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Quality in Sport

Expanding Horizons – A Broad-Spectrum Review of Emerging Medical Applications of N-Acetylcysteine
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Expanding Horizons – A Broad-Spectrum Review of Emerging Medical Applications of N-Acetylcysteine

Authors

  • Oskar Mikołajczyk Medical University of Warsaw https://orcid.org/0009-0006-8470-6845
  • Aleksandra Suchołbiak Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0001-2931-157X
  • Aleksander Małachowski Samodzielny Publiczny Zespół Opieki Zdrowotnej w Mińsku Mazowieckim, ul. Szpitalna 37, 05-300 Mińsk Mazowiecki https://orcid.org/0000-0002-4924-0000
  • Aleksandra Serafin Medical University of Warsaw https://orcid.org/0009-0002-2573-0811
  • Katarzyna Naja Medical University of Warsaw https://orcid.org/0009-0008-6513-6984
  • Karolina Baran Medical University of Warsaw https://orcid.org/0009-0006-3076-2892
  • Jakub Zwardoń Medical University of Warsaw https://orcid.org/0009-0005-3944-2943
  • Julia Sałata COPERNICUS Podmiot Leczniczy Sp. z o.o. Szpital im. M. Kopernika. Adres: Nowe Ogrody 1/6, 80-803 Gdańsk https://orcid.org/0009-0001-7905-9157
  • Filip Bracichowicz Military Institute of Aviation Medicine https://orcid.org/0009-0008-6661-5450

DOI:

https://doi.org/10.12775/QS.2025.43.62333

Keywords

N-acetylcysteine, N-acetyl-l-cysteine, Rheumatoid Arthritis, Polycystic ovary syndrome, physical exertion recovery

Abstract

N-acetyl-l-cysteine is a thiol-containing compound widely recognized for its antioxidant, mucolytic, and glutathione-replenishing properties. Historically established for use in acetaminophen toxicity and respiratory diseases, n-acetyl-l-cysteine has garnered growing interest for its broad therapeutic potential across diverse medical domains. This narrative review synthesizes evidence from meta-analyses published from January 2024 onwards, sourced from PubMed, to present emerging clinical applications of n-acetyl-l-cysteine. Findings suggest promising roles for n-acetyl-l-cysteine as an adjunctive therapy in managing rheumatoid arthritis, improving reproductive outcomes in women with polycystic ovary syndrome, and enhancing recovery following physical exertion by reducing oxidative stress and inflammation. While results for substance use disorders remain mixed, n-acetyl-l-cysteine’s modulation of glutamatergic and antioxidant pathways warrants further investigation. Nonetheless, n-acetyl-l-cysteine’s favorable safety profile and multifaceted biological actions underscore its potential in various clinical contexts. This review highlights medical areas of growing evidence on n-acetyl-l-cysteine’s efficacy while identifying gaps that necessitate further well-designed trials. Its aim is to inform about new research directions.

References

Adil, M., Amin, S. S., & Mohtashim, M. (2018). N-acetylcysteine in dermatology. Indian Journal of Dermatology, Venereology and Leprology, 84(6), 652–659. https://doi.org/10.4103/ijdvl.IJDVL_33_18

Atkuri, K. R., Mantovani, J. J., Herzenberg, L. A., & Herzenberg, L. A. (2007). N-acetylcysteine—a safe antidote for cysteine/glutathione deficiency. Current Opinion in Pharmacology, 7(4), 355–359. https://doi.org/10.1016/j.coph.2007.04.005

Chang, C. T., Hsieh, P. J., Lee, H. C., Lo, C. H., Tam, K. W., & Loh, E. W. (2021). Effectiveness of N-acetylcysteine in treating clinical symptoms of substance abuse and dependence: A meta-analysis of randomized controlled trials. Clinical Psychopharmacology and Neuroscience, 19(2), 282. https://doi.org/10.9758/cpn.2021.19.2.282

Cobley, J. N., McGlory, C., Morton, J. P., & Close, G. L. (2011). N-acetylcysteine’s attenuation of fatigue after repeated bouts of intermittent exercise: Practical implications for tournament situations. International Journal of Sport Nutrition and Exercise Metabolism, 21(6), 451–461. https://doi.org/10.1123/ijsnem.21.6.451

Demirkol, O., Adams, C., & Ercal, N. (2004). Biologically important thiols in various vegetables and fruits. Journal of Agricultural and Food Chemistry, 52(26), 8151–8154. https://doi.org/10.1021/jf040266f

Devrim-Lanpir, A., Hill, L., & Knechtle, B. (2021). How N-acetylcysteine supplementation affects redox regulation, especially at mitohormesis and sarcohormesis level: Current perspective. Antioxidants, 10(2), 153. https://doi.org/10.3390/antiox10020153

Dilliyappan, S., Kumar, A. S., Venkatesalu, S., et al. (2024). Polycystic ovary syndrome: Recent research and therapeutic advancements. Life Sciences, 359, 123221. https://doi.org/10.1016/j.lfs.2024.123221

