medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-18-82-89medsovet-7124Research ArticleРАЦИОНАЛЬНАЯ ФАРМАКОТЕРАПИЯRATIONAL PHARMACOTHERAPYМногогранные свойства эрдостеина и его место в лечении заболеваний респираторного трактаMultifaceted properties of erdostein and its place in the treatment of respiratory tract diseaseshttps://orcid.org/0000-0003-1851-0941СалуховВ. В.SalukhovV. V.

Салухов Владимир Владимирович, доктор медицинских наук, доцент, начальник 1-й кафедры и клиники (терапии усовершенствования врачей) имени академика Н.С. Молчанова

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

SPIN-код: 4531-6011

Vladimir V. Salukhov, Dr. Sci. (Med.), Associate Professor, Head of the 1st Department and Clinic (Advanced Physician Therapy)

6, Akademik Lebedev St., St Petersburg, 194044

vlasaluk@yandex.ruhttps://orcid.org/0000-0003-3209-3742НиколаевА. В.NikolaevA. V.

Николаев Андрей Владимирович, кандидат медицинских наук, доцент 1-й кафедры (терапии усовершенствования врачей)

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

SPIN-код: 5622-1765

Andrey V. Nikolaev, Cand. Sci. (Med.), Associate Professor of the 1st Department (Advanced Physician Therapy)

6, Akademik Lebedev St., St Petersburg, 194044

nikolaevpulmdoc@mail.ruhttps://orcid.org/0000-0003-2310-4518ИвановВ. В.IvanovV. V.

Иванов Владимир Владимирович, кандидат медицинских наук, начальник пульмонологического отделения 1-й клиники (терапии усовершенствования врачей)

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

SPIN-код: 1736-8285

Vladimir V. Ivanov, Cand. Sci. (Med.), Head of the Pulmonology Department of the 1st Clinic (Advanced Physician Therapy)

6, Akademik Lebedev St., St Petersburg, 194044

sea-89@yandex.ruhttps://orcid.org/0000-0003-0387-1090ЖуркинМ. А.ZhurkinM. A.

Журкин Михаил Александрович, кандидат медицинских наук, старший ординатор пульмонологического отделения 1-й клиники (терапии усовершенствования врачей)

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

SPIN-код: 7579-8035

Mikhail A. Zhurkin, Cand. Sci. (Med.), Senior Resident of the Pulmonology Department of the 1st Clinic (Advanced Physician Therapy)

6, Akademik Lebedev St., St Petersburg, 194044

mikhail.pulmo@mail.ruhttps://orcid.org/0000-0002-2532-6133ЧугуновА. А.ChugunovA. A.

Чугунов Александр Алексеевич, преподаватель 1-й кафедры (терапии усовершенствования врачей)

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

SPIN-код: 3839-7619

Alexander A. Chugunov, Lecturer of the 1st Department (Advanced Physician Therapy)

6, Akademik Lebedev St., St Petersburg, 194044

alexandrchugun@yandex.ruhttps://orcid.org/0000-0001-7585-3532МарченкоД. А.MarchenkoD. A.

Марченко Даниил Александрович, курсант 6-го курса факультета подготовки врачей (для Сухопутных, Ракетных и Воздушно-десантных войск)

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Daniil A. Marchenko, Cadet of the 6th year of the Faculty of Training Doctors (for the Ground, Missile and Airborne Forces)

6, Akademik Lebedev St., St Petersburg, 194044

Timberproof@gmail.comВоенно-медицинская академия имени С.М. КироваРоссияMilitary Medical Academy named after S.M. KirovRussian Federation20221510202216188289Copyright © Салухов В.В., Николаев А.В., Иванов В.В., Журкин М.А., Чугунов А.А., Марченко Д.А., 20222022Салухов В.В., Николаев А.В., Иванов В.В., Журкин М.А., Чугунов А.А., Марченко Д.А.Salukhov V.V., Nikolaev A.V., Ivanov V.V., Zhurkin M.A., Chugunov A.A., Marchenko D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7124

Мукоактивные препараты обычно используются при лечении заболеваний дыхательных путей, таких как хронический бронхит (ХБ) или хроническая обструктивная болезнь легких (ХОБЛ), при которых гиперкриния является одним из основных клинических признаков. Эрдостеин является одним из  наиболее часто используемых мукоактивных агентов для лечения респираторных заболеваний. Эрдостеин – препарат, одобренный для лечения острых и хронических заболеваний легких, изначально разработанный как муколитическое средство. Он принадлежит к семейству препаратов на основе тиолов, которые, наряду с муколитическим действием, также обладают антиоксидантными и противовоспалительными свойствами и проявляют антибактериальную активность в отношении различных видов бактерий. Эрдостеин является пролекарством, которое трансформируется до активного метаболита M1 (MET 1), обладающего муколитическими свойствами. Экспериментальные исследования подтвердили, что эрдостеин предотвращает или уменьшает повреждение легочной ткани, вызванное окислительным стрессом, а  также регулирует выработку активных форм кислорода. Приведены работы, показавшие высокую клиническую эффективность эродостеина при острых заболеваниях верхних и нижних дыхательных путей. Исследование RESTORE – единственное исследование, в котором изучалось влияние препарата на  основе тиолов при ХОБЛ с  частыми обострениями, подтвердило, что эрдостеин значительно снижает риск острых обострений ХОБЛ, уменьшает их длительность, а также снижает риск госпитализации по поводу ХОБЛ. На профилактическое действие эрдостеина в  отношении обострений ХОБЛ не  влияли наличие или отсутствие ингаляционных кортикостероидов (ИКС) или количество эозинофилов в крови. Последние исследования в области фармакологических эффектов эрдостеина продемонстрировали многообещающие результаты, что создает предпосылки использования дополнительных фармакологических эффектов эрдостеина в качестве перспективных терапевтических стратегий у больных с заболеваниями легких.

Mucoactive drugs are commonly used in  the treatment of  respiratory diseases such as chronic bronchitis  (CB) or chronic obstructive pulmonary disease (COPD), in which hypercrinia is one of the main clinical features. Erdostein is one of the most commonly used mucoactive agents for the treatment of respiratory diseases. Erdostein is a drug approved for the treatment of acute and chronic lung diseases, originally developed as a mucolytic agent. It belongs to a family of thiol-based drugs, which, in  addition to mucolytic action, also have antioxidant and anti-inflammatory properties and exhibit antibacterial activity against various types of bacteria. Erdosteine is a prodrug that is converted to the active metabolite M1 (MET 1), which has mucolytic properties. Experimental studies have confirmed that erdosteine prevents or reduces damage to lung tissue caused by oxidative stress, and also regulates the production of reactive oxygen species. The RESTORE study, the only study that examined the effect of a thiol-based drug in chronic obstructive pulmonary disease (COPD) with frequent exacerbations, confirmed that erdosteine significantly reduces the risk of acute exacerbations of COPD, reduces their duration, and also reduces the risk of hospitalization for COPD. The preventive effect of erdosteine against exacerbations of COPD was not affected by the presence or absence of inhaled corticosteroids (ICS) or the number of eosinophils in the blood. Recent studies on the pharmacological effects of erdosteine have shown promising results, which paves the way for the use of additional pharmacological effects of erdosteine as promising therapeutic strategies in patients with pulmonary diseases.

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The authors declare that there are no conflicts of interest present.