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Zaitsev AA, Filon EA, Storozheva YI. [Acute bronchitis - modern possibilities of mucactive therapy]. TERAPEVT ARKH 2023; 95:943-950. [PMID: 38158950 DOI: 10.26442/00403660.2023.11.202470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 01/03/2024]
Abstract
AIM Analysis of the clinical effectiveness and safety of erdosteine use in comparison with standard (real practice) mucoactive therapy in patients with acute bronchitis (АВ) in adults. MATERIALS AND METHODS The observational program included 100 adult patients with АВ, 50 of them (group 1) received erdosteine, the group 2 also included 50 patients who received acetylcysteine, bromhexine and other mucolytics (real clinical practice). The following were assessed: cough severity, average time for resolution of night and daytime cough, satisfaction with treatment, NO concentration in exhaled air, levels of C-reactive protein (CRP) and interleukin-6 (IL-6). RESULTS The average duration of relief of severe daytime cough requiring continued therapy was: in group 1 - 3.7±0.46 days, night cough - 1.14±0.94 days. In the second group, daytime cough was relieved in 3.8±0.4 days, night cough - 1.08±0.7 days. The duration of mucoactive therapy in group 1 was 5.32±0.82 days, in group 2 this figure was 8.5±1.4 days (p<0.05). The number of АВ patients with a significant reduction in the severity of productive cough (1 point on cough severity scale) on the 6th day from the beginning of treatment in group 1 (erdosteine) amounted to 32 (64%), in group 2 - 27 (54%). Satisfaction with the treatment was higher in the group receiving erdosteine: according to the indicators "very satisfied" and "extremely satisfied" the patients of the group 1 - 42 - were the leaders in comparison with the group 2, where these positions were marked by 28 patients. The level of CRP in patients with АВ in group 1 was 24.7±21.24 mg/l, in group 2 - 16.37±16.5 mg/l, which indicates the viral etiology of the process and no need in the prescription of antimicrobial drugs. For the first time in Russian practice, the following were determined: the level of IL-6, which in the group 1 was 10.3±6.7 pc/ml; in the group 2 - 10.03±3.94 pc/ml; the level of exhaled NO in group 1 was 16.5±5.1 ppb, in group 2 - 14.9±4.6 ppb (the norm is up to 25 ppb). These indicators, against the background of mucoactive therapy, decreased to normal values by 6th day. CONCLUSION The findings expand our understanding of АВ in adults. New results have been obtained on the role of CRP, IL-6 and NO in exhaled air during АВ. The use of erdosteine was accompanied by a significant mucoactive effect in the form of a pronounced regression of cough in patients with АВ compared to the comparison group in shorter term.
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Affiliation(s)
- A A Zaitsev
- Burdenko Main Military Clinical Hospital
- Russian Biotechnological University
- Central Research Institute of Epidemiology
| | - E A Filon
- Burdenko Main Military Clinical Hospital
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2
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Barbosa M, Chalmers JD. Bronchiectasis. Presse Med 2023; 52:104174. [PMID: 37778637 DOI: 10.1016/j.lpm.2023.104174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/03/2023] Open
Abstract
Bronchiectasis is a final common pathway of a wide variety of underlying conditions including infectious, autoimmune, allergic, genetic and inflammatory conditions. Patients experience a chronic disease with variable clinical symptoms and course, but most experience cough, sputum production and recurrent exacerbations. Symptoms of bronchiectasis lead to poor quality of life and exacerbations are the major driver of morbidity and mortality. Patients are often chronically infected with bacteria with the most common being Pseudomonas aeruginosa and Haemophilus influenzae. Treatment of bronchiectasis includes standardised testing to identify the underlying cause with targeted treatment if immune deficiency, allergic bronchopulmonary aspergillosis or non-tuberculous mycobacterial infection, for example, are identified. Airway clearance is the mainstay of therapy for patients with symptoms of cough and sputum production. Frequently exacerbating patients may benefit from long term antibiotic or mucoactive therapies. Bronchiectasis is a heterogeneous disease and increasingly precision medicine approaches are advocated to target treatments most appropriately and to limit the emergence of antimicrobial resistance.
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Affiliation(s)
- Miguel Barbosa
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK
| | - James D Chalmers
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK.
