High-Dose N-Acetylcysteine Therapy for Novel H1N1 Influenza Pneumonia
Authors: Kang Yiu Lai
Journal: Annals of Internal Medicine (2010)

Letters18 May 2010High-Dose N-Acetylcysteine Therapy for Novel H1N1 Influenza PneumoniaKang Yiu Lai, MRCP, Wing Yiu Ng, MRCP, Pik Kei Osburga Chan, MRCP, Kit Fai Wong, MD, MRCP, and Fanny Cheng, MRCPKang Yiu Lai, MRCPFrom Queen Elizabeth Hospital, Kowloon, Hong Kong., Wing Yiu Ng, MRCPFrom Queen Elizabeth Hospital, Kowloon, Hong Kong., Pik Kei Osburga Chan, MRCPFrom Queen Elizabeth Hospital, Kowloon, Hong Kong., Kit Fai Wong, MD, MRCPFrom Queen Elizabeth Hospital, Kowloon, Hong Kong., and Fanny Cheng, MRCPFrom Queen Elizabeth Hospital, Kowloon, Hong Kong.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-10-201005180-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: High-dose N-acetylcysteine synergizes with oseltamivir to protect mice from fatal influenza infection.Objective: To show the potential role of N-acetylcysteine in the treatment of novel H1N1 influenza pneumonia in a dose used to treat acetaminophen overdose.Case Report: On 15 July 2009, we admitted a previously healthy woman to the intensive care unit in a Hong Kong hospital for novel H1N1 human swine influenza (H1N1) pneumonia with septic shock and type 1 respiratory failure. She was 48 years of age, was not obese, and was a long-term smoker. She required pressure-controlled ventilation with 100% oxygen, 18-cm H2O positive end-expiratory ...References1. Knobil K, Choi AMK, Weigand GW, Kacoby DB. Role of oxidants in influenza virus-induced gene expression. Am J Physiol Lung Cell Mol Physiol. 1998;274:L134-42. CrossrefGoogle Scholar2. Nimmerjahn F, Dudziak D, Dirmeier U, Hobom G, Riedel A, Schlee M, et al. Active NF-kappaB signalling is a prerequisite for influenza virus infection. J Gen Virol. 2004;85:2347-56. [PMID: 15269376] CrossrefMedlineGoogle Scholar3. Garozzo A, Tempera G, Ungheri D, Timpanaro R, Castro A. N-acetylcysteine synergizes with oseltamivir in protecting mice from lethal influenza infection. Int J Immunopathol Pharmacol. 2007;20:349-54. [PMID: 17624247] CrossrefMedlineGoogle Scholar4. 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;10:1535-41. [PMID: 9230243] CrossrefMedlineGoogle Scholar5. Kaiser L, Fritz RS, Straus SE, Gubareva L, Hayden FG. Symptom pathogenesis during acute influenza: interleukin-6 and other cytokine responses. J Med Virol. 2001;64:262-8. [PMID: 11424113] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Queen Elizabeth Hospital, Kowloon, Hong Kong.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByIs COVID-19-induced liver injury different from other RNA viruses?‎N-acetylcysteine as a part of complex treatment of moderate COVID-associated pneumoniaPreventing the development of severe COVID-19 by modifying immunothrombosisN-Acetylcysteine as Adjuvant Therapy for COVID-19 – A Perspective on the Current State of the EvidenceThe effects of N-acetyl cysteine on acute viral respiratory infections in humans: A rapid reviewTherapeutic blockade of inflammation in severe COVID-19 infection with intravenous N-acetylcysteineTackle the free radicals damage in COVID-19Devilishly radical NETwork in COVID-19: Oxidative stress, neutrophil extracellular traps (NETs), and T cell suppressionEarly Nutritional Interventions with Zinc, Selenium and Vitamin D for Raising Anti-Viral Resistance Against Progressive COVID-19N-acetylcysteine as a potential treatment for COVID-19The many faces of the anti-COVID immune responseRole of Pseudomonas aeruginosa Glutathione Biosynthesis in Lung and Soft Tissue Infection N-Acetylcysteine to Combat COVID-19: An Evidence Review Dynamic thiol/disulfide homeostasis in children with community‐acquired pneumoniaN-acetylcysteine improves oxidative stress and inflammatory response in patients with community acquired pneumoniaThe role of adjuvant immunomodulatory agents for treatment of severe influenzaPandemic and Avian Influenza A Viruses in HumansInflammatory and oxidative stress in rotavirus infectionHow to approach and treat viral infections in ICU patientsHuman Ebola virus infection in West Africa: a review of available therapeutic agents that target different steps of the life cycle of Ebola virusN -Acetylcysteine Treatment of Rotavirus-Associated Diarrhea in ChildrenSeasonal Human Influenza: Treatment OptionsProteomics study of N -acetylcysteine response in H1N1-infected cells by using mass spectrometryAdjunctive therapies and immunomodulating agents for severe influenzaInhibition of rotavirus ECwt infection in ICR suckling mice by N-acetylcysteine, peroxisome proliferator-activated receptor gamma agonists and cyclooxygenase-2 inhibitorsAdjunctive therapies and immunomodulatory agents in the management of severe influenzaNewer influenza antivirals, biotherapeutics and combinationsN-Acetylcysteine inhibits platelet–monocyte conjugation in patients with type 2 diabetes with depleted intraplatelet glutathione: a randomised controlled trialInhibition of rotavirus infection in cultured cells by N-acetyl-cysteine, PPARγ agonists and NSAIDsTwo Years after Pandemic Influenza A/2009/H1N1: What Have We Learned?Development of acute ischemic stroke in a patient with acute respiratory distress syndrome (ARDS) resulting from H1N1 pneumoniaN-acetylcysteine lacks universal inhibitory activity against influenza A virusesReport of the 'Mechanisms of lung injury and immunomodulator interventions in influenza' workshop, 21 March 2010, Ventura, California, USA*Rhinovirus-Induced Barrier Dysfunction in Polarized Airway Epithelial Cells Is Mediated by NADPH Oxidase 1Antioxidant Therapy as a Potential Approach to Severe Influenza-Associated Complications 18 May 2010Volume 152, Issue 10Page: 687-688KeywordsC-reactive proteinsCytokinesH1N1OxygenPneumoniaPolymerase chain reactionPregnancyStormsSwine influenza ePublished: 18 May 2010 Issue Published: 18 May 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...