Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
The Second People's Hospital of Yichang, Yichang 443000, China.
Curr Pharm Biotechnol. 2021;22(12):1584-1590. doi: 10.2174/1389201021999201228212043.
N-Acetylcysteine (NAC) has been proposed to be used to treat Coronavirus Disease 2019 (COVID-19). By reviewing the existing pathological studies of COVID-19, it was found that abundant mucus secretion, formation of a hyaline membrane (supportive of acute respiratory distress syndrome), and interstitial fibrous exudation may be important characteristics of COVID-19 and pathological targets of drug therapy. In addition, multiple extrapulmonary organ injuries in COVID- 19 may be associated with cytokine storm. NAC is an important antioxidant and anti-inflammatory drug. NAC has been demonstrated to have mucolytic effects in bronchitis, relieve respiratory failure in acute respiratory distress syndrome, and inhibit fibrous exudation in interstitial lung disease in clinical studies. These findings suggest that NAC may have a therapeutic effect on the pathological targets of COVID-19. Furthermore, NAC decreases TNF-α, IL-1β, IL-6, IL-8, IL-10, and IL-17 serum levels in patients with sepsis, severe burns, acute liver failure, or peritoneal dialysis and may also reduce cytokine storm in COVID-19. The antiviral effect of NAC on other respiratory viruses may also benefit COVID-19 patients. Summarizing the potential mechanisms of NAC in treating COVID-19 suggests that the role of NAC in COVID-19 treatment is worthy of further research.
N-乙酰半胱氨酸（NAC）已被提议用于治疗 2019 年冠状病毒病（COVID-19）。通过对 COVID-19 的现有病理研究进行回顾，发现大量黏液分泌、透明膜形成（支持急性呼吸窘迫综合征）和间质纤维渗出可能是 COVID-19 的重要特征和药物治疗的病理靶点。此外，COVID-19 中的多个肺外器官损伤可能与细胞因子风暴有关。NAC 是一种重要的抗氧化剂和抗炎药物。在临床研究中，NAC 已被证明具有支气管炎的黏液溶解作用，可缓解急性呼吸窘迫综合征中的呼吸衰竭，并抑制间质性肺病中的纤维渗出。这些发现表明，NAC 可能对 COVID-19 的病理靶点具有治疗作用。此外，NAC 可降低败血症、严重烧伤、急性肝衰竭或腹膜透析患者的 TNF-α、IL-1β、IL-6、IL-8、IL-10 和 IL-17 血清水平，也可能减轻 COVID-19 中的细胞因子风暴。NAC 对其他呼吸道病毒的抗病毒作用也可能使 COVID-19 患者受益。总结 NAC 治疗 COVID-19 的潜在机制表明，NAC 在 COVID-19 治疗中的作用值得进一步研究。
