N-Acetylcysteine and probenecid adjuvant therapy for traumatic brain injury","volume":"20","author":"RSB Clark","year":"2023","journal-title":"Neurotherapeutics"},{"issue":"2","key":"pone.0360434.ref114","doi-asserted-by":"crossref","first-page":"164","DOI":"10.3390\/brainsci15020164","article-title":"Effect of N-Acetyl cysteine as an adjuvant treatment in alzheimer\u2019s disease","volume":"15","author":"SM Lomel\u00ed Mart\u00ednez","year":"2025","journal-title":"Brain Sci"},{"issue":"1","key":"pone.0360434.ref115","first-page":"11","article-title":"A review on various uses of N-acetyl Cysteine","volume":"19","author":"V Mokhtari","year":"2017","journal-title":"Cell J"},{"key":"pone.0360434.ref116","doi-asserted-by":"crossref","DOI":"10.2147\/IJNRD.S563298","article-title":"N-Acetylcysteine role in maintaining renal function in cancer patients with cisplatin-based chemotherapy","volume":"18","author":"OG Prabu","year":"2025","journal-title":"Int J Nephrol Renovasc Dis"},{"key":"pone.0360434.ref117","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.ijcard.2016.02.083","article-title":"The effect of N-acetylcysteine on the incidence of contrast-induced kidney injury: A systematic review and trial sequential analysis","volume":"209","author":"N Wang","year":"2016","journal-title":"Int J Cardiol"},{"key":"pone.0360434.ref118","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.ijcard.2016.07.086","article-title":"The efficacy of N-acetylcysteine plus sodium bicarbonate in the prevention of contrast-induced nephropathy after cardiac catheterization and percutaneous coronary intervention: A meta-analysis of randomized controlled trials","volume":"221","author":"S-J Zhao","year":"2016","journal-title":"Int J Cardiol"},{"key":"pone.0360434.ref119","doi-asserted-by":"crossref","first-page":"001","DOI":"10.29328\/journal.jcn.1001084","article-title":"An update in the utilization of N-acetylcysteine & vitamin c for tackling the oxidative stress in acute kidney injury secondary to robust sepsis- a systematic review","volume":"6","author":"KK Kaur","year":"2022","journal-title":"J Clin Nephrol"},{"key":"pone.0360434.ref120","article-title":"Prevalence of contrast nephropathy following the administration of N-acetyl cysteine; A systematic review and meta-analysis","volume":"6","author":"MK Moghadam","year":"2021","journal-title":"J Prev Epidemiol"},{"issue":"6","key":"pone.0360434.ref121","doi-asserted-by":"crossref","first-page":"406","DOI":"10.7326\/M15-1456","article-title":"Effectiveness of prevention strategies for contrast-induced nephropathy: A systematic review and meta-analysis","volume":"164","author":"RM Subramaniam","year":"2016","journal-title":"Ann Intern Med"},{"issue":"10","key":"pone.0360434.ref122","article-title":"Effect of N-acetylcysteine on prevention of contrast-associated acute kidney injury in patients with STEMI undergoing primary percutaneous coronary intervention: A systematic review and meta-analysis of randomised controlled trials","volume":"10","author":"Z Guo","year":"2020","journal-title":"BMJ Open"},{"key":"pone.0360434.ref123","article-title":"Efficacy of N-acetylcysteine in preventing acute kidney injury after cardiac surgery: A meta-analysis study","author":"M Mei","year":"2017","journal-title":"J Investig Surg"},{"issue":"7","key":"pone.0360434.ref124","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.20671","article-title":"Meta-analytic techniques to assess the association between N-acetylcysteine and acute kidney injury after contrast administration: A systematic review and meta-analysis","volume":"5","author":"K Magner","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"1","key":"pone.0360434.ref125","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/s12882-025-04037-y","article-title":"Effect of N-acetylcysteine on antimicrobials induced nephrotoxicity: A meta-analysis","volume":"26","author":"X Qiu","year":"2025","journal-title":"BMC Nephrol"},{"issue":"1","key":"pone.0360434.ref126","doi-asserted-by":"crossref","DOI":"10.1097\/MJT.0b013e31829dbc1c","article-title":"Role of N-Acetylcysteine to prevent contrast-induced nephropathy: A meta-analysis","volume":"23","author":"RS Loomba","year":"2016","journal-title":"Am J