Table 3. Role of NAC.

1	Protection against reactive oxygen species by increasing Nrf2 and HO-1 mRNA levels
2	Protection against mitochondrial dysfunction, which causes release of acylcarnitines in peripheral vasculature
3	Elimination of JNK activation and GDH release
4	The mechanism of protection during the early metabolism phase primarily involves improved scavenging of the reactive metabolite NAPQI due to accelerated GSH synthesis
5	Scavenging of the reactive metabolite NAPQI and decreasing of protein binding during the early phase occurs through increasing levels of GSH
6	Provision of increased amounts of cysteine to allow regeneration of GSH well beyond clearance of APAP, allowing for hepatocyte regeneration

Abbreviations: JNK, c-Jun-N-terminal kinase; GD, glutamate dehydrogenase; GSH, glutathione; NAC, N-acetylcysteine; HO-1, heme oxygenase-1; NAPQI, N-acetyl-para-benzo-quinone imine; Nrf2, nuclear factor erythroid 2-related factor 2.