Mucus production and chronic obstructive pulmonary disease, a possible treatment target: zooming in on N-acetylcysteine
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, it...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2025-01-01
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| Series: | Monaldi Archives for Chest Disease |
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| Online Access: | https://www.monaldi-archives.org/macd/article/view/3159 |
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| _version_ | 1841536088026382336 |
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| author | Federico Baraldi Tommaso Bigoni Maria Pia Foschino Barbaro Claudio Micheletto Giulia Scioscia Alessandro Vatrella Alberto Papi |
| author_facet | Federico Baraldi Tommaso Bigoni Maria Pia Foschino Barbaro Claudio Micheletto Giulia Scioscia Alessandro Vatrella Alberto Papi |
| author_sort | Federico Baraldi |
| collection | DOAJ |
| description |
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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| format | Article |
| id | doaj-art-45288a9d6f924095b6e628921016dcab |
| institution | Kabale University |
| issn | 1122-0643 2532-5264 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj-art-45288a9d6f924095b6e628921016dcab2025-01-15T01:39:06ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642025-01-0110.4081/monaldi.2025.3159Mucus production and chronic obstructive pulmonary disease, a possible treatment target: zooming in on N-acetylcysteineFederico Baraldi0https://orcid.org/0009-0007-5649-8409Tommaso Bigoni1https://orcid.org/0000-0003-1970-9653Maria Pia Foschino Barbaro2Claudio Micheletto3https://orcid.org/0000-0002-1138-3882Giulia Scioscia4https://orcid.org/0000-0002-2667-077XAlessandro Vatrella5https://orcid.org/0000-0001-8265-3037Alberto Papi6https://orcid.org/0000-0002-6924-4500Section of Respiratory Medicine, Department of Translational Medicine, University of FerraraSection of Respiratory Medicine, Department of Translational Medicine, University of Ferrara; Respiratory Unit, ULSS 8 Berica, VicenzaDepartment of Medical and Surgical Sciences, University of FoggiaRespiratory Unit, Integrated University Hospital of VeronaDepartment of Medical and Surgical Sciences, University of Foggia; Respiratory Medicine, Policlinico of FoggiaDepartment of Medicine, Surgery and Dentistry, University of SalernoSection of Respiratory Medicine, Department of Translational Medicine, University of Ferrara 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. https://www.monaldi-archives.org/macd/article/view/3159COPDmucus hyperproductionchronic bronchitisN-acetylcysteine |
| spellingShingle | Federico Baraldi Tommaso Bigoni Maria Pia Foschino Barbaro Claudio Micheletto Giulia Scioscia Alessandro Vatrella Alberto Papi Mucus production and chronic obstructive pulmonary disease, a possible treatment target: zooming in on N-acetylcysteine Monaldi Archives for Chest Disease COPD mucus hyperproduction chronic bronchitis N-acetylcysteine |
| title | Mucus production and chronic obstructive pulmonary disease, a possible treatment target: zooming in on N-acetylcysteine |
| title_full | Mucus production and chronic obstructive pulmonary disease, a possible treatment target: zooming in on N-acetylcysteine |
| title_fullStr | Mucus production and chronic obstructive pulmonary disease, a possible treatment target: zooming in on N-acetylcysteine |
| title_full_unstemmed | Mucus production and chronic obstructive pulmonary disease, a possible treatment target: zooming in on N-acetylcysteine |
| title_short | Mucus production and chronic obstructive pulmonary disease, a possible treatment target: zooming in on N-acetylcysteine |
| title_sort | mucus production and chronic obstructive pulmonary disease a possible treatment target zooming in on n acetylcysteine |
| topic | COPD mucus hyperproduction chronic bronchitis N-acetylcysteine |
| url | https://www.monaldi-archives.org/macd/article/view/3159 |
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