Acute bronchitis: Main accents


DOI: https://dx.doi.org/10.18565/therapy.2023.7.194-200

Leschenko I.V., Malyavin A.G., Zaitsev A.A., Esaulova N.A.

1) Ural State Medical University of the Ministry of Healthcare of Russia, Yekaterinburg; 2) Ural Research Institute of Phthisiopulmonology – a branch of National Medical Research Center for Phthisiopulmonology and Infectious Diseases of the Ministry of Healthcare of Russia, Yekaterinburg; 3) LLC «Medical association “New Hospital”», Yekaterinburg; 4) Academician N.N. Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russian Federation, Moscow; 5) Russian Biotechnological University, Moscow; 6) Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia
Abstract. Article is devoted to the aspect of acute bronchitis (AB), which is one of the most actual problems of modern pulmonology and therapy. Most often, the cause of its development is a viral infection, and the clinical picture depends on the type of pathogen. AB treatment is determined by the characteristics of the etiopathogenesis of the disease, while an important component of complex therapy are mucoactive drugs that allow to control cough by changing the quantity and characteristics of bronchial secretions. Particular attention in the review is paid to N-acetylcysteine (NAC), which has a unique variety of pharmacological properties. The mechanism of mucolytic action of NAC is based on reducing the viscosity of sputum during coughing, increasing efficiency of mucociliary clearance and reducing the adhesive properties of sputum, which, in turn, helps reduce inflammation in the bronchial mucosa. Along with this, according to the results of clinical studies presented in the article, NAC, due to the presence of antioxidant properties, has a positive effect at the severity of various viral infections.
Keywords: mucolytics, acute bronchitis, N-acetylcysteine
Read entire article

Literature

1. Wark P. Bronchitis (acute). BMJ Clin Evid. 2015; 2015: 1508.


2. Macfarlane J., Holmes W., Gard P. et al. Prospective study of the incidence, ae-tiology and outcome of adult lower respiratory tract illness in the community. Thorax. 2001; 56(2): 109–14. https://dx.doi.org/10.1136/thorax.56.2.109.


3. [Ott S., Rohde G., Lepper P. et al. The impact of viruses in lower respiratory tract infections of the adult. Part II: Acute bronchitis, acute exacerbated COPD, pneumonia, and influenza. Pneumologie. 2010; 64(1): 18–27 (In German)]. https://dx.doi.org/10.1055/s-0029-1215197.


4. Зайцев А.А., Будорагин И.Е., Исаева Е.И. с соавт. Фармакотерапия острого бронхита: расставляем приоритеты. Антибиотики и химиотерапия. 2019; 64(1–2): 17–22. [Zaitsev A.A., Budoragin I.E.1, Isaeva E.I. et al. Pharmacotherapy of acute bronchitis: Setting priorities. Antibiotiki i khimioterapiya = Antibiotics and Chemotherapy. 2019; 64(1–2): 17–22 (In Russ.)]. https://dx.doi.org/10.24411/0235-2990-2019-10008. EDN: FQJUGN.


5. Зайцев А.А. Острый бронхит: клинические рекомендации. Медицинский совет. 2020; (17): 27–32. [Zaitsev A.A. Acute bronchitis: Clinical guidelines. Meditsinskiy sovet = Medical Council. 2020; (17): 27–32 (In Russ.)]. https://dx.doi.org/10.21518/2079-701X-2020-17-27-32. EDN: YYVFNC.


6. Franck A., Smith R. Antibiotic use for acute upper respiratory tract infections in a veteran population. J Am Pharm Assoc (2003). 2010; 50(6): 726–29. https://dx.doi.org/10.1331/JAPhA.2010.09103.


7. Lior C., Moragas A., Bayona C. et al. Effectiveness of anti-inflammatory treatment versus antibiotic therapy and placebo for patients with non-complicated acute bronchitis with purulent sputum. The BAAP Study protocol. BMC Pulm Med. 2011; 11: 38. https://dx.doi.org/10.1186/1471-2466-11-38.


8. Smucny J., Fahey T., Becker L. et al. Antibiotics for acute bronchitis. Cochrane Database Syst Rev. 2000; (4): CD000245. https://dx.doi.org/10.1002/14651858.CD000245. Update in: Cochrane Database Syst Rev. 2004; (4): CD000245.


9. Morice A., McGarvey L., Pavord I. et al. Recommendations for the management of cough in adults. British Thoracic Society Cough Guideline Group. Thorax. 2006; 61 Suppl 1(Suppl 1): i1–24. https://dx.doi.org/10.1136/thx.2006.065144.


