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Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Compound monograph · evidence extract

Glutathione in immune modulation and adjunctive immunotherapy — evidence extract

The Institute's graded assessment of Glutathione for immune modulation and adjunctive immunotherapy, with the contributing trials and the domain-by-domain certainty reasoning.

Document identifier
CEI-MN-046/EV-IMMUNE-SUPPORT
Series
Evidence extract
Version
1.3
Published
06 May 2026
Last reviewed
06 May 2026
Next review
06 May 2028
Identifier
10.71829/cei.mono.46
Certainty
Very low
Cycle
2026 Q2

§1Evidence extract: Immune modulation and adjunctive immunotherapy

§1.1Question and anchor outcome

Population
Pharmacological modification of innate or adaptive immune function, assessed by cell counts, functional assays and clinical infection or oncological endpoints.
Intervention
Glutathione, intravenous, nebulised, topical or oral; subcutaneous and intramuscular in research contexts
Comparator
As used in each contributing trial; reported per trial rather than pooled across comparator types
Anchor outcome
CD4 and CD8 counts

Additional outcomes the Institute extracts for this indication: Response to vaccination; Infection incidence; Tumour response where applicable.

§1.2Contributing trials

No trial has been identified for Glutathione in immune modulation and adjunctive immunotherapy. The rating below reflects that absence.

§1.3Certainty assessment

Certainty assessment by domainDowngrading decision recorded for each certainty domain.Certainty domainNo concernSeriousVery seriousEffect on ratingRisk of biasno downgradeInconsistencyno downgradeIndirectnessdowngrade one levelImprecisiondowngrade two levelsPublication biasno downgradeTotal downgrading: 3 levelsVery low certainty
Figure 2. Domain-by-domain certainty assessment for Glutathione in immune modulation and adjunctive immunotherapy. The starting rating for a body of randomised evidence is high; each serious concern reduces it by one level and each very serious concern by two.

Table 2. Reasoning recorded against each certainty domain.

DomainRatingReasoning
Risk of biasNo concernNo serious concern identified in this domain.
InconsistencyNo concernNo serious concern identified in this domain.
IndirectnessSeriousThe outcome is a surrogate whose relationship to the clinical outcome is unvalidated for this indication.
ImprecisionVery seriousThe confidence interval spans values that would support different decisions.
Publication biasNo concernNo serious concern identified in this domain.
Overall rating: Very low certainty. The Institute has very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate. In this series a very low rating most often reflects an absence of controlled human evidence rather than conflicting evidence.

§1.4What this extract does not establish

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. D’Hondt M, Bracke N, Taevernier L, Gevaert B, Verbeke F, Wynendaele E, De Spiegeleer B. Related impurities in peptide medicines. Journal of Pharmaceutical and Biomedical Analysis 2014;101:2–30. doi:10.1016/j.jpba.2014.06.012 · PMID 25044089
  2. Manning MC, Chou DK, Murphy BM, Payne RW, Katayama DS. Stability of protein pharmaceuticals: an update. Pharmaceutical Research 2010;27(4):544–575. doi:10.1007/s11095-009-0045-6 · PMID 20143256
  3. United States Pharmacopeial Convention. General Chapter ⟨85⟩ Bacterial Endotoxins Test. United States Pharmacopeia — National Formulary (USP–NF) 2024;USP 2024 Issue 1. identifier not held by the Institute

Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.

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