{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T17:01:55Z","timestamp":1774026115170,"version":"3.50.1"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82174347"],"award-info":[{"award-number":["82174347"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"DOI":"10.1186\/s12890-026-04166-6","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T09:53:23Z","timestamp":1770976403000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of mucolytic agents in patients with chronic obstructive pulmonary disease: a systematic review and network meta-analysis"],"prefix":"10.1186","volume":"26","author":[{"given":"Yilin","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi","family":"Jing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8158-0742","authenticated-orcid":false,"given":"Fei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"issue":"5","key":"4166_CR1","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/S2213-2600(21)00511-7","volume":"10","author":"D Adeloye","year":"2022","unstructured":"Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I. Global, regional, and National prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022;10(5):447\u201358.","journal-title":"Lancet Respir Med"},{"issue":"10342","key":"4166_CR2","doi-asserted-by":"publisher","first-page":"2227","DOI":"10.1016\/S0140-6736(22)00470-6","volume":"399","author":"SA Christenson","year":"2022","unstructured":"Christenson SA, Smith BM, Bafadhel M, Putcha N. Chronic obstructive pulmonary disease. Lancet. 2022;399(10342):2227\u201342.","journal-title":"Lancet"},{"issue":"5","key":"4166_CR3","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1183\/09031936.00082507","volume":"30","author":"G Viegi","year":"2007","unstructured":"Viegi G, Pistelli F, Sherrill DL, Maio S, Baldacci S, Carrozzi L. Definition, epidemiology and natural history of COPD. Eur Respir J. 2007;30(5):993\u20131013.","journal-title":"Eur Respir J"},{"issue":"6","key":"4166_CR4","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1164\/rccm.200703-456SO","volume":"176","author":"KF Rabe","year":"2007","unstructured":"Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, Fukuchi Y, Jenkins C, Rodriguez-Roisin R, van Weel C, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2007;176(6):532\u201355.","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"4166_CR5","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1186\/s13063-020-04701-8","volume":"21","author":"H Tian","year":"2020","unstructured":"Tian H, Zhou Y, Tang L, Wu F, Deng Z, Lin B, Huang P, Wei S, Zhao D, Zheng J, et al. High-dose N-acetylcysteine for long-term, regular treatment of early-stage chronic obstructive pulmonary disease (GOLD I-II): study protocol for a multicenter, double-blinded, parallel-group, randomized controlled trial in China. Trials. 2020;21(1):780.","journal-title":"Trials"},{"issue":"4","key":"4166_CR6","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1080\/15412550600977361","volume":"3","author":"ER Sutherland","year":"2006","unstructured":"Sutherland ER, Crapo JD, Bowler RP. N-acetylcysteine and exacerbations of chronic obstructive pulmonary disease. Copd. 2006;3(4):195\u2013202.","journal-title":"Copd"},{"issue":"3","key":"4166_CR7","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1007\/s40264-020-01026-y","volume":"44","author":"P Calverley","year":"2021","unstructured":"Calverley P, Rogliani P, Papi A. Safety of N-Acetylcysteine at high doses in chronic respiratory diseases: A review. Drug Saf. 2021;44(3):273\u201390.","journal-title":"Drug Saf"},{"issue":"9470","key":"4166_CR8","doi-asserted-by":"publisher","first-page":"1552","DOI":"10.1016\/S0140-6736(05)66456-2","volume":"365","author":"M Decramer","year":"2005","unstructured":"Decramer M, Rutten-van M\u00f6lken M, Dekhuijzen PN, Troosters T, van Herwaarden C, Pellegrino R, van Schayck CP, Olivieri D, Del Donno M, De Backer W, et al. Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trial. Lancet. 2005;365(9470):1552\u201360.","journal-title":"Lancet"},{"issue":"3","key":"4166_CR9","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/S2213-2600(13)70286-8","volume":"2","author":"JP Zheng","year":"2014","unstructured":"Zheng JP, Wen FQ, Bai CX, Wan HY, Kang J, Chen P, Yao WZ, Ma LJ, Li X, Raiteri L, et al. Twice daily N-acetylcysteine 600\u00a0mg for exacerbations of chronic obstructive pulmonary disease (PANTHEON): a randomised, double-blind placebo-controlled trial. Lancet Respir Med. 2014;2(3):187\u201394.","journal-title":"Lancet Respir Med"},{"issue":"3","key":"4166_CR10","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1586\/17476348.1.3.307","volume":"1","author":"M Moretti","year":"2007","unstructured":"Moretti M. Pharmacology and clinical efficacy of erdosteine in chronic obstructive pulmonary disease. Expert Rev Respir Med. 2007;1(3):307\u201316.","journal-title":"Expert Rev Respir Med"},{"issue":"6","key":"4166_CR11","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1159\/000195871","volume":"57","author":"PC Braga","year":"1990","unstructured":"Braga PC, Allegra L, Rampoldi C, Ornaghi A, Beghi G. Long-lasting effects on rheology and clearance of bronchial mucus after short-term administration of high doses of carbocysteine-lysine to patients with chronic bronchitis. Respiration. 1990;57(6):353\u20138.","journal-title":"Respiration"},{"issue":"2","key":"4166_CR12","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1111\/j.1365-2273.1985.tb01171.x","volume":"10","author":"Y Sakakura","year":"1985","unstructured":"Sakakura Y, Majima Y, Saida S, Ukai K, Miyoshi Y. Reversibility of reduced mucociliary clearance in chronic sinusitis. Clin Otolaryngol Allied Sci. 1985;10(2):79\u201383.","journal-title":"Clin Otolaryngol Allied Sci"},{"issue":"1","key":"4166_CR13","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.ab.2004.08.003","volume":"335","author":"B Boonyapiwat","year":"2004","unstructured":"Boonyapiwat B, Forbes B, Steventon GB. Phenylalanine hydroxylase: possible involvement in the S-oxidation of S-carboxymethyl-l-cysteine. Anal Biochem. 2004;335(1):91\u20137.","journal-title":"Anal Biochem"},{"issue":"5","key":"4166_CR14","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1080\/15412555.2017.1347918","volume":"14","author":"M Cazzola","year":"2017","unstructured":"Cazzola M, Rogliani P, Calzetta L, Hanania NA, Matera MG. Impact of mucolytic agents on COPD exacerbations: A Pair-wise and network Meta-analysis. Copd. 2017;14(5):552\u201363.","journal-title":"Copd"},{"issue":"6","key":"4166_CR15","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1016\/j.resinv.2024.10.004","volume":"62","author":"H Ohnishi","year":"2024","unstructured":"Ohnishi H, Tanimoto T, Inaba R, Eitoku M. Efficacy and safety of mucolytics in patients with stable chronic obstructive pulmonary disease: A systematic review and meta-analysis. Respir Investig. 