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Central to this process is the dysregulation of arginine metabolism, where M2 macrophage-derived arginase-1 (Arg-1) shunts arginine toward polyamine synthesis, driving airway smooth muscle hyperplasia, while concurrent downregulation of epithelial NOS2 expression reduces nitric oxide (NO) production and exacerbates bronchoconstriction

[] By promoting greater glutathione synthesis, which is essential for reducing oxidative stress, NAC may reduce dopamine

Yang G., Wang L

The results may indicate that subjects with high baseline oxidative burden may be poor responders to oral glutathione supplementation

doi: 10.1111/j.1349-7006.2009.01257.x