Ther"},{"issue":"2","key":"pone.0360434.ref127","doi-asserted-by":"crossref","first-page":"138","DOI":"10.5761\/atcs.oa.21-00132","article-title":"N-Acetylcysteine\u2019s renoprotective effect in cardiac surgery: A systematic review and meta-analysis","volume":"28","author":"YK Tan","year":"2022","journal-title":"Ann Thorac Cardiovasc Surg"},{"issue":"10","key":"pone.0360434.ref128","doi-asserted-by":"crossref","first-page":"297","DOI":"10.3109\/0886022X.2015.1012985","article-title":"N-acetylcysteine for the prevention of contrast-induced nephropathy in patients with pre-existing renal insufficiency or diabetes: A systematic review and meta-analysis","volume":"37","author":"X Kang","year":"2015","journal-title":"Ren Fail"},{"issue":"1","key":"pone.0360434.ref129","doi-asserted-by":"crossref","DOI":"10.1532\/hsf.1424","article-title":"N-acetyl cysteine therapy does not prevent renal failure in high-risk patients undergoing open-heart surgery","volume":"19","author":"AM Rababa\u2019h","year":"2016","journal-title":"Heart Surg Forum"},{"issue":"6","key":"pone.0360434.ref130","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1111\/nep.13068","article-title":"N-acetylcysteine versus ascorbic acid or N-acetylcysteine plus ascorbic acid in preventing contrast-induced nephropathy: A meta-analysis","volume":"23","author":"Y Feng","year":"2018","journal-title":"Nephrology (Carlton)"},{"issue":"6","key":"pone.0360434.ref131","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1007\/s11255-022-03455-3","article-title":"N-Acetylcysteine: more than preventing contrast-induced nephropathy in uremic patients-focus on the antioxidant and anti-inflammatory properties","volume":"55","author":"D Cepaityte","year":"2023","journal-title":"Int Urol Nephrol"},{"issue":"2","key":"pone.0360434.ref132","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1177\/0003319720950162","article-title":"Latest clinical evidence about effect of acetylcysteine on preventing contrast-induced nephropathy in patients undergoing angiography: A meta-analysis","volume":"72","author":"W Xie","year":"2021","journal-title":"Angiology"},{"issue":"23","key":"pone.0360434.ref133","doi-asserted-by":"crossref","DOI":"10.1111\/jcmm.70198","article-title":"The impact of N-acetylcysteine on lactate, biomarkers of oxidative stress, immune response, and muscle damage: A systematic review and meta-analysis","volume":"28","author":"M Sadowski","year":"2024","journal-title":"J Cell Mol Med"},{"issue":"8","key":"pone.0360434.ref134","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1007\/s40279-017-0677-3","article-title":"Performance and side effects of supplementation with N-Acetylcysteine: A systematic review and meta-analysis","volume":"47","author":"K Rhodes","year":"2017","journal-title":"Sports Med"},{"key":"pone.0360434.ref135","doi-asserted-by":"crossref","DOI":"10.1111\/jfbc.14116","article-title":"The effects of N- acetylcysteine on recovery biomarkers: A systematic review and meta- analysis of controlled trials","volume":"46","author":"M Nejati","year":"2022","journal-title":"J Food Biochem"},{"key":"pone.0360434.ref136","doi-asserted-by":"crossref","first-page":"3606","DOI":"10.1093\/jn\/nxab309","article-title":"GlyNAC supplementation improves glutathione deficiency, oxidative stress, mitochondrial dysfunction, inflammation, aging hallmarks, metabolic defects, muscle strength, cognitive decline, and body composition: Implications for healthy aging","volume":"151","author":"RV Sekhar","year":"2021","journal-title":"J Nutr"},{"issue":"9","key":"pone.0360434.ref137","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1007\/s00726-022-03185-x","article-title":"N-Acetyl-L-cysteine in human rheumatoid arthritis and its effects on nitric oxide (NO) and malondialdehyde (MDA): Analytical and clinical considerations","volume":"54","author":"D Tsikas","year":"2022","journal-title":"Amino Acids"},{"issue":"4","key":"pone.0360434.ref138","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3390\/cells8040323","article-title":"The potential use of Metformin, Dipyridamole, N-Acetylcysteine and statins as adjunctive therapy for systemic lupus erythematosus","volume":"8","author":"MKX Tan","year":"2019","journal-title":"Cells"},{"issue":"11","key":"pone.0360434.ref139","doi-asserted-by":"crossref","first-page":"1","DOI":"10.12968\/hmed.2024.0560","article-title":"Efficacy