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Identification
- Summary
Carbocisteine is a expectorant mucolytic used in the relief of respiratory of COPD and other conditions associated with increased mucus viscosity.
- Generic Name
- Carbocisteine
- DrugBank Accession Number
- DB04339
- Background
Dyspnea and cough are common symptoms of chronic obstructive pulmonary disease (COPD)11 and other respiratory conditions characterized by increased mucus production. Individuals with COPD have a greater risk of pulmonary infection due to the growth and accumulation of viruses and bacteria in thick bronchial mucus. Carbocisteine is a mucolytic drug that alleviates respiratory symptoms and infections by reducing the viscosity of mucus, allowing it to be expelled.16
Several licenses for this drug were withdrawn following serious and fatal paradoxical effects after carbocisteine therapy in children; respiratory dress, dyspnea, and cough aggravation were reported by physicians in France and Italy.3 Carbocisteine is currently not FDA or Health Canada approved, but is approved for use in Asia, Europe, and South America.
- Type
- Small Molecule
- Groups
- Approved, Investigational
- Structure
Structure for Carbocisteine (DB04339)
- Weight
- Average: 179.194
Monoisotopic: 179.025228471 - Chemical Formula
- C5H9NO4S
- Synonyms
- (L)-2-Amino-3-(carboxymethylthio)propionic acid
- (R)-S-(carboxymethyl)cysteine
- carbocisteína
- Carbocisteine
- L-3-((carboxymethyl)thio)alanine
- L-carbocysteine
- S-(carboxymethyl)-(R)-cysteine
- S-carboxymethyl-L-cysteine
- S-carboxymethylcysteine
- External IDs
- AHR-3053
- LJ 206
- LJ-206
- NSC-14156
- R05CB03
Pharmacology
- Indication
Carbocisteine is indicated over the counter and in prescription formulas to clear airway secretions in conditions associated with increased mucus.19,20,21
Reduce drug development failure ratesBuild, train, & validate machine-learning modelswith evidence-based and structured datasets.Build, train, & validate predictive machine-learning models with structured datasets.- Associated Conditions
Indication Type Indication Combined Product Details Approval Level Age Group Patient Characteristics Dose Form Symptomatic treatment of Coughing ••• ••• ••••••••• •••••••• • ••••• Treatment of Respiratory illness •••••••••••• •••••••• •••• •••••••• ••• ••••••••• •••••••• ••• ••••••••••• ••••••• ••• ••••••••• •••••• ••••••• ••••••• •••• •••••• Treatment of Respiratory illness ••• ••• ••••••• •••• •••••• Symptomatic treatment of Excess mucus or phlegm ••• ••• ••••••••• •••••••• • ••••• Symptomatic treatment of Excess mucus or phlegm ••• ••• ••••••••• •••••••• • ••••• - Associated Therapies
- Contraindications & Blackbox Warnings
Prevent Adverse Drug Events TodayTap into our Clinical API for life-saving information on contraindications & blackbox warnings, population restrictions, harmful risks, & more.Avoid life-threatening adverse drug events with our Clinical API- Pharmacodynamics
Due to its mucolytic effects, carbocisteine significantly reduces sputum viscosity, cough, dyspnea and fatigue.1,2 Additionally, it prevents pulmonary infections by decreasing accumulated mucus in the respiratory tract; this is especially beneficial in preventing exacerbations of COPD caused by bacteria and viruses.2 It has in-vitro anti-inflammatory activity with some demonstrated action against free radicals.2
- Mechanism of action
The hypersecretion of mucus characterizes serious respiratory conditions including asthma, cystic fibrosis (CF), and chronic obstructive pulmonary disease (COPD).8 It blocks bacterial adherence to cells, preventing pulmonary infections.2 Glycoproteins (fucomucins, sialomucins and sulfomucins) regulate the viscoelastic properties of bronchial mucus. Increased fucomucins can be found in the mucus of patients with COPD. Carbocisteine serves to restore equilibrium between sialomucins and fucomucins, likely by intracellular stimulation of sialyl transferase enzyme, thus reducing mucus viscosity.2
A study found that L-carbocisteine can inhibit damage to cells by hydrogen peroxide (H2O2) by activating protein kinase B (Akt) phosphorylation, suggesting that carbocisteine may have antioxidant effects and prevent apoptosis of lung cells.5 There is some evidence that carbocisteine suppresses NF-κB and ERK1/2 MAPK signalling pathways, reducing TNF-alpha induced inflammation in the lungs, as well as other inflammatory pathways.8,9 An in-vitro study found that L-carbocisteine reduces intracellular adhesion molecule 1 (ICAM-1), inhibiting rhinovirus 14 infection, thereby reducing airway inflammation.10
Target Actions Organism AKelch-like ECH-associated protein 1 modulatorHumans ANuclear factor erythroid 2-related factor 2 activatorHumans UPI-PLC X domain-containing protein 3 inhibitorHumans ULactosylceramide alpha-2,3-sialyltransferase inducerHumans - Absorption
Carbocisteine is rapidly absorbed in the gastrointestinal tract when taken orally with peak serum concentrations achieved within 1 to 1.7 hours.2
- Volume of distribution
Carbocisteine penetrates well into the lung and bronchial secretions.2
- Protein binding
Plasma protein binding information for carbocisteine is not readily available in the literature.
