PMC:7600245 / 66790-68382 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7600245","sourcedb":"PMC","sourceid":"7600245","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7600245","text":"4.15. N-Acetylcysteine (Acetadote)\nIt is a small molecule in which the amino group of cysteine amino acid is acetylated (Figure S6). N-acetylcysteine was approved by the U.S. FDA in 1963 for the oral use as mucolytic agent and parenteral use to treat acetaminophen overdose [235]. Currently, there are about six ongoing clinical trials to evaluate its use in COVID-19 patients. The rationale for these studies is attributed to its potential antiviral, antioxidant, and immunomodulatory effects. In this arena, several experiments have shown that acetylcysteine may eventually inhibit the viral replication of influenza A [236,237,238]. Acetylcysteine has also been evaluated for use in the treatment of HIV in two randomized studies [239]. Although its effect on the viral load was not consistent, the two studies consistently demonstrated that acetylcysteine substantially increased immunological functions and plasma albumin concentrations [239]. Furthermore, its free sulfhydryl group cleaves the disulfide bonds in mucoproteins which lowers mucous viscosity in patients with cystic fibrosis or chronic obstructive pulmonary disease [240,241,242]. At higher doses, acetylcysteine can also be used as an antioxidant to mitigate the symptoms of many diseases complicated by oxidative stress. In fact, as a component in the synthesis of the antioxidant glutathione, it may reduce the formation of proinflammatory cytokines [243,244]. Acetylcysteine has also been found to mitigate the oxidative stress and improve the inflammatory response in patients with community acquired pneumonia 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