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Eur Rev Med Pharmacol Sci ; 26(2): 715-721, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1675570


OBJECTIVE: 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. MATERIALS AND METHODS: A search was performed in PubMed/Medline for "NAC", "viral Infection", COVID-19", oxidative stress", "inflammation", retrieving preclinical and clinical studies. RESULTS: 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. CONCLUSIONS: Clinical and experimental data suggest that NAC may act on the mechanisms leading to the prothrombotic state observed in severe COVID-19.

Acetylcysteine/therapeutic use , COVID-19/drug therapy , Acetylcysteine/chemistry , Antioxidants/chemistry , COVID-19/metabolism , COVID-19/virology , Glutathione/chemistry , Glutathione/metabolism , Humans , Oxidative Stress , Randomized Controlled Trials as Topic , Reactive Oxygen Species/metabolism , SARS-CoV-2/isolation & purification , Virus Diseases/drug therapy , Virus Diseases/metabolism
Clin Biochem ; 92: 71-76, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1141672


Owing to their ease of use, glucose meters are frequently used in research and medicine. However, little is known of whether other non-glucose molecules, besides vitamin C, interfere with glucometry. Therefore, we sought to determine whether other antioxidants might behave like vitamin C in causing falsely elevated blood glucose levels, potentially exposing patients to glycemic mismanagement by being administered harmful doses of glucose-lowering drugs. To determine whether various antioxidants can be detected by seven commercial glucose meters, human blood samples were spiked with various antioxidants ex vivo and their effect on the glucose results were assessed by Parkes error grid analysis. Several of the glucose meters demonstrated a positive bias in the glucose measurement of blood samples spiked with vitamin C, N-acetylcysteine, and glutathione. With the most interference-sensitive glucose meter, non-blood solutions of 1 mmol/L N-acetylcysteine, glutathione, cysteine, vitamin C, dihydrolipoate, and dithiothreitol mimicked the results seen on that glucose meter for 0.7, 1.0, 1.2, 2.6, 3.7 and 5.5 mmol/L glucose solutions, respectively. Glucose meter users should be alerted that some of these devices might produce spurious glucose results not only in patients on vitamin C therapy but also in those being administered other antioxidants. As discussed herein, the clinical relevance of the data is immediate in view of the current use of antioxidant therapies for disorders such as the metabolic syndrome, diabetes, cardiovascular diseases, and coronavirus disease 2019.

Antioxidants/chemistry , Blood Glucose Self-Monitoring/instrumentation , Blood Glucose/analysis , Acetylcysteine/blood , Acetylcysteine/chemistry , Antioxidants/analysis , Antioxidants/metabolism , Ascorbic Acid/analysis , Ascorbic Acid/blood , Blood Glucose/chemistry , Blood Glucose Self-Monitoring/methods , Glutathione/blood , Glutathione/chemistry , Humans , Point-of-Care Systems
Med Hypotheses ; 144: 110133, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-670653


COVID-19 is an overwhelming pandemic which has shattered the whole world. Lung injury being the main clinical manifestation, it is likely to cause COPD (chronic obstructive pulmonary disease) and ARDS (acute respiratory distress syndrome). The possible cause behind this might be redox imbalance due to viral infection. Elevation in Glutathione (GSH) levels by administration of its promolecule might be effective. N-acetylcysteine is one such drug with potency to scavenge Reactive Oxygen Species, least side effects, and an effective precursor of glutathione. Consequently we hypothesize that N-acetylcysteine along with the conventional treatment may be treated as a potential therapeutic solution in cases of COVID-19 patients.

Acetylcysteine/therapeutic use , Glutathione/metabolism , Acetylcysteine/chemistry , Antioxidants/therapeutic use , Humans , Oxidation-Reduction , Oxidative Stress , Pulmonary Disease, Chronic Obstructive/virology , Reactive Oxygen Species/metabolism , Respiratory Distress Syndrome/drug therapy , Respiratory Distress Syndrome/virology