of N-acetylcysteine as an adjuvant therapy for rheumatoid arthritis: A systematic review and meta-analysis of randomized controlled trials","volume":"85","author":"T He","year":"2024","journal-title":"Br J Hosp Med (Lond)"},{"key":"pone.0360434.ref140","doi-asserted-by":"crossref","first-page":"2835787","DOI":"10.1155\/2018\/2835787","article-title":"Biological activities and potential oral applications of N-Acetylcysteine: Progress and prospects","volume":"2018","author":"Y Pei","year":"2018","journal-title":"Oxid Med Cell Longev"},{"key":"pone.0360434.ref141","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.lfs.2016.03.003","article-title":"A minireview on N-acetylcysteine: An old drug with new approaches","volume":"151","author":"I Elbini Dhouib","year":"2016","journal-title":"Life Sci"},{"key":"pone.0360434.ref142","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1089\/ars.2023.0524","article-title":"Oxidative stress, endothelial dysfunction, and N-Acetylcysteine in type 2 diabetes mellitus","volume":"40","author":"X Li","year":"2024","journal-title":"Antioxid Redox Signal"},{"key":"pone.0360434.ref143","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1016\/j.clinbiochem.2015.04.017","article-title":"A review on the possible molecular mechanism of action of N-acetylcysteine against insulin resistance and type-2 diabetes development","volume":"48","author":"MM Lasram","year":"2015","journal-title":"Clin Biochem"},{"issue":"4","key":"pone.0360434.ref144","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.aimed.2020.07.006","article-title":"The effects of N-acetyl cysteine on acute viral respiratory infections in humans: A rapid review","volume":"7","author":"J Schloss","year":"2020","journal-title":"Adv Integr Med"},{"issue":"1","key":"pone.0360434.ref145","first-page":"41","article-title":"N-acetylcysteine efficacy in patients hospitalized with COVID-19 pneumonia: A systematic review and meta-analysis","volume":"61","author":"T Paraskevas","year":"2023","journal-title":"Rom J Intern Med"},{"key":"pone.0360434.ref146","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.21873\/invivo.11946","article-title":"COVID-19: The potential role of copper and N-acetylcysteine (NAC) in a combination of candidate antiviral treatments against SARS-CoV-2","volume":"34","author":"A Andreou","year":"2020","journal-title":"In Vivo"},{"key":"pone.0360434.ref147","doi-asserted-by":"crossref","first-page":"686","DOI":"10.2174\/011570159X343115241030094848","article-title":"Neuropsychiatric manifestations of COVID-19 disease and post COVID syndrome: The role of N-acetylcysteine and acetyl-L-carnitine","volume":"23","author":"T Barlattani","year":"2025","journal-title":"Curr Neuropharmacol"},{"key":"pone.0360434.ref148","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.rmed.2016.06.015","article-title":"The effect of N-acetylcysteine on biofilms: Implications for the treatment of respiratory tract infections","volume":"117","author":"F Blasi","year":"2016","journal-title":"Respir Med"},{"issue":"2","key":"pone.0360434.ref149","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1177\/0885066617696850","article-title":"N-Acetylcysteine\u2019s role in sepsis and potential benefit in patients with microcirculatory derangements","volume":"33","author":"J Chertoff","year":"2018","journal-title":"J Intensive Care Med"},{"issue":"16","key":"pone.0360434.ref150","doi-asserted-by":"crossref","first-page":"3573","DOI":"10.3390\/nu15163573","article-title":"Novel key ingredients in urinary tract health-the role of D-mannose, Chondroitin Sulphate, Hyaluronic Acid, and N-acetylcysteine in Urinary Tract Infections (Uroial PLUS\u00ae)","volume":"15","author":"F Crocetto","year":"2023","journal-title":"Nutrients"},{"issue":"1","key":"pone.0360434.ref151","doi-asserted-by":"crossref","first-page":"127","DOI":"10.3390\/v17010127","article-title":"Additive effects of glutathione in improving antibiotic efficacy in HIV-M.tb co-infection in the central nervous system: A systematic review","volume":"17","author":"L Nabipur","year":"2025","journal-title":"Viruses"},{"issue":"2","key":"pone.0360434.ref152","article-title":"N-acetylcysteine as an adjuvant therapy for Helicobacter pylori eradication","volume":"2","author":"LES