Duailibi, M. S., Cordeiro, Q., Brietzke, E., et al. (2017). N-acetylcysteine in the treatment of craving in substance use disorders: Systematic review and meta-analysis. American Journal of Addiction, 26(7), 660–666. https://doi.org/10.1111/ajad.12620

Ghomian, N., Khadem, N., Moeindarbari, S., & Abdolrazagh, A. (2019). Comparison of pregnancy rate in patients with polycystic ovary syndrome treated with clomiphene alone and in combination with N-acetyl cysteine: A randomized clinical trial. International Journal of Women's Health and Reproduction Sciences, 7, 185–189. https://doi.org/10.15296/ijwhr.2019.31

Greenberg, N. R., Farhadi, F., Kazer, B., Potenza, M., & Gustavo, A. A. (2022). Mechanistic effects and use of N-acetylcysteine in substance use disorders. Current Behavioral Neuroscience Reports, 9(4), 124–143. https://doi.org/10.1007/s40473-022-00250-3

Han, H., Zhang, G., Zhang, X., & Zhao, Q. (2024). Nrf2-mediated ferroptosis inhibition: A novel approach for managing inflammatory diseases. Inflammopharmacology, 32(5), 2961–2986. https://doi.org/10.1007/s10787-024-01519-7

He, T., Ren, K., Xiang, L., Yao, H., Huang, Y., & Gao, Y. (2024). Efficacy of N-acetylcysteine as an adjuvant therapy for rheumatoid arthritis: A systematic review and meta-analysis of randomized controlled trials. British Journal of Hospital Medicine, 85(11), 1–16. https://doi.org/10.12968/hmed.2024.0560

Herzenberg, L. A. (2018). History of N-acetylcysteine. In The therapeutic use of N-acetylcysteine (NAC) in medicine (pp. 1–15). Springer. https://doi.org/10.1007/978-981-10-5311-5

Hoeger, K. M., Dokras, A., & Piltonen, T. (2021). Update on PCOS: Consequences, challenges, and guiding treatment. Journal of Clinical Endocrinology & Metabolism, 106(3), e1071–e1083. https://doi.org/10.1210/clinem/dgaa839

Hofman, Z. L. M., Roodenrijs, N. M. T., Nikiphorou, E., et al. (2025). Difficult-to-treat rheumatoid arthritis: What have we learned and what do we still need to learn? Rheumatology, 64(1), 65–73. https://doi.org/10.1093/rheumatology/keae544

Joshy, A., Thomas, A., Baby, E., Biju, S., Mishra, B., & Jose, N. (2023). Pharmacological applications and pharmacokinetic modifications of N-acetylcysteine. International Journal of Pharmaceutics and Drug Analysis, 17–30. https://doi.org/10.47957/ijpda.v11i1.535

Kalyanaraman, B. (2022). NAC, NAC, knockin’ on heaven’s door: Interpreting the mechanism of action of N-acetylcysteine in tumor and immune cells. Redox Biology, 57, 102497. https://doi.org/10.1016/j.redox.2022.102497

Kerksick, C. M., Kreider, R. B., & Willoughby, D. S. (2010). Intramuscular adaptations to eccentric exercise and antioxidant supplementation. Amino Acids, 39(1), 219–232. https://doi.org/10.1007/s00726-009-0432-7

Kobylarz, D., Noga, M., Frydrych, A., et al. (2023). Antidotes in clinical toxicology—Critical review. Toxics, 11(9), 723. https://doi.org/10.3390/toxics11090723

Michailidis, Y., Karagounis, L. G., Terzis, G., et al. (2013). Thiol-based antioxidant supplementation alters human skeletal muscle signaling and attenuates its inflammatory response and recovery after intense eccentric exercise. American Journal of Clinical Nutrition, 98(1), 233–245. https://doi.org/10.3945/ajcn.112.049163

Mokhtari, V., Afsharian, P., Shahhoseini, M., Kalantar, S. M., & Moini, A. (2017). A review on various uses of N-acetyl cysteine. Cell Journal, 19(1), 11–17. https://doi.org/10.22074/cellj.2016.4872

Ooi, S. L., Green, R., & Pak, S. C. (2018). N-acetylcysteine for the treatment of psychiatric disorders: A review of current evidence. BioMed Research International, 2018, 2469486. https://doi.org/10.1155/2018/2469486

Pedre, B., Barayeu, U., Ezeriņa, D., & Dick, T. P. (2021). The mechanism of action of N-acetylcysteine (NAC): The emerging role of H₂S and sulfane sulfur species. Pharmacology & Therapeutics, 228, 107916. https://doi.org/10.1016/j.pharmthera.2021.107916

Rhodes, K., & Braakhuis, A. (2017). Performance and side effects of supplementation with N-acetylcysteine: A systematic review and meta-analysis. Sports Medicine, 47(8), 1619–1636. https://doi.org/10.1007/s40279-017-0677-3

Sadowski, M., Zawieja, E., & Chmurzynska, A. (2024). The impact of N-acetylcysteine on lactate, biomarkers of oxidative stress, immune response, and muscle damage: A systematic review and meta-analysis. Journal of Cellular and Molecular Medicine, 28(23), e70198. https://doi.org/10.1111/jcmm.70198

