However, the mechanism by which NAC-mediated VWF/p38 MAPK affects pulmonary fibrosis in COPD involving the immune response and EMT is still poorly understood, highlighting a major gap in knowledge given that NAC-mediated VWF/p38 MAPK may be of significance to pulmonary fibrosis in COPD. Here, VWF is linked to chronic obstructive pulmonary disease.