https://doi.org/10.4081/monaldi.2025.3159
Mucus production and chronic obstructive pulmonary disease, a possible treatment target: zooming in on N-acetylcysteine
Submitted: July 30, 2024
Accepted: October 28, 2024
Published: January 14, 2025
Accepted: October 28, 2024
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Mucus hypersecretion is a trait of chronic obstructive pulmonary disease (COPD) associated with poorer outcomes. As it may be present before airway obstruction, its early treatment may have a preventive role. This narrative review of the literature presents the role of mucus dysfunction in COPD, its pathophysiology, and the rationale for the use of N-acetylcysteine (NAC). NAC can modify mucus rheology, improving clearance and reducing damage induced MUC5AC expression. It exerts a direct and indirect (glutathione replenishment) antioxidant mechanism; it interferes with inflammatory molecular pathways, including inhibition of nuclear factor-kB activation in epithelial airway cells and reduction in the expression of cytokine tumor necrosis factor α, interleukin (IL)-6, and IL-10. Some clinical experiences suggest that the adjunctive use of NAC may reduce symptoms and improve outcomes for patients with COPD. In conclusion, NAC may be a candidate drug for the early treatment of subjects at risk of COPD development.
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How to Cite
Baraldi, Federico, Tommaso Bigoni, Maria Pia Foschino Barbaro, Claudio Micheletto, Giulia Scioscia, Alessandro Vatrella, and Alberto Papi. 2025. “Mucus Production and Chronic Obstructive Pulmonary Disease, a Possible Treatment Target: Zooming in on N-Acetylcysteine”. Monaldi Archives for Chest Disease, January. https://doi.org/10.4081/monaldi.2025.3159.
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