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Orally delivered NAC undergoes extensive first-pass metabolism resulting in about 90% loss by enzymatic deacetylation to form cysteine in the small intestine [9]

[DOI] [PMC free article] [PubMed] [Google Scholar] 51.Sies H., Belousov V.V., Chandel N.S., Davies M.J., Jones D.P., Mann G.E., Murphy M.P., Yamamoto M., Winterbourn C

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Due to a combination of host and microbial factors, NTHi persists in the lower airways of these individuals which is associated with an increased frequency of exacerbations, worsening symptoms, inflammation causing tissue damage, compositional changes to the lung microbiome and overall worse clinical prognosis (Sethi and Murphy, 2001