- Metabolism
Metabolic pathways for carbocisteine include acetylation, decarboxylation, and sulfoxidation, leading to the formation of pharmacologically inactive carbocisteine derivatives. Significant variability exists in metabolism due to genetic polymorphism in sulfoxidation capacity. Two cytosolic enzymes are responsible for the metabolism of carbocisteine: cysteine dioxygenase and phenylalanine 4-hydroxylase.7 Reduced metabolism can cause increased exposure to carbocisteine, explaining variable clinical response between patients who may polymorphisms affecting the enzymes responsible for carbocisteine metabolism.2 It is generally accepted that sulfodixation is the main metabolic pathway of carbocisteine, however, one group of researchers found a novel urinary metabolite, S-(carboxymethylthio)-L-cysteine (CMTC). No cysteinyl sulfoxide metabolites were found in the urine of patients taking carbocisteine in this study.4
- Route of elimination
About 30% to 60% of an orally administered dose is detected unchanged in the urine.2
- Half-life
The plasma half-life of carbicostine is 1.33 hours.2
- Clearance
Clearance information for carbocisteine is not readily available in the literature.
- Adverse Effects
Improve decision support & research outcomesWith structured adverse effects data, including: blackbox warnings, adverse reactions, warning & precautions, & incidence rates. View sample adverse effects data in our new Data Library!Improve decision support & research outcomes with our structured adverse effects data.- Toxicity
The oral LD50 of carbocisteine in rats is >15000 mg/kg.15 An overdose with carbocisteine is likely to result in gastrointestinal discomfort with nausea and vomiting.14
- Pathways
- Not Available
- Pharmacogenomic Effects/ADRs
- Not Available
Interactions
- Drug Interactions
- This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction Integrate drug-drug
interactions in your softwareAcetohexamide The risk or severity of adverse effects can be increased when Acetohexamide is combined with Carbocisteine. Chloramphenicol The risk or severity of adverse effects can be increased when Chloramphenicol is combined with Carbocisteine. Chlorpropamide The risk or severity of adverse effects can be increased when Chlorpropamide is combined with Carbocisteine. Disulfiram The risk or severity of adverse effects can be increased when Disulfiram is combined with Carbocisteine. Gliclazide The risk or severity of adverse effects can be increased when Gliclazide is combined with Carbocisteine. - Food Interactions
- Take with or without food.
Products
Drug product information from 10+ global regionsOur datasets provide approved product information including:dosage, form, labeller, route of administration, and marketing period.Access drug product information from over 10 global regions.- Product Ingredients
Ingredient UNII CAS InChI Key Carbocisteine lysine 1D1Y95PXXA 49673-81-6 SAGXGPWVLUSDSQ-RVZXSAGBSA-N - International/Other Brands
- Actithiol (Almirall) / Lisomucil (Sanofi-Aventis) / Muciclar (Pfizer) / Mucodyne (Sanofi-Aventis) / Mucolex (General Pharma) / Rhinathiol (Sanofi-Aventis) / Transbronchin (Meda)
- Over the Counter Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image CARBOSOL SYRUP 125MG/5ML Syrup 125 MG/5ML Oral PRIME PHARMACEUTICAL SDN. BHD. 2020-09-08 Not applicable Malaysia 
CARBOSOL TABLET 375MG Tablet 375 MG Oral PRIME PHARMACEUTICAL SDN. BHD. 2020-09-08 Not applicable Malaysia FLUIFORT Syrup 450 mg/5ml Oral บริษัท เอ็ม แอนด์ เอ็ช แมนูแฟคเจอริ่ง จำกัด 2006-03-01 Not applicable Thailand 
FluiFort -2.7g Sachet Granule, for solution 2.7 g Oral EURODRUG LABORATORIES (M) SDN. BHD. 2020-09-08 Not applicable Malaysia FLUIFORT® Syrup 9g/100ml Syrup 9 g/100mL Oral EURODRUG LABORATORIES (M) SDN. BHD. 2020-09-08 Not applicable Malaysia - Mixture Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image AXIM TOSTHERAPY FORTE® Carbocisteine (3 g) + Guaifenesin (2 g) Syrup Oral Laboratorios Incobra S.A. 2021-09-02 Not applicable Colombia 
CP Cough Syrup Carbocisteine (100 mg) + Promethazine hydrochloride (2.5 mg) Syrup Oral Hovid Berhad 2020-09-08 Not applicable Malaysia Mucoease Plus Syrup Carbocisteine (100 mg) + Promethazine hydrochloride (2.5 mg) Syrup Oral PHARMANIAGA MANUFACTURING BERHAD 2020-09-08 Not applicable Malaysia MUCOPROM SYRUP Carbocisteine (100 mg/5ml) + Promethazine hydrochloride (2.5 mg/5ml) Syrup Oral XEPA-SOUL PATTINSON (MALAYSIA) SDN. BHD. 2020-09-08 Not applicable Malaysia Promethiol Syrup Carbocisteine (20 mg/ml) + Promethazine hydrochloride (0.5 mg/ml) Syrup Oral Y.S.P. INDUSTRIES (M) SDN. BHD. 2020-09-08 Not applicable Malaysia
Categories
- ATC Codes
- R05CB03 — Carbocisteine
- Drug Categories
- Chemical TaxonomyProvided by Classyfire
- Description
- This compound belongs to the class of organic compounds known as l-cysteine-s-conjugates. These are compounds containing L-cysteine where the thio-group is conjugated.
