Table 2.

Proposed mechanisms for N-acetylcysteine to reduce exacerbations of chronic obstructive pulmonary disease

Mucolytic effect by reducing viscosity of sputum and secretion in airway

Inhibit attachment of bacteria to epithelium by disrupting bacterial receptor sites on epithelial surface and mucus

Inhibit transmigration of neutrophils by suppressing interleukin-8 and intercellular adhesion molecule-1

Improve small airway function by decreasing epithelial thickening, reducing secretory cell hyperplasia

Reduce lung hyperinflation and reduce emphysema

Reduce lysozyme and lactoferrin concentration

Reduce activation of neutrophils and macrophages

Restore the host innate antiviral response by preventing suppression of oxidant-sensitive retinoic acid inducible gene