Friday Hope: N-Acetyl Cysteine (NAC) Revisited: Taming the ROS Storm

The Oxygen Radical Removal Specialist

We have long known of the cytokine and bradykinin storms associated with the severity and mortality of COVID-19. However, as my research began to reveal, I believe these are secondary to the main culprit in COVID-19 and Spike Protein pathology: The Reactive Oxygen Species (ROS) Storm.

Indeed, this has been hypothesized by others.

Previous studies highlighted the significance of a cytokine storm to the severity of SARS-CoV-2 infection, and more recently, the possibility of another storm, the bradykinin one, also contributing to the widespread tissue damage observed in some COVID-19 patients, involving those with hypertension comorbidity. Under these unprecedented conditions, there is yet, another equally relevant, still overlooked, storm on the forecast for hypertension: the reactive oxygen species (ROS) storm.

COVID-19 and ROS Storm: What is the Forecast for Hypertension
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385570/

One of the key mediators of cytokines/chemokines induction is NF-κB. The pathway of this transcription factor is directly activated by ROS and by certain proinflammatory cytokines, such as TNF-α and IL-1β.

Oxidative Stress-Related Mechanisms in SARS-CoV-2 Infection
https://www.hindawi.com/journals/omcl/2022/5589089/

Note the induction of all the severe and fatal COVID-19 pathologies by ROS:

Therefore, we propose a hypothesis based on strong scientific documentation, associating oxidative stress with changes found in patients with COVID-19, such as its participation in the amplification and perpetuation of the cytokine storm, coagulopathy, and cell hypoxia.

SARS-CoV-2 infection pathogenesis is related to oxidative stress as a response to aggression
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7357498/

This is where NAC enters the picture.

It acts directly as a scavenger of free radicals, especially oxygen radicals. NAC is a powerful antioxidant. It is also recommended as a potential treatment option for different disorders resulted from generation of free oxygen radicals.

A Review on Various Uses of N-Acetyl Cysteine
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507

What I put forth is that stopping the production of ROS by SARS-CoV-2 (obviously including the Spike Protein) will mitigate the severity and mortality of COVID-19. Even more encouraging is that NAC is plentiful and inexpensive.

N-acetyl cysteine (NAC), as a safe and inexpensive medication, is commercially accessible since long-time ago. This drug is not found in natural sources, although cysteine is present in some meals like chicken and turkey meats, garlic, yogurt, and eggs. NAC is a well-tolerated mucolytic drug that moderates clinging mucous secretions and enhances glutathione S-transferase activity. During oral administration, deacetylation reaction of NAC happens while passing along the small intestine as well as liver, thus its bioavailability is decreased to 4-10%. NAC stimulates glutathione biosynthesis, promotes detoxification, and acts directly as a scavenger of free radicals. It is a powerful antioxidant and a potential treatment option for diseases characterized by the generation of free oxygen radicals.

A Review on Various Uses of N-Acetyl Cysteine
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507

I believe, especially given that we now have a better understanding of the mechanisms SARS-CoV-2 and its Spike Protein, that NAC should be trialed for those with COVID, Long COVID and Spike Protein pathologies. It may even be effective as a prophylaxis.

N-acetylcysteine (NAC) is inexpensive, has very low toxicity, has been FDA approved for many years, and has the potential to improve therapeutic strategies for COVID-19. NAC administered intravenously, orally, or inhaled, may suppress SARS-CoV-2 replication and may improve outcomes if used timely. Potential therapeutic benefits of NAC include, extracellularly scavenging ROS radicals, replenishing intracellular GSH, suppression of cytokine storm, and T cell protection, thus mitigating inflammation and tissue injury. NAC administration in combination with other antiviral agents may dramatically reduce hospital admission rate, mechanical ventilation and mortality.

N-Acetylcysteine to Combat COVID-19: An Evidence Review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649937/

NAC has the potential to be one of our most effective weapons against SARS-CoV-2 and its Spike Protein.