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3
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Cazzola M, Page CP, Wedzicha JA, Celli BR, Anzueto A, Matera MG. Use of thiols and implications for the use of inhaled corticosteroids in the presence of oxidative stress in COPD. Respir Res 2023; 24:194. [PMID: 37517999 PMCID: PMC10388561 DOI: 10.1186/s12931-023-02500-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Oxidative stress and persistent airway inflammation are thought to be important contributors to the development of chronic obstructive pulmonary disease (COPD). This review summarizes the evidence for targeting oxidative stress and inflammation in patients with COPD with mucolytic/antioxidant thiols and inhaled corticosteroids (ICS), either alone or in combination. MAIN BODY Oxidative stress is increased in COPD, particularly during acute exacerbations. It can be triggered by oxidant air pollutants and cigarette smoke and/or by endogenous reactive oxygen species (ROS) released from mitochondria and activated inflammatory, immune and epithelial cells in the airways, together with a reduction in endogenous antioxidants such as glutathione (GSH). Oxidative stress also drives chronic inflammation and disease progression in the airways by activating intracellular signalling pathways and the release of further inflammatory mediators. ICS are anti-inflammatory agents currently recommended for use with long-acting bronchodilators to prevent exacerbations in patients with moderate-to-severe COPD, especially those with eosinophilic airway inflammation. However, corticosteroids can also increase oxidative stress, which may in turn reduce corticosteroid sensitivity in patients by several mechanisms. Thiol-based agents such as erdosteine, N-acetyl L-cysteine (NAC) and S-carboxymethylcysteine (S-CMC) are mucolytic agents that also act as antioxidants. These agents may reduce oxidative stress directly through the free sulfhydryl groups, serving as a source of reducing equivalents and indirectly though intracellular GSH replenishment. Few studies have compared the effects of corticosteroids and thiol agents on oxidative stress, but there is some evidence for greater antioxidant effects when they are administered together. The current Global Initiative for Chronic Obstructive Lung Disease (GOLD) report supports treatment with antioxidants (erdosteine, NAC, S-CMC) in addition to standard-of-care therapy as they have been demonstrated to reduce COPD exacerbations. However, such studies have demonstrated that NAC and S-CMC reduced the exacerbation risk only in patients not treated with ICS, whereas erdosteine reduced COPD exacerbations irrespective of concomitant ICS use suggesting that erdosteine has additional pharmacological actions to ICS. CONCLUSIONS Further clinical trials of antioxidant agents with and without ICS are needed to better understand the place of thiol-based drugs in the treatment of patients with COPD.
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Affiliation(s)
- Mario Cazzola
- Chair of Respiratory Medicine, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - Clive P Page
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, UK
| | - Jadwiga A Wedzicha
- Respiratory Medicine Division, National Heart and Lung Institute, Imperial College London, London, UK
| | - Bartolome R Celli
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Antonio Anzueto
- Department of Pulmonary Medicine and Critical Care, University of Texas Health and South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Maria Gabriella Matera
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
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4
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Poletti V, Pagnini F, Banfi P, Volpato E. Illness Perceptions, Cognitions, and Beliefs on COPD Patients' Adherence to Treatment - A Systematic Review. Patient Prefer Adherence 2023; 17:1845-1866. [PMID: 37533752 PMCID: PMC10392903 DOI: 10.2147/ppa.s412136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/07/2023] [Indexed: 08/04/2023] Open
Abstract
Background Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease characterized by persistent respiratory symptoms and airflow limitation. Besides its irreversibility, COPD is a treatable condition, and patients would strongly benefit from being adherent to their treatments. However, almost half of them are non-adherent, and, according to several recent studies, the way the patient perceives the disease might influence this variable. Aim This systematic review provided a synthesis of studies about the relationships between illness perceptions (IP), cognitions, beliefs, and adherence in COPD. Methods English language publications were searched in PubMed, Medline, Scopus, ResearchGate, PsycINFO, and Cochrane Library databases from November 2022 to February 2023, following PRISMA guidelines. The reference lists of eligible studies were also searched. Data extraction and critical appraisal were undertaken by two reviewers working independently. Results A total of 14 studies were included. Adherence to treatment in COPD is confirmed to be low, using both self-report questionnaires and objective assessment systems. Most studies concluded that COPD is perceived as a moderate threat destined to last forever, even if many participants referred to little disease knowledge. This perception did not change between adherent and non-adherent groups. Those who considered more necessary to take their medicines and had a caregiver were more adherent and less concerned about their future. On the other side, forgetfulness, lack of trust in medications, and difficulties in understanding how to take them were perceived as the main causes of non-adherence. Other predictors of non-adherence, like depression, low self-efficacy, and severity of disease were confirmed. Conclusion The systematic review highlights the variability of the relationship between IP, cognitions and beliefs, and COPD treatment adherence. A new level of awareness of the relationship between patients' subjective point of view and treatment adherence may inform future treatment options and promote a more personalized intervention.
