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In a study examining whether ICS and NAC have any effect on oxidative stress markers in patients with stable COPD, fluticasone propionate administered for 10 weeks led to a small improvement from baseline in the systemic redox balance by increasing GPX activity, whereas 10 weeks of NAC tended to decrease interleukin (IL)-8 levels in sputum, but did not affect trolox equivalent antioxidant capacity (TEAC), which reflects antioxidant activity against ROS and reactive nitrogen species [83]

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One major limitation is the incomplete knowledge of the metabolic pathways and transformations that polyphenols undergo after ingestion, particularly due to interactions with the gut microbiome and the formation of diverse metabolites whose biological activities are not well characterized (119)