Multifaceted properties of erdostein and its place in the treatment of respiratory tract diseases

Abstract

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.