N-Acetyl-L-Cysteine (NAC) is known to have diverse physiological and therapeutic benefits, attributed largely to its antioxidant, anti-inflammatory and mucolytic effects. It is well-accepted to increase the critical intracellular antioxidant glutathione, by supplying a stable form of L-cysteine, the rate-limiting factor for glutathione synthesis.1 The number of conditions with altered glutathione homeostasis continues to grow, including not only cardiovascular, neurodegenerative, pulmonary and age-related diseases, but there is also a growing clinical recognition of metabolic disturbances linked to environmental toxin exposure, such as diabetes and persistent organic pollutants.2 By restoring glutathione levels, NAC also is well established as the most effective therapy for acetaminophen toxicity.3
Additionally, NAC’s ability to cleave disulfide bonds provides efficacy as a mucolytic agent, with clinical benefit for individuals with COPD and pulmonary fibrosis.4,5 Breaking disulfide bonds may also be the same mechanism by which it lowers homocysteine and improves endothelial function in coronary artery disease.6 NAC has immunomodulating and anti-inflammatory effects, improving influenza symptomology and SLE disease activity.7,8 By modulating glutamatergic and neurotropic pathways, NAC also has shown benefit for schizophrenia, bipolar disorder and autism
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