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Vagotomy in animal studies is said to disrupt the transfer of -synuclein derived from the gut to the CNS, but human observational evidence is inconsistent, with some studies indicating no change in PD incidence and others suggesting a reduced risk following truncal vagotomy (Elfil et al., 2020)

In the intestine for example, several drug metabolising enzymes are presumed to decrease the bioavailability of orally administered drugs or to activate environmental carcinogens

While these findings are highly promising, the substantial heterogeneity ( I 2 = 49%) reflect more recent trial outcomes which have not shown statistically significant N-acetylcysteine and placebo differences

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