Pleiotropic effects of carbocysteine in patients with COPD


DOI: https://dx.doi.org/10.18565/pharmateca.2025.1.145-152

S.L. Babak, M.V. Gorbunova, A.G. Malyavin

Russian University of Medicine, Moscow, Russia
Chronic obstructive pulmonary disease (COPD) is a heterogenic obstructive disease with a wide range of clinical manifestations, which is the 3rd leading cause of death among patients worldwide. Based on the available therapeutic strategies for COPD patients, mucoactive therapy, including carbocysteine, has received intensive attention from specialists. In this review, we analyzed data from randomized clinical trials (RCTs) that expand our knowledge of the mechanisms of effect of mucoactive carbocysteine therapy on the frequency and characteristics of exacerbation in COPD patients. Carbocysteine, being a powerful mucoregulator, actively influences mucins/ciliary cells, oppose viral/bacterial infections, eliminates reactive oxygen species (antioxidant effect), and has a marked cytoprotective effect. The pleotropic effect of carbocysteine may also include the expression of histone deacetylase-2, which increases receptor sensitivity to systemic and inhaled glucocorticosteroids with evident anti-inflammatory effects. Our review will demonstrate that long-term carbocysteine therapy of COPD patients is well tolerated, has a beneficial safety profile and improves the quality of life of those patients.
Keywords: deacetylase-2, histone deacetylase-2, carbocysteine, glucocorticosteroids, chronic obstructive pulmonary disease
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About the Autors

Sergey L. Babak, Dr. Sci. (Med.), Associate Professor, Pulmonologist, Professor, Department of Phthisiology and Pulmonology, Research Institute of Clinical Medicine n.a. N.A. Semashko, Russian University of Medicine, Moscow, Russia; sergbabak@mail.ru, ORCID: https://orcid.org/0000-0002-6571-1220, Scopus Author ID: 45560913500, Web of Science ResearcherID: KAO-3183-2024, SPIN-code: 5213-3620 (corresponding author)
Marina V. Gorbunova, Dr. Sci. (Med.), Pulmonologist, Associate Professor at the Department of Phthisiology and Pulmonology, Research and Educational Institute of Clinical Medicine named after N.A. Semashko, Russian University of Medicine, Moscow, Russia; mgorb@mail.ru, Scopus Author ID: 45561369300, ORCID: https://orcid.org/0000-0002-2039-0072
Andrey G. Malyavin, Dr. Sci. (Med.), Pulmonologist, Professor at the Department of Phthisiology and Pulmonology, Research and Educational Institute of Clinical Medicine named after N.A. Semashko, Russian University of Medicine; Secretary General of the Russian Scientific Medical Society of Therapists; Chief External Expert in Pulmonology of the Ministry of Healthcare of the Russian Federation for the Central Federal District, Moscow, Russia;
maliavin@mail.ru, Scopus Author ID: 6701876872, ORCID: https://orcid.org/0000-0002-6128-5914, SPIN-code: 8264-5394


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