Clinical aspects of the use of erdosteine in respiratory diseases

Abstract

Erdosteine is a drug based on thiol and used at the beginning only as a mucolytic. The main indication for it is the treatment of acute and chronic lung diseases, accompanied by difficult sputum discharge. The therapeutic effect of erdosteine is due to the action of thiol metabolites, which, in addition to mucoactive, have antioxidant, anti-inflammatory and antibacterial activities. Experimental studies have shown that this drug reduces the degree of damage to lung tissue caused by oxidative stress, primarily by reducing the production of reactive oxygen species. It increases the concentration of IgA in the respiratory mucosa, thereby reducing the damaging effect of tobacco smoke on endothelial and macrophage cells. In the RESTORE clinical study, which studied the effect of erdosteine on the frequency of exacerbations of chronic obstructive pulmonary disease, it was demonstrated that it significantly reduces the risk, frequency and severity of COPD exacerbations, regardless of patients taking inhaled corticosteroids and eosinophil levels. Recent experimental studies have shown that erdosteine also has the ability to slow the progression rate of fibrosis in pulmonary tissue. It has been shown to inhibit the development of bleomycin-induced fibrosis. The authors of the study suggested that this effect may be related to the suppression of neutrophil migration metabolite erastheine, the inhibition of lipid peroxidation and, in general, the regulation of antioxidant protection mechanisms Data obtained in recent studies also open up new possibilities for the use of erdosteine in patients with bronchial asthma and idiopathic pulmonary fibrosis, significantly expanding the indications for its use.