Publication Name	World Journal of Critical Care Medicine
Manuscript ID	108638
Country	United States

Category	Immunology
Manuscript Type	Basic Study
Article Title	Reactive oxygen species elevations in human immune cell subsets during sepsis are mitigated by norepinephrine and N-acetylcysteine
Manuscript Source	Unsolicited Manuscript
All Author List	Joby Thoppil, J David Farrar, Drashya Sharma, Shaun Kirby, Angela Mobley and Daniel Mark Courtney
Funding Agency and Grant Number	Funding Agency Grant Number Emergency Medicine Foundation Zoll Foundation
Corresponding Author	Joby Thoppil, Assistant Professor, MD, PhD, Department of Emergency Medicine, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd E6.110A, Dallas, TX 75390, United States. joby.thoppil@utsouthwestern.edu
Key Words	Sepsis; Reactive oxygen species; Norepinephrine; N-acetylcysteine; Peripheral blood mononuclear cells; Flow cytometry; Redox biology; Inflammation
Core Tip	Sepsis is a life-threatening condition characterized by immune dysregulation, in which peripheral blood mononuclear cells are believed to play a central role. Reactive oxygen species (ROS) are critical to immune cell signaling, but excessive ROS may contribute to immune alterations during sepsis. In this observational study, we demonstrate elevated ROS levels in CD3+ T cells and CD14+ monocytes from septic patients. Using in vitro models, we show that norepinephrine and N-acetylcysteine attenuate ROS accumulation following inflammatory stimulation. These findings suggest that targeting oxidative imbalance may represent a promising direction for future sepsis research.
Citation	Thoppil J, Farrar JD, Sharma D, Kirby S, Mobley A, Courtney DM. Reactive oxygen species elevations in human immune cell subsets during sepsis are mitigated by norepinephrine and N-acetylcysteine. World J Crit Care Med 2025; In press

Received	2025-04-20 03:43
Peer-Review Started	2025-04-20 03:43
To Make the First Decision
Return for Revision	2025-05-12 03:15
Revised	2025-05-13 16:51
Second Decision	2025-05-29 02:54
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-05-29 10:59
Articles in Press	2025-05-29 10:59
Publication Fee Transferred	2025-05-14 16:02
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3141(online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
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