2 An open-label study of 1,392 patients found that N-acetylcysteine reduced the viscosity of expectorated phlegm, reduced cough severity, and improved ease of expectoration in 80, 74, and 71 percent of patients, respectively, after two months of treatment. All rights reserved.N-acetylcysteine has been shown to have a positive effect on the clinical course of COPD. The antioxidative and cytoprotective activities of per- and polysulfides may explain many of the effects that have previously been ascribed to NAC or NAC-derived glutathione.Īntioxidants Cysteine Cytoprotection Disulfide reduction Glutathione Hydrogen sulfide N-acetylcysteine Oxidative stress Persulfides ROS scavenging Sulfane sulfur species.Ĭopyright © 2021 The Author(s).
In this review, we discuss the validity of conventional assumptions and the scope of a newly discovered mechanism of action, namely the conversion of NAC into hydrogen sulfide and sulfane sulfur species. In most cases the mechanism of action has remained unclear and untested. While these mechanisms may apply under specific circumstances, they cannot be generalized to explain the effects of NAC in a majority of settings and situations. Conventionally, it is assumed that NAC acts as (i) a reductant of disulfide bonds, (ii) a scavenger of reactive oxygen species and/or (iii) a precursor for glutathione biosynthesis. Most investigators use and test NAC with the idea that it prevents or attenuates oxidative stress. Arguably, it is the most widely used "antioxidant" in experimental cell and animal biology, as well as clinical studies. Additionally, NAC increasingly became the epitome of an "antioxidant". Initially adopted as a mucolytic about 60 years ago, the cysteine prodrug N-acetylcysteine (NAC) is the standard of care to treat paracetamol intoxication, and is included on the World Health Organization's list of essential medicines.
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