Mucous hypersecretion is an important clinical manifestation of COPD, bronchiectasis and pulmonary cystic fibrosis. N-Acetylcysteine has mucolytic properties and has been used for decades as a mucolytic agent in several lung disorders.
In COPD inflammatory responses induced by cigarette smoking together with oxidative stress injure airway epithelial cells and stimulate mucous hyper secretion.
In bronchiectasis , irreversible expansion of the airway bronchial lumen compromises mucous clearance and allows bacteria to colonise the airway. Airway mucous hypersecretion can obstruct the respiratory tract lumen , limit airflow and accelerate the decline in lung function.
This can lead to recurrent airway infection, causing airway obstruction and remodelling, thereby creating a vicious cycle.
NAC’s mucolytic action:
Oral NAC has been tested as a medication that may influence oxidative stress and inflammation in COPD, thereby reducing hospitalisation rates.
As early as 1985 it was reported that NAC reduced oxidative damage to polymorphonuclear lymphocytes in vitro.
It also plays a muco regulatory role as it can decrease sputum hypersecretion as it also inhibits the mucous secretory cell hyperplasia