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Affiliation(s)
- Valentina Poletti
- Department of Psychology, Università Cattolica Del Sacro Cuore, Milan, Italy
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica Del Sacro Cuore, Milan, Italy
| | | | - Eleonora Volpato
- Department of Psychology, Università Cattolica Del Sacro Cuore, Milan, Italy
- IRCCS Fondazione Don Gnocchi, Milan, Italy
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5
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Tai J, Shin JM, Park J, Han M, Kim TH. Oxidative Stress and Antioxidants in Chronic Rhinosinusitis with Nasal Polyps. Antioxidants (Basel) 2023; 12:antiox12010195. [PMID: 36671057 PMCID: PMC9854928 DOI: 10.3390/antiox12010195] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Oxidative stress results from an imbalance between the production of reactive oxygen species and the body's antioxidant defense system. It plays an important role in the regulation of the immune response and can be a pathogenic factor in various diseases. Chronic rhinosinusitis (CRS) is a complex and heterogeneous disease with various phenotypes and endotypes. Recently, an increasing number of studies have proposed that oxidative stress (caused by both environmental and intrinsic stimuli) plays an important role in the pathogenesis and persistence of CRS. This has attracted the attention of several researchers. The relationship between the presence of reactive oxygen species composed of free radicals and nasal polyp pathology is a key topic receiving attention. This article reviews the role of oxidative stress in respiratory diseases, particularly CRS, and introduces potential therapeutic antioxidants that may offer targeted treatment for CRS.
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Affiliation(s)
- Junhu Tai
- Department of Otorhinolaryngology—Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Jae-Min Shin
- Department of Otorhinolaryngology—Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Jaehyung Park
- Department of Otorhinolaryngology—Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Munsoo Han
- Department of Otorhinolaryngology—Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea
- Mucosal Immunology Institute, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Tae Hoon Kim
- Department of Otorhinolaryngology—Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea
- Mucosal Immunology Institute, College of Medicine, Korea University, Seoul 02841, Republic of Korea
- Correspondence: ; Tel.: +82-02-920-5486
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Insights into Personalised Medicine in Bronchiectasis. J Pers Med 2023; 13:jpm13010133. [PMID: 36675794 PMCID: PMC9863431 DOI: 10.3390/jpm13010133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/01/2023] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
Bronchiectasis is a heterogenous disease with multiple aetiologies resulting in inflammation and dilatation of the airways with associated mucus production and chronic respiratory infection. The condition is being recognised ever more frequently as the availability of computed tomography increases. It is associated with significant morbidity and healthcare-related costs. With new understanding of the disease process, varying endotypes, identification of underlying causes and treatable traits, the management of bronchiectasis can be increasingly personalised.
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7
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Jiang S, Chen Y. The role of sulfur compounds in chronic obstructive pulmonary disease. Front Mol Biosci 2022; 9:928287. [PMID: 36339716 PMCID: PMC9626809 DOI: 10.3389/fmolb.2022.928287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/03/2022] [Indexed: 11/19/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common respiratory disease that brings about great social and economic burden, with oxidative stress and inflammation affecting the whole disease progress. Sulfur compounds such as hydrogen sulfide (H2S), thiols, and persulfides/polysulfides have intrinsic antioxidant and anti-inflammatory ability, which is engaged in the pathophysiological process of COPD. Hydrogen sulfide mainly exhibits its function by S-sulfidation of the cysteine residue of the targeted proteins. It also interacts with nitric oxide and acts as a potential biomarker for the COPD phenotype. Thiols’ redox buffer such as the glutathione redox couple is a major non-enzymatic redox buffer reflecting the oxidative stress in the organism. The disturbance of redox buffers was often detected in patients with COPD, and redressing the balance could delay COPD exacerbation. Sulfane sulfur refers to a divalent sulfur atom bonded with another sulfur atom. Among them, persulfides and polysulfides have an evolutionarily conserved modification with antiaging effects. Sulfur compounds and their relative signaling pathways are also associated with the development of comorbidities in COPD. Synthetic compounds which can release H2S and persulfides in the organism have gradually been developed. Naturally extracted sulfur compounds with pharmacological effects also aroused great interest. This study discussed the biological functions and mechanisms of sulfur compounds in regulating COPD and its comorbidities.
