Impact of N-Acetylcysteine on Mucus Hypersecretion in the Airways: A Systematic Review.

IF 2.7 3区 医学 Q2 RESPIRATORY SYSTEM International Journal of Chronic Obstructive Pulmonary Disease Pub Date : 2024-10-29 eCollection Date: 2024-01-01 DOI:10.2147/COPD.S474512
Paola Rogliani, Gian Marco Manzetti, Shima Gholamalishahi, Mario Cazzola, Luigino Calzetta
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Abstract

Mucus clearance is crucial for airway protection, and its dysfunction leads to chronic obstructive pulmonary disease (COPD) characterized by mucus hypersecretion (MHS) and impaired clearance. MUC5AC and MUC5B mucin proteins are key components of airway mucus, with MUC5AC being particularly responsive to environmental stimuli, making it a potential COPD biomarker. N-acetylcysteine (NAC) is a mucolytic agent with known effects on mucus viscosity and clearance, but its precise mechanisms in COPD remain unclear. This systematic review evaluated the impact of NAC on MHS in the airways, reporting significant inhibitory effects on MUC5AC and MUC5B gene and protein expression, as well as a reduction in the number of goblet cells. NAC has demonstrated efficacy in vitro and in animal models of MHS, including COPD models, but data on human bronchial tissue are lacking. This systematic review suggests that NAC acts as a mucolytic and a mucoregulator, directly inhibiting mucus secretion and goblet cell hyperplasia. Given the critical role of MHS in COPD progression, exacerbations, and mortality, these findings highlight the potential of NAC as a targeted therapy for hypersecretion COPD phenotypes. However, further studies are needed to confirm the results of this systematic review, even in human bronchial tissue, to provide translatable evidence in clinical settings. Understanding the intimate mechanism of NAC versus MHS regulation may pave the way for more effective treatments targeting airway mucus dysfunction in COPD, ultimately improving patient outcomes and reducing morbidity and mortality associated with chronic mucus hypersecretion.

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N-乙酰半胱氨酸对呼吸道黏液分泌过多的影响:系统综述。
粘液清除对保护气道至关重要,其功能障碍会导致以粘液分泌过多(MHS)和清除障碍为特征的慢性阻塞性肺病(COPD)。MUC5AC 和 MUC5B 粘蛋白是气道粘液的关键成分,其中 MUC5AC 对环境刺激的反应特别灵敏,因此是一种潜在的慢性阻塞性肺病生物标记物。N-乙酰半胱氨酸(NAC)是一种粘液溶解剂,对粘液粘度和清除率有已知的影响,但其在慢性阻塞性肺病中的确切机制仍不清楚。本系统综述评估了 NAC 对气道中 MHS 的影响,报告了 NAC 对 MUC5AC 和 MUC5B 基因和蛋白表达的显著抑制作用,以及对减少鹅口疮细胞数量的作用。NAC 已在体外和 MHS 动物模型(包括慢性阻塞性肺病模型)中显示出疗效,但缺乏有关人体支气管组织的数据。本系统综述表明,NAC 可作为粘液溶解剂和粘液调节剂,直接抑制粘液分泌和鹅口疮细胞增生。鉴于 MHS 在慢性阻塞性肺病的发展、病情加重和死亡率中的关键作用,这些发现凸显了 NAC 作为一种针对高分泌型慢性阻塞性肺病表型的靶向疗法的潜力。然而,还需要进一步的研究来证实本系统综述的结果,甚至在人体支气管组织中进行研究,以便为临床提供可转化的证据。了解 NAC 与 MHS 的密切调节机制可能会为针对慢性阻塞性肺病气道粘液功能障碍的更有效治疗铺平道路,最终改善患者预后,降低与慢性粘液分泌过多相关的发病率和死亡率。
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来源期刊
CiteScore
4.80
自引率
10.70%
发文量
372
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals
期刊最新文献
Analysis of Predictive Value of Cellular Inflammatory Factors and T Cell Subsets for Disease Recurrence and Prognosis in Patients with Acute Exacerbations of COPD. Impact of N-Acetylcysteine on Mucus Hypersecretion in the Airways: A Systematic Review. Associations of Platelet to High-Density Lipoprotein Cholesterol Ratio with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study from the US National Health and Nutrition Examination Survey. Prevalence and Impact of Chronic Obstructive Pulmonary Disease in Ischemic Heart Disease: A Systematic Review and Meta-Analysis of 18 Million Patients. Association of Physical Activity with Asthma and Chronic Obstructive Pulmonary Disease and Mediation of Frailty: Mendelian Randomization Analyses.
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