Department of Health Sciences, University of Milan, Milan, Italy.
Eur Rev Med Pharmacol Sci. 2022 Jan;26(2):715-721. doi: 10.26355/eurrev_202201_27898.
As N-acetylcysteine (NAC) is promising as a re-purposed drug for the adjunctive or supportive treatment of serious COVID-19, this article aimed to describe current evidence.
A search was performed in PubMed/Medline for "NAC", "viral Infection", COVID-19", oxidative stress", "inflammation", retrieving preclinical and clinical studies.
NAC is a pleiotropic molecule with a dual antioxidant mechanism; it may neutralize free radicals and acts as a donor of cysteine, restoring the physiological pool of GSH. Serious COVID-19 patients have increased levels of reactive oxygen species (ROS) and free radicals and often present with glutathione depletion, which prompts a cytokine storm. NAC, which acts as a precursor of GSH inside cells, has been currently used in many conditions to restore or protect against GSH depletion and has a wide safety margin. In addition, NAC has anti-inflammatory activity independently of its antioxidant activity.
Clinical and experimental data suggest that NAC may act on the mechanisms leading to the prothrombotic state observed in severe COVID-19.
由于 N-乙酰半胱氨酸（NAC）作为一种有前途的药物，可用于辅助或支持严重 COVID-19 的治疗，本文旨在描述现有证据。
在 PubMed/Medline 中搜索“NAC”、“病毒感染”、“COVID-19”、“氧化应激”、“炎症”，检索临床前和临床研究。
NAC 是一种具有双重抗氧化机制的多效分子；它可以中和自由基，并作为半胱氨酸的供体，恢复 GSH 的生理池。严重 COVID-19 患者的活性氧（ROS）和自由基水平升高，常伴有谷胱甘肽耗竭，从而引发细胞因子风暴。NAC 作为细胞内 GSH 的前体，目前已在许多情况下用于恢复或防止 GSH 耗竭，并具有较宽的安全范围。此外，NAC 具有独立于其抗氧化活性的抗炎活性。
临床和实验数据表明，NAC 可能作用于导致严重 COVID-19 中观察到的血栓前状态的机制。