10. Зайцев А.А., Оковитый С.В., Крюков Е.В. Кашель. Практическое пособие для врачей. М.: Медиа-Сфера. 2015; 60 с. [Zaitsev A.A., Okovity S.V., Kryukov E.V. Cough. Practical guide for doctors. Moscow: Media-Sfera. 2015; 60 pp. (In Russ.)]. ISBN: 9-785-89084-039-4.


11. Семаш Н.А., Тюрин И.Е., Белевский А.С., Вязьменова Н.И. Высокие дозы N-ацетилцистеина при внебольничной пневмонии. Лечебное дело. 2012; (2): 81–86. [Syomash N.A., Turin I.E., Belevsky A.S., Vyazmenova N.I. High-dose N-acetylcysteine in the treatment of community acquired pneumonia. Lechebnoe delo = General Medicine. 2012; (2): 81–86 (In Russ.)]. EDN: PCNUWR.


12. Webb W. Clinical evaluation of a new mucolytic agent, acetylcysteine. J Thorac Cardiovasc Surg. 1962; 44: 330–43. https://dx.doi.org/10.1016/S0022-5223(19)32956-3.


13. Reas H. The effect of N-acetylcysteine on the viscosity of tracheobronchial secretion in cystic fibrosis of the pancreas. J Pediatr. 1963; 62: 31–35. https://dx.doi.org/10.1016/s0022-3476(63)80067-0.


14. De Vries N., De Flora S. N-acetyl-l-cysteine. J Cell Biochem Suppl. 1993; 17F: 270–77. https://dx.doi.org/10.1002/jcb.240531040.


15. De Flora S., Izzotti A., D’Agostini F., Cesarone C.F. Antioxidant activity and other mechanisms of thiols involved in chemoprevention of mutation and cancer. Am J Med. 1991; 91(3C): 122S–130S. https://dx.doi.org/10.1016/0002-9343(91)90295-9.


16. De Flora S., Cesarone C.F., Balansy R.M. et al. Chemopreventive properties and mechanisms of N-acetylcysteine. The experimental background. J Cell Biochem Suppl. 1995; 22: 33–41. https://dx.doi.org/10.1002/jcb.240590806.


17. Fishbane S., Durham J.H., Marzo K. et al. Rudnick M. N-acetylcysteine in the prevention of radiocontrastinduced nephropathy. J Am Soc Nephrol. 2004; 15(2): 251–60. https://dx.doi.org/10.1097/01.asn.0000107562.68920.92.


18. Moklesi B., Leikin J.B., Murray P., Corbridge T.C. Adult toxicology in critical care. Part II: specific poisoning. Chest. 2003; 123(3): 897–922. https://dx.doi.org/10.1378/chest.123.3.897.


19. Smilkstein M.J., Knapp G.L., Kulig K.W. et al. Efficacy of oral N-acetylcysteine in the treatment of accetaminophen overdose: Analysis of the national multicenter study (1976 to 1985). N Engl J Мed. 1988; 319(24): 1557–62. https://dx.doi.org/10.1056/NEJM198812153192401.


20. Blasi F., Clive Page C., Rossolini G.M. et al. The effect of N-acetylcysteine on biofilms: Implications for the treatment of respiratory tract infections. Respir Med. 2016; 117: 190–97. https://dx.doi.org/10.1016/j.rmed.2016.06.015.


21. Wolcott R.D., Ehrlich G.D. Biofilms and chronic infections. JAMA. 2008; 299(22): 2682–84. https://dx.doi.org/10.1001/jama.299.22.2682.


22. Perez-Giraldo C., Rodríguez-Benito A., Moran F.J. et al. Influence of N-acetylcysteine on the formation of biofilm by Staphylococcus epidermidis. J Antimicrob Chemother. 1997; 39(5): 643–46. https://dx.doi.org/10.1093/jac/39.5.643.


23. Zheng J.P., Wen F.Q., Bai C.X. et al. Twice daily N-acetylcysteine 600 mg for exacerbations of chronic obstructive pulmonary disease (PANTHEON): A randomised, double-blind placebo-controlled trial. Lancet Respir Med. 2014; 2(3): 187–94. https://dx.doi.org/10.1016/S2213-2600(13)70286-8.


24. Chousterman B.G., Swirski F.K., Weber G.F. Cytokine storm and sepsis disease pathogenesis. Semin Immunopathol. 2017; 39(5): 517–28. https://dx.doi.org/10.1007/s00281-017-0639-8.


25. Treadway G., Pontani D. Paediatric savety of azithromycin: World-wide experience. J Antimicrob Chemother. 1996; 37 Suppl C: 143–49. https://dx.doi.org/10.1093/jac/37.suppl_c.143.


