Macciò Antonio, Madeddu Clelia, Panzone Filomena, Mantovani Giovanni
Sirai Hospital, Department of Obstetrics and Gynecology, Carbonia, Italy.
Expert Opin Pharmacother. 2009 Mar;10(4):693-703. doi: 10.1517/14656560902758343.
Carbocysteine is a muco-active drug with free radical scavenging and anti-inflammatory properties. It is actually approved for clinical use as adjunctive therapy of respiratory tract disorders characterized by excessive, viscous mucus, including chronic obstructive airways disease (COPD).
The intriguing antioxidant and anti-inflammatory properties of carbocysteine, beyond its known mucolytic activity, are described to explain its therapeutic efficacy and suggest new clinical uses.
After reviewing physiology and preclinical studies, human studies on the use of carbocysteine in chronic inflammatory diseases, i.e., COPD and cancer cachexia, are reviewed.
RESULTS/CONCLUSIONS: Carbocysteine has been recently recognized as an effective and safe treatment for the long-term management of COPD, able to reduce the incidence of exacerbations and improve patient quality of life. Moreover, carbocysteine was effective in counteracting some symptoms associated with cancer cachexia. Preclinical and clinical studies have demonstrated that the antioxidant and anti-inflammatory properties of carbocysteine are more important than mucolysis itself for its therapeutic efficacy. Therefore, carbocysteine may be able to reverse the oxidative stress associated with several chronic inflammatory diseases, such as cardiovascular diseases and neurodegenerative disorders. Controlled, randomized studies in humans are warranted.
羧甲司坦是一种具有自由基清除和抗炎特性的黏液活性药物。它实际上已被批准作为临床辅助治疗药物，用于治疗以过多、黏稠黏液为特征的呼吸道疾病，包括慢性阻塞性气道疾病（COPD）。
描述羧甲司坦除已知的黏液溶解活性外有趣的抗氧化和抗炎特性，以解释其治疗效果并提出新的临床用途。
在回顾生理学和临床前研究后，对羧甲司坦在慢性炎症性疾病（即COPD和癌症恶病质）中应用的人体研究进行综述。
结果/结论：羧甲司坦最近被认为是一种有效且安全的COPD长期管理治疗药物，能够降低急性加重的发生率并改善患者生活质量。此外，羧甲司坦在对抗与癌症恶病质相关的一些症状方面有效。临床前和临床研究表明，羧甲司坦的抗氧化和抗炎特性对其治疗效果比黏液溶解本身更重要。因此，羧甲司坦可能能够逆转与几种慢性炎症性疾病（如心血管疾病和神经退行性疾病）相关的氧化应激。有必要在人体中进行对照、随机研究。