2024;62(6):1168\u201375.","journal-title":"Respir Investig"},{"key":"4166_CR16","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","volume":"366","author":"JAC Sterne","year":"2019","unstructured":"Sterne JAC, Savovi\u0107 J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng HY, Corbett MS, Eldridge SM, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.","journal-title":"BMJ"},{"issue":"3","key":"4166_CR17","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.pupt.2006.03.011","volume":"20","author":"J Rysz","year":"2007","unstructured":"Rysz J, Stolarek RA, Luczynski R, Sarniak A, Wlodarczyk A, Kasielski M, Nowak D. Increased hydrogen peroxide concentration in the exhaled breath condensate of stable COPD patients after nebulized N-acetylcysteine. Pulm Pharmacol Ther. 2007;20(3):281\u20139.","journal-title":"Pulm Pharmacol Ther"},{"issue":"2","key":"4166_CR18","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1016\/j.pupt.2007.07.004","volume":"21","author":"RW Dal Negro","year":"2008","unstructured":"Dal Negro RW, Visconti M, Micheletto C, Tognella S. Changes in blood ROS, e-NO, and some pro-inflammatory mediators in bronchial secretions following erdosteine or placebo: a controlled study in current smokers with mild COPD. Pulm Pharmacol Ther. 2008;21(2):304\u20138.","journal-title":"Pulm Pharmacol Ther"},{"issue":"9629","key":"4166_CR19","doi-asserted-by":"publisher","first-page":"2013","DOI":"10.1016\/S0140-6736(08)60869-7","volume":"371","author":"JP Zheng","year":"2008","unstructured":"Zheng JP, Kang J, Huang SG, Chen P, Yao WZ, Yang L, Bai CX, Wang CZ, Wang C, Chen BY, et al. Effect of carbocisteine on acute exacerbation of chronic obstructive pulmonary disease (PEACE Study): a randomised placebo-controlled study. Lancet. 2008;371(9629):2013\u20138.","journal-title":"Lancet"},{"issue":"4","key":"4166_CR20","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1016\/j.rmed.2008.11.003","volume":"103","author":"T Schermer","year":"2009","unstructured":"Schermer T, Chavannes N, Dekhuijzen R, Wouters E, Muris J, Akkermans R, van Schayck O, van Weel C. Fluticasone and N-acetylcysteine in primary care patients with COPD or chronic bronchitis. Respir Med. 2009;103(4):542\u201351.","journal-title":"Respir Med"},{"issue":"1","key":"4166_CR21","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1186\/1465-9921-10-69","volume":"10","author":"H Worth","year":"2009","unstructured":"Worth H, Schacher C, Dethlefsen U. Concomitant therapy with cineole (Eucalyptole) reduces exacerbations in COPD: a placebo-controlled double-blind trial. Respir Res. 2009;10(1):69.","journal-title":"Respir Res"},{"issue":"2","key":"4166_CR22","doi-asserted-by":"publisher","first-page":"151","DOI":"10.4103\/1658-354X.114069","volume":"7","author":"SJ Mirhosseini","year":"2013","unstructured":"Mirhosseini SJ, Forouzannia SK, Nasirian M, Ali-Hassan-Sayegh S. N-acetylcysteine instead of Theophylline in patients with COPD who are candidates for elective off-pump CABG surgery: is it possible in cardiovascular surgery unit? Saudi J Anaesth. 2013;7(2):151\u20134.","journal-title":"Saudi J Anaesth"},{"issue":"1","key":"4166_CR23","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1378\/chest.12-2357","volume":"144","author":"HN Tse","year":"2013","unstructured":"Tse HN, Raiteri L, Wong KY, Yee KS, Ng LY, Wai KY, Loo CK, Chan MH. High-dose N-acetylcysteine in stable COPD: the 1-year, double-blind, randomized, placebo-controlled HIACE study. Chest. 2013;144(1):106\u201318.","journal-title":"Chest"},{"key":"4166_CR24","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.pupt.2015.06.004","volume":"33","author":"RW Dal Negro","year":"2015","unstructured":"Dal Negro RW, Visconti M, Turco P. Efficacy of erdosteine 900 versus 600\u00a0mg\/day in reducing oxidative stress in patients with COPD exacerbations: results of a double blind, placebo-controlled trial. Pulm Pharmacol Ther. 2015;33:47\u201351.","journal-title":"Pulm Pharmacol Ther"},{"key":"4166_CR25","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.pupt.2016.09.007","volume":"41","author":"RW Dal Negro","year":"2016","unstructured":"Dal Negro RW, Visconti M. Erdosteine reduces the exercise-induced oxidative stress in patients with