- Kingdom
- Organic compounds
- Super Class
- Organic acids and derivatives
- Class
- Carboxylic acids and derivatives
- Sub Class
- Amino acids, peptides, and analogues
- Direct Parent
- L-cysteine-S-conjugates
- Alternative Parents
- L-alpha-amino acids / Dicarboxylic acids and derivatives / Amino acids / Sulfenyl compounds / Dialkylthioethers / Carboxylic acids / Organopnictogen compounds / Organic oxides / Monoalkylamines / Hydrocarbon derivatives show 1 more
- Substituents
- Aliphatic acyclic compound / Alpha-amino acid / Amine / Amino acid / Carbonyl group / Carboxylic acid / Dialkylthioether / Dicarboxylic acid or derivatives / Hydrocarbon derivative / L-alpha-amino acid show 12 more
- Molecular Framework
- Aliphatic acyclic compounds
- External Descriptors
- non-proteinogenic L-alpha-amino acid, L-cysteine thioether (CHEBI:16163)
- Affected organisms
- Humans and other mammals
Chemical Identifiers
- UNII
- 740J2QX53R
- CAS number
- 638-23-3
- InChI Key
- GBFLZEXEOZUWRN-VKHMYHEASA-N
- InChI
- InChI=1S/C5H9NO4S/c6-3(5(9)10)1-11-2-4(7)8/h3H,1-2,6H2,(H,7,8)(H,9,10)/t3-/m0/s1
- IUPAC Name
- (2R)-2-amino-3-[(carboxymethyl)sulfanyl]propanoic acid
- SMILES
- N[C@@H](CSCC(O)=O)C(O)=O
References
- Synthesis Reference
Maierhofer, A. and Wagner, H.: US. Patent 4,129,593; December 12,1978: assigned to Deutsche Gold- und Silber-Scheideanstalt vormals Roessler (Germany).
- General References
- Alibasic E, Skopljak A, Cengic A, Krstovic G, Trifunovic N, Catic T, Kapo B, Mehic M, Hadzimuratovic A: Efficacy of carbocisteine in the treatment of chronic obstructive pulmonary disease and impact on the quality of life. Med Glas (Zenica). 2017 Aug 1;14(2):182-188. doi: 10.17392/906-17. [Article]
- Hooper C, Calvert J: The role for S-carboxymethylcysteine (carbocisteine) in the management of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2008;3(4):659-69. [Article]
- Mallet P, Mourdi N, Dubus JC, Bavoux F, Boyer-Gervoise MJ, Jean-Pastor MJ, Chalumeau M: Respiratory paradoxical adverse drug reactions associated with acetylcysteine and carbocysteine systemic use in paediatric patients: a national survey. PLoS One. 2011;6(7):e22792. doi: 10.1371/journal.pone.0022792. Epub 2011 Jul 27. [Article]
- Gregory WL, James OF, Turner I, Meese CO, Idle JR: Re-evaluation of the metabolism of carbocisteine in a British white population. Pharmacogenetics. 1993 Oct;3(5):270-4. doi: 10.1097/00008571-199310000-00007. [Article]
- Yoshida M, Nakayama K, Yasuda H, Kubo H, Kuwano K, Arai H, Yamaya M: Carbocisteine inhibits oxidant-induced apoptosis in cultured human airway epithelial cells. Respirology. 2009 Sep;14(7):1027-34. doi: 10.1111/j.1440-1843.2009.01594.x. Epub 2009 Aug 2. [Article]
- Hofmann U, Eichelbaum M, Seefried S, Meese CO: Identification of thiodiglycolic acid, thiodiglycolic acid sulfoxide, and (3-carboxymethylthio)lactic acid as major human biotransformation products of S-carboxymethyl-L-cysteine. Drug Metab Dispos. 1991 Jan-Feb;19(1):222-6. [Article]
- Prasanta Raghab Mohapatra, Deepak Aggarwal: Carbocisteine for acute exacerbations of COPD . 2008 Nov 8;372(9650):1630-1631. [Article]
- Balsamo R, Lanata L, Egan CG: Mucoactive drugs. Eur Respir Rev. 2010 Jun;19(116):127-33. doi: 10.1183/09059180.00003510. [Article]
