Review Article
N-Acetyl Cysteine as an Adjunct in the Treatment of Tuberculosis
Table 1
Summary of studies on anti-TB effects of NAC against MTB.
| Author | Year | Type of study | Anti-TB effect | Effect measurement | Type of immune cells | Type of MTB | Conc. of NAC | Study subjects | Remark | Reference |
| Venketaraman et al. | 2006 | Cell culture | Yes | CFU reduction, effect size not indicated | Human Øs | H37Rv | 10 mM | HIV +ve and -ve | | [9] | Cao et al. | 2018 | Cell culture | Yes | 50% CFU reduction | THP-1 | Erdman strain | 10 mM | NA | Also showed that anti-TB drugs and NAC have synergistic effects | [10] | Venketaraman et al. | 2008 | Cell culture | Yes | CFU reduction, effect size not indicated | Human Øs | H37Rv | 10 mM | HIV -ve | Used whole blood culture | [11] | Guerra et al. | 2011 | Cell culture | Yes | CFU reduction, effect size not indicated | Human NK cells | H37Rv | 20 mM | HIV +ve and -ve | NK cells pretreated with NAC | [20] | Morris et al. | 2013 | Cell culture | Yes | CFU against control, effect size not indicated | Human Øs | H37Rv | 10 mM | HIV +ve and -ve | | [13] | Amaral et al. | 2016 | Cell culture | Yes | CFU vs. control, effect size not indicated | THP-1 | H37Rv, avium, Beijing 1471, M. bovis | 10 mM | HIV -ve | | [14] | Guerra et al. | 2011 | Cell culture | Yes | CFU reduction, effect size not indicated | Human Øs | H37Rv | 5, 10, 20 mM | HIV +ve and -ve | | [20] | Vilchèze et al. | 2017 | Cell culture & 7H9 | No | 4-5 log CFU reduction | J774 Øs | H37Rv | 5-10 mM | NA | Anti-TB effect when only combined with RIF/INH | [23] | Lamprecht et al. | 2016 | 7H9 medium | Yes | CFU reduction, sterilized | NA | H37Rv | 5 mM | NA | Combined with BDQ, Q203, and CFZ | [30] | Teskey et al. | 2018 | Cell culture & animal study | Yes | CFU reduction | Human PBMCs | Erdman strain | 10 mM | Healthy and T2DM patients, rats | | [24] | Palanisamy et al. | 2011 | Animal study | Yes | CFU reduction | NA | H37Rv | 400 mg/kg/day for 60 days | Guinea pigs | | [26] | Mahakalkar et al. | 2017 | Clinical trial | Yes | Sputum conversion | NA | NA | 600 mg/day | Smear +ve TB patients | | [28] | Khameneh et al. | 2016 | LJ media | No | NA | NA | H37Rv | 0.04-40 mg/ml | NA | Anti-TB effect only when combined with RIF or INH | [29] |
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CFU: colony-forming unit; Øs: macrophages; NK cells: natural killer cells; LJ: Lowenstein Jensen; PBMC: peripheral blood mononuclear cells; T2DM: type 2 diabetes mellitus; NAC: N-acetyl cysteine; INH: isoniazid; RIF: rifampicin; BDQ: bedaquiline; CFZ: clofazimine; Q203: investigational product.
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