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Moreover, NAC modulates other pro-inflammatory mechanisms, including cyclooxygenase (COX)-2, matrix metalloproteinases (MMP)-3 and -4, or the expression of the intercellular adhesion molecule (ICAM)-1, and inhibits the phosphorylation of p38 mitogen-activated protein kinase (MAPK) by decreasing the intracellular concentration of H 2 O 2 and restoring the redox balance [63]