Fontes","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"9","key":"pone.0360434.ref153","first-page":"4316","article-title":"Rationale and evidence for the adjunctive use of N-acetylcysteine in multidrug-resistant infections","volume":"27","author":"A Oliva","year":"2023","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"1","key":"pone.0360434.ref154","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1186\/s12903-022-02433-6","article-title":"Antibacterial and anti-inflammatory efficacy of N-acetyl cysteine in endodontic treatment: A scoping review","volume":"22","author":"S Abdulrab","year":"2022","journal-title":"BMC Oral Health"},{"key":"pone.0360434.ref155","first-page":"5907839","article-title":"N-Acetyl cysteine as an adjunct in the treatment of tuberculosis","volume":"2020","author":"DA Ejigu","year":"2020","journal-title":"Tuberc Res Treat"},{"issue":"11","key":"pone.0360434.ref156","doi-asserted-by":"crossref","first-page":"2298","DOI":"10.3390\/antiox11112298","article-title":"Impact of N-Acetyl Cysteine (NAC) on Tuberculosis (TB) patients-a systematic review","volume":"11","author":"DA Mapamba","year":"2022","journal-title":"Antioxidants (Basel)"},{"issue":"11","key":"pone.0360434.ref157","doi-asserted-by":"crossref","first-page":"6051","DOI":"10.3390\/ijms25116051","article-title":"Molecular mechanisms of N-Acetylcysteine in RSV infections and air pollution-induced alterations: A scoping review","volume":"25","author":"A Wrotek","year":"2024","journal-title":"Int J Mol Sci"},{"issue":"2","key":"pone.0360434.ref158","doi-asserted-by":"crossref","first-page":"31406","DOI":"10.34172\/ipp.2022.31406","article-title":"The role of N-acetyl cysteine and some other clinical antidotes in the treatment of patients with COVID-19; review of the current evidence","volume":"9","author":"S Zoofaghari","year":"2022","journal-title":"Immunopathol Persa"},{"issue":"6","key":"pone.0360434.ref159","first-page":"2802","article-title":"Therapeutic potential of N-acetyl cysteine (NAC) in preventing cytokine storm in COVID-19: Review of current evidence","volume":"25","author":"RR Mohanty","year":"2021","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"12","key":"pone.0360434.ref160","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1016\/j.jiph.2022.11.009","article-title":"N-acetylcysteine for prevention and treatment of COVID-19: Current state of evidence and future directions","volume":"15","author":"JL Izquierdo-Alonso","year":"2022","journal-title":"J Infect Public Health"},{"issue":"10","key":"pone.0360434.ref161","doi-asserted-by":"crossref","first-page":"13185","DOI":"10.1096\/fj.202001807","article-title":"Rationale for the use of N-acetylcysteine in both prevention and adjuvant therapy of COVID-19","volume":"34","author":"S De Flora","year":"2020","journal-title":"FASEB J"},{"issue":"2","key":"pone.0360434.ref162","first-page":"715","article-title":"Where are we with the use of N-acetylcysteine as a preventive and adjuvant treatment for COVID-19?","volume":"26","author":"F Di Marco","year":"2022","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"pone.0360434.ref163","doi-asserted-by":"crossref","first-page":"101544","DOI":"10.1016\/j.redox.2020.101544","article-title":"Oxidative stress-based therapeutics in COPD","volume":"33","author":"PJ Barnes","year":"2020","journal-title":"Redox Biol"},{"issue":"8","key":"pone.0360434.ref164","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1080\/00016489.2025.2509662","article-title":"Is pharmaceutical treatment of noise-induced hearing loss a realistic option? Debate article","volume":"145","author":"U Rosenhall","year":"2025","journal-title":"Acta Otolaryngol"},{"issue":"1","key":"pone.0360434.ref165","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/idh.12617","article-title":"Effects of antimicrobial mouthwashes on the human oral microbiome: Systematic review of controlled clinical trials","volume":"21","author":"GCLS do Amaral","year":"2023","journal-title":"Int J Dent Hyg"},{"issue":"2","key":"pone.0360434.ref166","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1007\/s00784-022-04585-9","article-title":"Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: A randomized clinical trial","volume":"27","author":"FC Martinho","year":"2023","journal-title":"Clin Oral