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Mast cells are hypersensitive immune cells that release histamine and other inflammatory mediators—often in response to oxidative stress, environmental toxins, and immune imbalance. Many patients with MCAS have low levels of glutathione.

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The recommendations explicitly state that “in COPD patients not receiving inhaled corticosteroids, regular treatment with mucolytics such as carbocysteine and N-acetylcysteine may reduce exacerbations and modestly improve health status” [35]