26. Izquierdo J.L., Soriano J.B., Gonzalez Y. et al. Use of N-Acetylcysteine at high doses as an oral treatment for patients hospitalized with COVID-19. Sci Prog. 2022; 105(1): 368504221074574. https://dx.doi.org/10.1177/00368504221074574.


27. Chousterman B.G., Swirski F.K., Weber G.F. Cytokine storm and sepsis disease pathogenesis. Semin Immunopathol. 2017; 39(5): 517–28. https://dx.doi.org/10.1007/s00281-017-0639-8.


28. Ibrahim H., Perl A., Smith D. et al. Therapeutic blockade of inflammation in severe COVID-19 infection with intravenous N-acetylcysteine. Clin Immunol. 2020; 219: 108544. https://dx.doi.org/10.1016/j.clim.2020.108544.


29. Sadowska A.M., Manuel-Y-Keenoy B., De Backer W.A. Antioxidant and anti-inflammatory efficacy of NAC in the treatment of COPD: Discordant in vitro and in vivo dose-effects: A review. Pulm Pharmacol Ther. 2007; 20(1): 9–22. https://dx.doi.org/10.1016/j.pupt.2005.12.007.


30. Lai K., Ng W., Osburga Chan P., Wong K., Cheng F. High-dose N-acetylcysteine therapy for novel H1N1 influenza pneumonia. Ann Intern Med. 2010; 152(10): 687–88. https://dx.doi.org/10.7326/0003-4819-152-10-201005180-00017.


31. Авдеев С.Н., Карчевская Н.А., Баймаканова Г.Е., Черняк А.В.. Годичное наблюдение за больными, перенесшими острое повреждение легких/острый респираторный дистресс-синдром, вызванный вирусом гриппа А/H1N1. Пульмонология. 2011; (4):58–66. [Avdeev S.N., Karchevskaya N.A., Baimakanova G.E., Cherniak A.V. A one-year follow-up study of patients survived after ALI/ ARDS caused by influenza A/H1N1. Pul’monologiya = Pulmonology. 2011; (4): 58–66 (In Russ.)]. https://dx.doi.org/10.18093/0869-0189-2011-0-4-58-66. EDN: OHXOSX.


32. Государственный реестр лекарственных средств Минздрава России. Инструкция по медицинскому применению лекарственного препарата Флуимуцил (таблетки шипучие). РУ: П N012975/01. Доступ: https://grls.rosminzdrav.ru/Grls_View_ v2.aspx?routingGuid=3ee7b062-dc79-411b-83d5-6c1c9854e249 (дата обращения – 01.09.2023). [State register of medicines of the Ministry of Healthcare of Russia. Instructions for medical use of the drug Fluimucil (soluble tablets). Registration certificate: П N012975/01. URL: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=3ee7b062-dc79-411b-83d5-6c1c9854e249 (date of access – 01.09.2023) (In Russ.)].


About the Autors

Igor V. Leshchenko, MD, professor, professor of the Department of phthisiology and pulmonology, Ural State Medical University of the Ministry of Healthcare of Russia, chief researcher of Ural Research Institute of Phthisiopulmonology
– a branch of National Medical Research Center for Phthisiopulmonology and Infectious Diseases of the Ministry of Healthcare of Russia, scientific director of the clinic LLC «Medical association “New hospital”». Address: 620028, Yekaterinburg, 3 Repina Str.
E-mail: leshchenkoiv@yandex.ru
ORCID: https://orcid.org/0000-0002-1620-7159. SPIN code: 1851-8986
Andrey G. Malyavin, MD, professor, professor of the Department of phthisiology and pulmonology, Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 107150, Moscow, 39/1 Losinoosyrovskaya Str. E-mail: maliavin@mail.ru. ORCID: https://orcid.org/0000-0002-6128-5914
Andrey A. Zaitsev, MD, professor, chief pulmonologist at Academician N.N. Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russian Federation, chief pulmonologist of the Ministry of Defense of the Russian Federation, head of the Department of pulmonology (with a course of allergology) of the Medical institute of continuous education of Russian Biotechnological University. Address: 105094, Moscow, 3 Gospitalnaya Sq.
E-mail: a-zaicev-a@yandex.ru
ORCID: https://orcid.org/0000-0002-0934-7313
Natalya A. Esaulova, PhD in Medical Sciences, associate professor of the Department of phthisiology and pulmonology, Ural State Medical University of the Ministry of Healthcare of Russia, pulmonologist at Ural Research Institute of Phthisiopulmonology – a branch of the National Medical Research Center for Phthisiopulmonology and Infectious Diseases of the Ministry of Healthcare of Russia. Address: 620028, Yekaterinburg, 3 Repina Str.
E-mail: esan-at1@yandex.ru
ORCID: https://orcid.org/0000-0001-9565-3570


Similar Articles

Back to Content

Бионика Медиа