Sakelliou, A., Fatouros, I. G., Athanailidis, I., et al. (2016). Evidence of a redox-dependent regulation of immune responses to exercise-induced inflammation. Oxidative Medicine and Cellular Longevity, 2016, 2840643. https://doi.org/10.1155/2016/2840643

Schwalfenberg, G. K. (2021). N-acetylcysteine: A review of clinical usefulness (an old drug with new tricks). Journal of Nutrition and Metabolism, 2021, 9949453. https://doi.org/10.1155/2021/9949453

Sharpe, A., Morley, L. C., Tang, T., Norman, R. J., & Balen, A. H. (2019). Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews, 12, CD013505. https://doi.org/10.1002/14651858.CD013505

Song, Y., Wang, H., Huang, H., & Zhu, Z. (2020). Comparison of the efficacy between NAC and metformin in treating PCOS patients: A meta-analysis. Gynecological Endocrinology, 36(3), 204–210. https://doi.org/10.1080/09513590.2019.1689553

Suzuki, K. (2009). Anti-oxidants for therapeutic use: Why are only a few drugs in clinical use? Advanced Drug Delivery Reviews, 61(4), 287–289. https://doi.org/10.1016/j.addr.2009.03.002

Šalamon, Š., Kramar, B., Marolt, T. P., Poljšak, B., & Milisav, I. (2019). Medical and dietary uses of N-acetylcysteine. Antioxidants, 8(5), 111. https://doi.org/10.3390/antiox8050111

Syiem, R. P., Wahlang, J. B., R. K., Kalyan, P. B., Nahakpam, D., & Langstieh, A. J. (2024). Exploring the novel therapeutic potential of N-acetylcysteine in depression, bipolar disorders and anxiety. Journal of Pharmacology and Pharmacotherapeutics, 15(2), 133–141. https://doi.org/10.1177/0976500X241246402

Tardiolo, G., Bramanti, P., & Mazzon, E. (2018). Overview on the effects of N-acetylcysteine in neurodegenerative diseases. Molecules, 23(12), 3305. https://doi.org/10.3390/molecules23123305

Tenório, M. C. D. S., Graciliano, N. G., Moura, F. A., Oliveira, A. C. M., & Goulart, M. O. F. (2021). N-acetylcysteine (NAC): Impacts on human health. Antioxidants, 10(6), 967. https://doi.org/10.3390/antiox10060967

Tieu, S., Charchoglyan, A., Paulsen, L., et al. (2023). N-acetylcysteine and its immunomodulatory properties in humans and domesticated animals. Antioxidants, 12(10), 1867. https://doi.org/10.3390/antiox12101867

Verhasselt, V., Vanden Berghe, W., Vanderheyde, N., Willems, F., Haegeman, G., & Goldman, M. (1999). N-acetyl-L-cysteine inhibits primary human T cell responses at the dendritic cell level: Association with NF-κB inhibition. Journal of Immunology, 162(5), 2569–2574.

Viña, I., Viña, J. R., Carranza, M., & Mariscal, G. (2025). Efficacy of N-acetylcysteine in polycystic ovary syndrome: Systematic review and meta-analysis. Nutrients, 17(2), 284. https://doi.org/10.3390/nu17020284

Wang, R., Li, W., Bordewijk, E. M., et al. (2019). First-line ovulation induction for polycystic ovary syndrome: An individual participant data meta-analysis. Human Reproduction Update, 25(6), 717–732. https://doi.org/10.1093/humupd/dmz029

Winterlind, E. L., Malone, S. G., Setzer, M. R., Murphy, M. A., Saunders, D., & Gray, J. C. (2024). N-acetylcysteine as a treatment for substance use cravings: A meta-analysis. medRxiv. https://doi.org/10.1101/2024.05.13.24306839

Xiao, H., Wu, M., Shao, F., et al. (2016). N-acetyl-L-cysteine protects the enterocyte against oxidative damage by modulation of mitochondrial function. Mediators of Inflammation, 2016, 8364279. https://doi.org/10.1155/2016/8364279

Yifu, P. (2024). A review of antioxidant N-acetylcysteine in addressing polycystic ovary syndrome. Gynecological Endocrinology, 40(1), 2381498. https://doi.org/10.1080/09513590.2024.2381498

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2025-07-09

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MIKOŁAJCZYK, Oskar, SUCHOŁBIAK, Aleksandra, MAŁACHOWSKI, Aleksander, SERAFIN, Aleksandra, NAJA , Katarzyna, BARAN, Karolina, ZWARDOŃ , Jakub, SAŁATA , Julia and BRACICHOWICZ, Filip. Expanding Horizons – A Broad-Spectrum Review of Emerging Medical Applications of N-Acetylcysteine. Quality in Sport. Online. 9 July 2025. Vol. 43, p. 62333. [Accessed 27 December 2025]. DOI 10.12775/QS.2025.43.62333.
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Copyright (c) 2025 Oskar Mikołajczyk, Aleksandra Suchołbiak, Aleksander Małachowski, Aleksandra Serafin, Katarzyna Naja , Karolina Baran, Jakub Zwardoń , Julia Sałata , Filip Bracichowicz

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