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8
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Iciek M, Bilska-Wilkosz A, Kozdrowicki M, Górny M. Reactive Sulfur Compounds in the Fight against COVID-19. Antioxidants (Basel) 2022; 11:antiox11061053. [PMID: 35739949 PMCID: PMC9220020 DOI: 10.3390/antiox11061053] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 02/04/2023] Open
Abstract
The SARS-CoV-2 coronavirus pandemic outbreak in 2019 resulted in the need to search for an effective and safe strategy for treating infected patients, relieving symptoms, and preventing severe disease. SARS-CoV-2 is an RNA virus that can cause acute respiratory failure and thrombosis, as well as impair circulatory system function. Permanent damage to the heart muscle or other cardiovascular disorders may occur during or after the infection. The severe course of the disease is associated with the release of large amounts of pro-inflammatory cytokines. Due to their documented anti-inflammatory, antioxidant, and antiviral effects, reactive sulfur compounds, including hydrogen sulfide (H2S), lipoic acid (LA), N-acetylcysteine (NAC), glutathione (GSH), and some other lesser-known sulfur compounds, have attracted the interest of scientists for the treatment and prevention of the adverse effects of diseases caused by SARS-CoV-2. This article reviews current knowledge about various endogenous or exogenous reactive sulfur compounds and discusses the possibility, or in some cases the results, of their use in the treatment or prophylaxis of COVID-19.
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9
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Birdane YO, Avci G, Birdane FM, Turkmen R, Atik O, Atik H. The protective effects of erdosteine on subacute diazinon-induced oxidative stress and inflammation in rats. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:21537-21546. [PMID: 34766221 DOI: 10.1007/s11356-021-17398-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
In today's world, pesticides are commonly used to control pests and in advanced agriculture. As an organophosphorus insecticide (OPI), diazinon (DZN) is a commonly used substance. However, the widespread usage of DZN increases the probability of incidence of toxication. This toxication has been reported to be shaped not through cholinergic syndromes that are experienced as a result of acetylcholinesterase inhibition, which is the primary effect of these cases. It is rather shaped by the altering of the facilitation of oxidative stress and inflammatory response. In this study, the protective effect of administering erdosteine (ERDOS) subacute DZN exposure was investigated. A total of 24 male Wistar albino rats were separated into 4 groups (with 6 rats in each group), namely, the control, DZN (15 mg/kg/day), ERDOS (10 mg/kg/day), and DZN + ERDOS (15 mg/kg/day DZN + 10 mg/kg/day ERDOS) groups. These medications were given through oral gavage for 28 days. With the whole blood, plasma, and serum samples taken from the rats, oxidant-antioxidant parameters and cytokine levels were measured. The MDA and NOx levels and SOD and CAT enzyme activities of the DZN group were higher than those of the control group, while the GSH levels and TAC and GPx activities of the DZN group were lower than those of the control group (p < 0.05). It was also found that cytokine (IL-1β, IL-10, and TNF-α) levels in the DZN group were higher than those in the control group (p < 0.05). On the other hand, the ERDOS implementations were detected to ameliorate the harmful effects of DZN on the oxidant-antioxidant parameters and cytokine levels (p < 0.05). Conclusively, besides the known mucolytic efficacy of ERDOS, it may also be stated to display free radical scavenger, antioxidant, and anti-inflammatory characteristics to inhibit some proinflammatory cytokines that are specifically involved in oxidative stress. Additionally, the ameliorating property of ERDOS can be benefited from in possible DZN-induced toxication cases.
