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Conversely, BCAAs can also exacerbate hepatic oxidative stress and hepatocyte apoptosis

Preclinical findings suggest these approaches can suppress tumor proliferation and improve responsiveness to radiation and chemotherapy, although clinical evidence remains limited

An RCT of 174 patients with severe alcoholic hepatitis found that the combination of prednisolone + NAC (IV for 5 days, then oral for 2 weeks) significantly reduced 1-month mortality compared to prednisolone alone (8% vs 24%, p=0.006), though the difference was not significant at 6 months (Nguyen-Khac et al., N Engl J Med, 2011) [36]

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