severe COPD: results of a placebo-controlled trial. Pulm Pharmacol Ther. 2016;41:48\u201351.","journal-title":"Pulm Pharmacol Ther"},{"key":"4166_CR26","first-page":"799","volume":"11","author":"K Johnson","year":"2016","unstructured":"Johnson K, McEvoy CE, Naqvi S, Wendt C, Reilkoff RA, Kunisaki KM, Wetherbee EE, Nelson D, Tirouvanziam R, Niewoehner DE. High-dose oral N-acetylcysteine fails to improve respiratory health status in patients with chronic obstructive pulmonary disease and chronic bronchitis: a randomized, placebo-controlled trial. Int J Chron Obstruct Pulmon Dis. 2016;11:799\u2013807.","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"6","key":"4166_CR27","doi-asserted-by":"publisher","first-page":"e0156999","DOI":"10.1371\/journal.pone.0156999","volume":"11","author":"M Koppitz","year":"2016","unstructured":"Koppitz M, Eschenburg C, Salzmann E, Rosewich M, Schubert R, Zielen S. Mucolytic effectiveness of tyloxapol in chronic obstructive pulmonary Disease - A Double-Blind, randomized controlled trial. PLoS ONE. 2016;11(6):e0156999.","journal-title":"PLoS ONE"},{"key":"4166_CR28","doi-asserted-by":"crossref","unstructured":"Caleffi Pereira M, Ferreira J, Iamonti V, Cardenas L, Pletsch R, Santana P, Carvalho C, Caruso P, Albuquerque A, Trevizan P. Lung function in seated and supine positions to predict diaphragm weakness in diaphragmatic paralysis; 2017.","DOI":"10.1183\/1393003.congress-2017.PA2197"},{"key":"4166_CR29","doi-asserted-by":"publisher","unstructured":"Kuzmenko N, Iaremenko O, Dobrianskiy D, Ilnytskyi R, Gumeniuk G. The efficacy and safety of inhaled acetylcysteine in comparison with oral acetylcysteine in chronic obstructive pulmonary disease: A randomized single-center study. Polish Annals of Medicine. 2020 ; CorpusID:226715190. https:\/\/doi.org\/10.29089\/2020.20.00112.","DOI":"10.29089\/2020.20.00112"},{"issue":"9","key":"4166_CR30","first-page":"3192","volume":"26","author":"V Kolarov","year":"2022","unstructured":"Kolarov V, Kotur Stevuljevi\u0107 J, Ili\u0107 M, Bogdan M, Tu\u0161ek B, Agic A, Dugajli\u0107 M, Tot Vere\u0161 K, Kutle\u0161i\u0107 Stevi\u0107 S, Zvezdin B. Factorial analysis of N-acetylcysteine and propolis treatment effects on symptoms, life quality and exacerbations in patients with chronic obstructive pulmonary disease (COPD): a randomized, double-blind, placebo-controlled trial. Eur Rev Med Pharmacol Sci. 2022;26(9):3192\u20139.","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"1","key":"4166_CR31","doi-asserted-by":"publisher","first-page":"8468","DOI":"10.1038\/s41467-024-51079-1","volume":"15","author":"Y Zhou","year":"2024","unstructured":"Zhou Y, Wu F, Shi Z, Cao J, Tian J, Yao W, Wei L, Li F, Cai S, Shen Y, et al. Effect of high-dose N-acetylcysteine on exacerbations and lung function in patients with mild-to-moderate COPD: a double-blind, parallel group, multicentre randomised clinical trial. Nat Commun. 2024;15(1):8468.","journal-title":"Nat Commun"},{"key":"4166_CR32","first-page":"12","volume":"14","author":"A Bachh","year":"2007","unstructured":"Bachh A, Shah N, Ahmed Z, Pandey D, Dar KA, Haq I. Effect of oral N-acetylcysteine in COPD - A randomised controlled trial. JK Practitioner. 