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The landmark PANTHEON trial, a 1-year multicenter RCT in 1,006 Chinese COPD patients, found that high-dose NAC (600 mg twice daily) reduced the rate of acute exacerbations by 22% compared to placebo (1.16 vs 1.49 exacerbations per year, p=0.0011) (Zheng et al., Lancet Respir Med, 2014) [44]

ROS function in redox signaling and oxidative stress

Interestingly, a follow-up study found that neither pre- nor post-treatment of metformin against APAP hepatotoxicity inhibited JNK activation or its mitochondrial translocation [31], [32]

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It can also boost immunity and support overall cellular health by neutralizing free radicals