N-Acetylcysteine as a Potential Immunomodulator in Tuberculosis: Evidence of IL-2 Elevation in a Pilot Study

Aimed to investigate the potential of N-acetylcysteine (NAC) as an adjunctive immunomodulatory therapy to support the host immune response against Mycobacterium tuberculosis by enhancing interleukin-2 (IL-2) production.

A quasi-experimental study was conducted on the effect of NAC administration on IL-2 levels in patients newly diagnosed with pulmonary tuberculosis at Universitas Airlangga Teaching Hospital, Indonesia. Participants who met the inclusion criteria were subsequently divided into two groups: treatment group (received 600 mg every 12 hours of NAC therapy, n = 15) and control group (did not receive NAC therapy, n = 15). Enzyme-linked immunosorbent assay (ELISA) was used to analyze IL-2 levels in both groups, which were subsequently compared using statistical analysis.

Analysis of IL-2 levels before treatment with NAC revealed no significant difference between the treatment and control groups. The treatment group exhibited a significant increase in IL-2 levels after NAC administration (p=0.023). The median IL-2 level in the treatment group increased from 243.7 to 386.62 ng/L after two weeks of NAC administration, whereas in the control group, it decreased from 303.6 to 285.89 ng/L. The comparison test analysis of delta IL-2 levels also showed a significant difference between the treatment and control group (p = 0.025), with the median value of delta IL-2 levels in the treatment group being 147.0 ng/L and -24.7 ng/L in the control group.

This preliminary study demonstrated that IL-2 levels significantly increased with NAC supplementation, suggesting an enhanced immune response and its potential as an adjunct to standard tuberculosis therapy.