2007;14:12\u20136.","journal-title":"JK Practitioner"},{"issue":"5","key":"4166_CR33","first-page":"6122","volume":"12","author":"JWQJ Hu","year":"2019","unstructured":"Hu JWQJ, Zhou ZX. The effects of N-acetylcysteine on the Th1\/Th2 ratio in elderly patients with chronic obstructive pulmonary disease. Int J Clin Exp Med. 2019;12(5):6122\u20137.","journal-title":"Int J Clin Exp Med"},{"key":"4166_CR34","doi-asserted-by":"publisher","unstructured":"Dal Negro RW, Wedzicha JA, Iversen MI, Fontana G, Page C, Cicero AF, Pozzi E, Calverley PMA. Effect of erdosteine on the rate and duration of COPD exacerbations: the RESTORE study (Reducing exacerbations and symptoms by treatment with oral Erdosteine). Eur Respir J. 2017 Oct 12;50(4):1700711.50(suppl 61):PA675. https:\/\/doi.org\/10.1183\/13993003.00711-2017","DOI":"10.1183\/13993003.00711-2017"},{"issue":"3","key":"4166_CR35","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1177\/1535370217750088","volume":"243","author":"RM Califf","year":"2018","unstructured":"Califf RM. Biomarker definitions and their applications. Exp Biol Med (Maywood). 2018;243(3):213\u201321.","journal-title":"Exp Biol Med (Maywood)"},{"issue":"7","key":"4166_CR36","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1111\/resp.12780","volume":"21","author":"FW Ko","year":"2016","unstructured":"Ko FW, Chan KP, Hui DS, Goddard JR, Shaw JG, Reid DW, Yang IA. Acute exacerbation of COPD. Respirology. 2016;21(7):1152\u201365.","journal-title":"Respirology"},{"issue":"1","key":"4166_CR37","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1186\/s12931-019-1078-y","volume":"20","author":"P Rogliani","year":"2019","unstructured":"Rogliani P, Matera MG, Page C, Puxeddu E, Cazzola M, Calzetta L. Efficacy and safety profile of mucolytic\/antioxidant agents in chronic obstructive pulmonary disease: a comparative analysis across erdosteine, carbocysteine, and N-acetylcysteine. Respir Res. 2019;20(1):104.","journal-title":"Respir Res"},{"issue":"6","key":"4166_CR38","doi-asserted-by":"publisher","first-page":"401","DOI":"10.2165\/00044011-200525060-00005","volume":"25","author":"R Zuin","year":"2005","unstructured":"Zuin R, Palamidese A, Negrin R, Catozzo L, Scarda A, Balbinot M. High-dose N-acetylcysteine in patients with exacerbations of chronic obstructive pulmonary disease. Clin Drug Investig. 2005;25(6):401\u20138.","journal-title":"Clin Drug Investig"},{"issue":"2","key":"4166_CR39","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1164\/rccm.201511-2219OC","volume":"194","author":"SP Bhatt","year":"2016","unstructured":"Bhatt SP, Soler X, Wang X, Murray S, Anzueto AR, Beaty TH, Boriek AM, Casaburi R, Criner GJ, Diaz AA, et al. Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2016;194(2):178\u201384.","journal-title":"Am J Respir Crit Care Med"},{"key":"4166_CR40","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.ctim.2016.09.017","volume":"29","author":"Y Chen","year":"2016","unstructured":"Chen Y, Shergis JL, Wu L, Yu X, Zeng Q, Xu Y, Guo X, Zhang AL, Xue CC, Lin L. A systematic review and meta-analysis of the herbal formula Buzhong Yiqi Tang for stable chronic obstructive pulmonary disease. Complement Ther Med. 2016;29:94\u2013108.","journal-title":"Complement Ther Med"},{"issue":"Suppl 1","key":"4166_CR41","doi-asserted-by":"publisher","first-page":"S53","DOI":"10.1016\/S0367-326X(02)00191-0","volume":"73","author":"F Borrelli","year":"2002","unstructured":"Borrelli F, Maffia P, Pinto L, Ianaro A, Russo A, Capasso F, Ialenti A. Phytochemical compounds involved in the anti-inflammatory effect of propolis extract. Fitoterapia. 2002;73(Suppl 1):S53\u201363.","journal-title":"Fitoterapia"},{"key":"4166_CR42","doi-asserted-by":"publisher","first-page":"807578","DOI":"10.1155\/2013\/807578","volume":"2013","author":"W Kr\u00f3l","year":"2013","unstructured":"Kr\u00f3l W, Bankova V, Sforcin JM, Szliszka E, Czuba Z, Kuropatnicki AK. Propolis: properties, application, and its potential. Evid Based Complement Alternat Med. 2013;2013:807578.","journal-title":"Evid Based Complement Alternat Med"},{"issue":"5","key":"4166_CR43","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1007\/BF02719705","volume":"168","author":"CF Marchioni","year":"1990","unstructured":"Marchioni CF, Moretti M, Muratori M, Casadei MC, Guerzoni P, Scuri R, Fregnan GB. Effects of erdosteine on sputum biochemical and rheologic properties: pharmacokinetics in chronic obstructive lung disease. Lung. 1990;168(5):285\u201393.","journal-title":"Lung"},{"issue":"4","key":"4166_CR44","first-page":"344","volume":"49","author":"PC Braga","year":"1999","unstructured":"Braga PC, Dal Sasso M, Sala MT, Gianelle V. Effects of erdosteine and its metabolites on bacterial adhesiveness. Arzneimittelforschung. 