Investig"},{"key":"pone.0360434.ref167","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/bs.apha.2024.05.003","article-title":"Journey from lab to clinic: Design, preclinical, and clinical development of systemic, targeted dendrimer-N-acetylcysteine (D-NAC) nanomedicines","volume":"100","author":"W Liyanage","year":"2024","journal-title":"Adv Pharmacol"},{"key":"pone.0360434.ref168","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.freeradbiomed.2021.08.239","article-title":"Emerging therapeutic opportunities of novel thiol-amides, NAC-amide (AD4\/NACA) and thioredoxin mimetics (TXM-Peptides) for neurodegenerative-related disorders","volume":"176","author":"D Atlas","year":"2021","journal-title":"Free Radic Biol Med"},{"key":"pone.0360434.ref169","doi-asserted-by":"crossref","first-page":"8057259","DOI":"10.1155\/2019\/8057259","article-title":"Severe chest pain due to N-Acetylcysteine-Induced esophagitis","volume":"2019","author":"W Wang","year":"2019","journal-title":"Case Rep Med"},{"issue":"7","key":"pone.0360434.ref170","doi-asserted-by":"crossref","first-page":"727","DOI":"10.3109\/15563650.2013.820313","article-title":"Anaphylactoid reactions to N-acetylcysteine","volume":"51","author":"JM Coulson","year":"2013","journal-title":"Clin Toxicol (Phila)"},{"issue":"10","key":"pone.0360434.ref171","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1111\/ijd.15389","article-title":"Drug interactions of natural supplements in dermatology: A review","volume":"60","author":"EK Hadeler","year":"2021","journal-title":"Int J Dermatol"},{"issue":"2","key":"pone.0360434.ref172","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s00726-019-02700-x","article-title":"Assessing acrolein for determination of the severity of brain stroke, dementia, renal failure, and Sj\u00f6gren\u2019s syndrome","volume":"52","author":"K Igarashi","year":"2020","journal-title":"Amino Acids"},{"issue":"23","key":"pone.0360434.ref173","article-title":"Endoplasmic reticulum stress: A novel target for the prevention and treatment of hypertension and its related diseases","volume":"29","author":"X Ma","year":"2025","journal-title":"J Cell Mol Med"},{"issue":"2","key":"pone.0360434.ref174","doi-asserted-by":"crossref","first-page":"100949","DOI":"10.1016\/j.mycmed.2020.100949","article-title":"Treatment and management strategies of onychomycosis","volume":"30","author":"R Aggarwal","year":"2020","journal-title":"J Mycol Med"},{"issue":"21","key":"pone.0360434.ref175","doi-asserted-by":"crossref","first-page":"4623","DOI":"10.3390\/nu15214623","article-title":"Nurturing through nutrition: Exploring the role of antioxidants in maternal diet during pregnancy to mitigate developmental programming of chronic diseases","volume":"15","author":"MS Diniz","year":"2023","journal-title":"Nutrients"},{"key":"pone.0360434.ref176","doi-asserted-by":"crossref","first-page":"108373","DOI":"10.1016\/j.pharmthera.2023.108373","article-title":"Molecular mechanisms of ferroptosis and their involvement in brain diseases","volume":"244","author":"I Costa","year":"2023","journal-title":"Pharmacol Ther"},{"key":"pone.0360434.ref177","doi-asserted-by":"crossref","first-page":"104332","DOI":"10.1016\/j.phrs.2019.104332","article-title":"The beneficial effects of N-acetyl cysteine (NAC) against obesity associated complications: A systematic review of pre-clinical studies","volume":"146","author":"PV Dludla","year":"2019","journal-title":"Pharmacol Res"},{"key":"pone.0360434.ref178","doi-asserted-by":"crossref","DOI":"10.1093\/jn\/nxaa134","article-title":"Lessons learned from inherited metabolic disorders of sulfur-containing amino acids metabolism","volume":"150","author":"V Ko\u017eich","year":"2020","journal-title":"J Nutr"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0360434","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:23:41Z","timestamp":1791566621000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0360434"}},"subtitle":[],"editor":[{"given":"UDAYAN","family":"BHATTACHARYA","sequence":"first","affiliation":[{"name":"Michigan Medicine","place":["UNITED STATES OF AMERICA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,9]]},"references-count":178,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0360434","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,9]]}}}