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NAC was found to suppress airway inflammation and hyperreactivity in animals70 and inhibit ROS production in human peripheral blood eosinophils.71 In animal models, oral NAC exerted an antioxidant protective effect and attenuated pulmonary inflammation.70,72 In humans, according to meta-analyses, NAC is able to decrease the exacerbation rate in patients with COPD by more than 20%.73–75 However, in a controlled randomized study, NAC was found to be ineffective in preventing the deterioration in lung function and exacerbations in patients with COPD.76 In a recent study, NAC produced no significant benefit when added to conventional treatment during an asthma attack.77 The lack of clear benefit in human studies may be related to the relative instability of NAC.78,79 In addition to NAC, a more potent and orally available thiol antioxidant is bucillamine