1999;49(4):344\u201350.","journal-title":"Arzneimittelforschung"},{"issue":"8","key":"4166_CR45","first-page":"739","volume":"50","author":"PC Braga","year":"2000","unstructured":"Braga PC, Dal Sasso M, Zuccotti T. Assessment of the antioxidant activity of the SH metabolite I of erdosteine on human neutrophil oxidative bursts. Arzneimittelforschung. 2000;50(8):739\u201346.","journal-title":"Arzneimittelforschung"},{"issue":"4","key":"4166_CR46","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/j.phrs.2006.12.006","volume":"55","author":"M Moretti","year":"2007","unstructured":"Moretti M, Marchioni CF. An overview of erdosteine antioxidant activity in experimental research. Pharmacol Res. 2007;55(4):249\u201354.","journal-title":"Pharmacol Res"},{"issue":"3","key":"4166_CR47","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1053\/rmed.2003.1432","volume":"97","author":"UR Juergens","year":"2003","unstructured":"Juergens UR, Dethlefsen U, Steinkamp G, Gillissen A, Repges R, Vetter H. Anti-inflammatory activity of 1.8-cineol (eucalyptol) in bronchial asthma: a double-blind placebo-controlled trial. Respir Med. 2003;97(3):250\u20136.","journal-title":"Respir Med"},{"issue":"2","key":"4166_CR48","first-page":"102","volume":"82","author":"SM Farber","year":"1955","unstructured":"Farber SM, Benioff MA, Smith JD. Planned care for patients with bronchiectasis. Calif Med. 1955;82(2):102\u20136.","journal-title":"Calif Med"},{"key":"4166_CR49","unstructured":"Disease GIfCOL. Global Strategy for the Prevention, Diagnosis and Management of COPD: 2024 Report. In.; 2024."},{"issue":"18","key":"4166_CR50","doi-asserted-by":"publisher","first-page":"3482","DOI":"10.12998\/wjcc.v12.i18.3482","volume":"12","author":"LY Huang","year":"2024","unstructured":"Huang LY, Huang B, Lv Z, Lu XD. Effects of acetylcysteine on micro-inflammation and pulmonary ventilation in chronic obstructive pulmonary disease exacerbation. World J Clin Cases. 2024;12(18):3482\u201390.","journal-title":"World J Clin Cases"},{"issue":"1","key":"4166_CR51","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.ejcdt.2013.02.012","volume":"62","author":"MAE Hafiz","year":"2013","unstructured":"Hafiz MAE, Mohammed El Wakeel A, Mohammed El Hady L, Mourad H. High dose N-acetyl cysteine improves inflammatory response and outcome in patients with COPD exacerbations. Egypt J Chest Dis Tuberculosis. 2013;62(1):51\u20137.","journal-title":"Egypt J Chest Dis Tuberculosis"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12890-026-04166-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-026-04166-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-026-04166-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T16:02:37Z","timestamp":1774022557000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12890-026-04166-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,13]]},"references-count":51,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4166"],"URL":"https:\/\/doi.org\/10.1186\/s12890-026-04166-6","relation":{},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,13]]},"assertion":[{"value":"19 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"124"}}