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Abbreviations ALT: Alanine transaminase AST: Aspartate transaminase AKT/mTOR: Protein kinase B (also known as AKT)/mechanistic target of rapamycin hTERT-HSC: Immortal activated human hepatic stellate cells IL: Interleukin JAK/STAT: Janus kinasesignal transducer and activator of transcriptions JNK pathways: c-Jun N-terminal kinase (a type of MAPK pathway) MAPK/ERK: Mitogen-activated protein kinase/extracellular signal-regulated kinase MTX: Methotrexate MTX-PGs: Methotrexate-polyglutamate STAT3: Signal transducer and activator of transcription 3 TGF-1: Transforming growth factor receptor beta-1 TLRs: Toll like receptors TNF-: Tissue necrosis factors-alpha TWEAK Pathways: TNF-like weak inducer of apoptosis References Komiski P, Halik PK, Chesori R, Gniazdowska E (2020) Overview of dual-acting drug methotrexate in different neurological diseases, autoimmune pathologies and cancers

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M.et al (2018)

ERS Clinical Practice Guidelines (2025): The European Respiratory Society updated its management guidelines, issuing a conditional recommendation for the use of mucoactive drugs like NAC in specific NCFB phenotypes, particularly those with high sputum production and frequent exacerbations (94)

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