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Affiliation(s)
- Yavuz Osman Birdane
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
| | - Gulcan Avci
- Department of Biochemistry, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Fatih Mehmet Birdane
- Department of Internal Medicine, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Ruhi Turkmen
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Orkun Atik
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Hulya Atik
- Department of Physiology, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
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Emrah Yaman M, Atila A. A rapid and sensitive UPLC–MS/MS method for quantification of erdosteine as bulk drug and in capsules as dosage forms. MAKEDONSKO FARMACEVTSKI BILTEN 2022. [DOI: 10.33320/10.33320/maced.pharm.bull.2021.67.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A rapid, sensitive, specific ultra-performance liquid chromatography-tandem mass spectrometric (UPLC-MS-MS) method was developed for the determination of erdosteine (ERD) in pharmaceutical preparations. The chromatographic separation was achieved with 0.1% formic acid in combination with acetonitrile (25:75 v/v) using C18 UPLC column, 95Å, 2.1 x 50 mm, 1.8 µm. The flow rate was 0.15 mL/min and the total run time was 2.0 min. The column temperature was kept constant at 40 °C and the injection volume was 5 μL. Ibuprofen was used as internal standard (IS). The mass transitions of ERD and IS were m/z 249.9 → 231.8 and 205.1 → 161.0. Also, another product ion of ERD (m/z 249.80 → 231.80) was monitored as predictive ion during the analysis. The standard calibration curve shows determination coefficient (R2) greater than 0.996 with a range of 1-5000 ng/mL using the linear regression model. Within-run precision and between-run repeatability were expressed as relative standard deviation and were lower than 5%. The developed method was successfully applied in the analysis of ERD-containing capsule formulation indicating that the method could be used for routine quality control analyses.
Keywords: erdosteine, UPLC-MS/MS, multiple reaction monitoring, pharmaceutical analysis, method validation
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Affiliation(s)
- Mehmet Emrah Yaman
- Department of Analytical Chemistry, Faculty of Pharmacy, Ataturk University, 25240 Erzurum, Turkey
| | - Alptug Atila
- Department of Analytical Chemistry, Faculty of Pharmacy, Ataturk University, 25240 Erzurum, Turkey
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Cattò C, Villa F, Cappitelli F. Understanding the Role of the Antioxidant Drug Erdosteine and Its Active Metabolite on Staphylococcus aureus Methicillin Resistant Biofilm Formation. Antioxidants (Basel) 2021; 10:antiox10121922. [PMID: 34943025 PMCID: PMC8698571 DOI: 10.3390/antiox10121922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 01/02/2023] Open
Abstract
Increasing numbers of researches have suggested that some drugs with reactive oxygen species (ROS)-mediated mechanisms of action modulate biofilm formation of some pathogenic strains. However, the full contribution of ROS to biofilm development is still an open question. In this paper, the correlations between the antioxidant drug Erdosteine (Er) and its active Metabolite I (Met I), ROS and biofilm development of two strains of methicillin resistant Staphylococcus aureus are presented. Experiments revealed that Er and Met I at 2 and 5 mg/L increased up to three orders of magnitude the number of biofilm-dwelling cells, while the content of ROS within the biofilms was reduced above the 87%, with a major effect of Met I in comparison to Er. Comparative proteomics showed that, 5 mg/L Met I modified the expression of 30% and 65% of total proteins in the two strains respectively. Some proteins involved in cell replication were upregulated, and a nitric oxide-based mechanism is assumed to modulate the biofilm development by changing quorum sensitive pathways. Additionally, several proteins involved in virulence were downregulated in the presence of Met I, suggesting that treated cells, despite being greater in number, might have lost part of their virulence.
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Abstract
There is a possible role for oxidative stress, a state characterized by an altered balance between the production of free radicals or reactive oxygen species (ROS) and antioxidant defences, in coronavirus disease 2019 (COVID-19), the genesis of which is quite complex. Excessive oxidative stress could be responsible for the alveolar damage, thrombosis, and red blood cell dysregulation observed in COVID-19. Apparently, deficiency of glutathione (GSH), a low-molecular-weight thiol that is the most important non-enzymatic antioxidant molecule and has the potential to keep the cytokine storm in check, is a plausible explanation for the severe manifestations and death in COVID-19 patients. Thiol drugs, which are considered mucolytic, also possess potent antioxidant and anti-inflammatory properties. They exhibit antibacterial activity against a variety of medically important bacteria and may be an effective strategy against influenza virus infection. The importance of oxidative stress during COVID-19 and the various pharmacological characteristics of thiol-based drugs suggest a possible role of thiols in the treatment of COVID-19. Oral and intravenous GSH, as well as GSH precursors such as N-acetylcysteine (NAC), or drugs containing the thiol moiety (erdosteine) may represent a novel therapeutic approach to block NF-kB and address the cytokine storm syndrome and respiratory distress observed in COVID-19 pneumonia patients
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