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N-acetylglutamic acid (NAG) is a naturally occurring metabolite and an essential allosteric activator of carbamoyl phosphate synthetase 1 (CPS1), the rate-limiting enzyme of the urea cycle. Beyond its endogenous role in nitrogen metabolism and arginine biosynthesis, NAG is being investigated as a microbiota-derived therapeutic for inflammatory and fibrotic diseases. Research indicates that oral administration of NAG can alleviate chronic colitis-associated intestinal fibrosis and alcohol-associated liver disease by up-regulating the NRF2 (Nuclear factor erythroid 2-related factor 2) signaling pathway. This activation inhibits fibroblast activation, reduces collagen synthesis, and prevents ferroptosis. It is currently being studied in preclinical models, often in the context of gut microbiota modulation (e.g., via low-molecular-weight heparin).
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