Similar to our findings, Zhang et al., in their study evaluating NAC effect on oxidative and inflammatory response in patients with community acquired pneumonia, reported a decline in TNF-alpha levels in the NAC group versus the non- NAC group (P < 0.05) [46] On the other hand, a study by Oner and Muderris reported an increase in TNF-alpha in women with polycystic ovary syndrome before and after taking acetyl cysteine. This evidence concerns the gene TNF and polycystic ovary syndrome.