{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T01:07:30Z","timestamp":1790557650873,"version":"4.1.0"},"reference-count":118,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>N-acetyl-L-cysteine (NAC) was initially introduced as a treatment for mucus reduction and widely used for chronic respiratory conditions associated with mucus overproduction. However, the mechanism of action for NAC extends beyond its mucolytic activity and is complex and multifaceted. Contrary to other mucoactive drugs, NAC has been found to exhibit antioxidant, anti-infective, and anti-inflammatory activity in pre-clinical and clinical reports. These properties have sparked interest in its potential for treating chronic lung diseases, including chronic obstructive pulmonary disease (COPD), bronchiectasis (BE), cystic fibrosis (CF), and idiopathic pulmonary fibrosis (IPF), which are associated with oxidative stress, increased levels of glutathione and inflammation. NAC\u2019s anti-inflammatory activity is noteworthy, and it is not solely secondary to its antioxidant capabilities. In ex vivo models of COPD exacerbation, the anti-inflammatory effects have been observed even at very low doses, especially with prolonged treatment. The mechanism involves the inhibition of the activation of NF-kB and neurokinin A production, resulting in a reduction in interleukin-6 production, a cytokine abundantly present in the sputum and breath condensate of patients with COPD and correlates with the number of exacerbations. The unique combination of mucolytic, antioxidant, anti-infective, and anti-inflammatory properties positions NAC as a safe, cost-effective, and efficacious therapy for a plethora of respiratory conditions.<\/jats:p>","DOI":"10.3390\/jcm13144127","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T14:15:49Z","timestamp":1721052949000},"page":"4127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Anti-Inflammatory and Anti-Oxidant Properties of N-Acetylcysteine: A Fresh Perspective"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-8253","authenticated-orcid":false,"given":"Pierachille","family":"Santus","sequence":"first","affiliation":[{"name":"Division of Respiratory Diseases, \u201cL. Sacco\u201d University Hospital, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Camilo","family":"Signorello","sequence":"additional","affiliation":[{"name":"Division of Respiratory Diseases, \u201cL. Sacco\u201d University Hospital, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiammetta","family":"Danzo","sequence":"additional","affiliation":[{"name":"Division of Respiratory Diseases, \u201cL. Sacco\u201d University Hospital, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Lazzaroni","sequence":"additional","affiliation":[{"name":"Division of Respiratory Diseases, \u201cL. Sacco\u201d University Hospital, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Saad","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9013-3418","authenticated-orcid":false,"given":"Dejan","family":"Radovanovic","sequence":"additional","affiliation":[{"name":"Division of Respiratory Diseases, \u201cL. Sacco\u201d University Hospital, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"},{"name":"Department of Biomedical and Clinical Sciences, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1111\/j.1749-6632.1963.tb16647.x","article-title":"The reduction in vitro in viscosity of mucoprotein solutions by a new mucolytic agent, N-acetyl-L-cysteine","volume":"106","author":"Sheffner","year":"1963","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/S0140-6736(77)90612-2","article-title":"Treatment of paracetamol (acetaminophen) poisoning with N-acetylcysteine","volume":"2","author":"Prescott","year":"1977","journal-title":"Lancet"},{"key":"ref_3","unstructured":"(2024, May 06). 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