- Wang W, Guan WJ, Huang RQ, Xie YQ, Zheng JP, Zhu SX, Chen M, Zhong NS: Carbocisteine attenuates TNF-alpha-induced inflammation in human alveolar epithelial cells in vitro through suppressing NF-kappaB and ERK1/2 MAPK signaling pathways. Acta Pharmacol Sin. 2016 May;37(5):629-36. doi: 10.1038/aps.2015.150. Epub 2016 Mar 21. [Article]
- Yamaya M, Nomura K, Arakawa K, Nishimura H, Lusamba Kalonji N, Kubo H, Nagatomi R, Kawase T: Increased rhinovirus replication in nasal mucosa cells in allergic subjects is associated with increased ICAM-1 levels and endosomal acidification and is inhibited by L-carbocisteine. Immun Inflamm Dis. 2016 Apr 15;4(2):166-181. doi: 10.1002/iid3.102. eCollection 2016 Jun. [Article]
- Devine JF: Chronic obstructive pulmonary disease: an overview. Am Health Drug Benefits. 2008 Sep;1(7):34-42. [Article]
- Medici TC, Radielovic P: Effects of drugs on mucus glycoproteins and water in bronchial secretion. J Int Med Res. 1979;7(5):434-42. doi: 10.1177/030006057900700518. [Article]
- NPRA Product Information: Mucoprom (carbocisteine/promethazine hydrochloride) oral syrup [Link]
- Medicines UK: Carbocisteine 250 mg/ 5 ml syrup [Link]
- Toronto Research Chemical MSDS: Carbocisteine [Link]
- NIH StatPearls: Mucolytic Medications [Link]
- NHS UK: Carbocisteine [Link]
- NIH Stat Pearls: Chronic Obstructive Pulmonary Disease (COPD) [Link]
- FDA Thailand: LOVISCOL INFANT (Carbocisteine) oral drops [Link]
- INVIMA information: PEDIALAB® 50 mg/ 1 mL (carbocisteine) oral solution [Link]
- FDA Thailand: CARBOCTER (carbocisteine) oral tablet [Link]
- External Links
- KEGG Drug
- D00175
- KEGG Compound
- C03727
- PubChem Compound
- 193653
- PubChem Substance
- 46507988
- ChemSpider
- 168055
- BindingDB
- 50213735
- 2023
- ChEBI
- 16163
- ChEMBL
- CHEMBL396416
- ZINC
- ZINC000001529732
- PDBe Ligand
- CCS
- Wikipedia
- Carbocisteine
- PDB Entries
- 1dss / 1err / 1gti / 1l2i / 1stf / 2bj4 / 2jfa / 2jx4 / 3dmt / 3pqz … show 20 more
Clinical Trials
- Clinical Trials
Clinical Trial & Rare Diseases Add-on Data Package
Explore 4,000+ rare diseases, orphan drugs & condition pairs, clinical trial why stopped data, & more. Preview package Phase Status Purpose Conditions Count Start Date Why Stopped 100+ additional columns Unlock 175K+ rows when you subscribe.View sample dataNot Available Completed Treatment Obstructive Sleep Apnea (OSA) 1 somestatus stop reason just information to hide 4 Completed Treatment Cough / Upper Respiratory Tract Infection 1 somestatus stop reason just information to hide 4 Unknown Status Treatment Acute Tracheobronchitis / Acute Upper Respiratory Infections 1 somestatus stop reason just information to hide 3 Recruiting Treatment Bronchiectasis 1 somestatus stop reason just information to hide 1 Completed Treatment Bronchitis 1 somestatus stop reason just information to hide
Pharmacoeconomics
- Manufacturers
- Not Available
- Packagers
- Not Available
- Dosage Forms
Form Route Strength Syrup Oral 5.0000 g Syrup Oral 7.5 g Syrup Oral 5 g Syrup Oral 100 mg Solution Oral 5 g Solution Oral 50 mg Powder, for solution Oral Syrup Oral Granule, for solution Oral 2.7 G Syrup Oral 2.7 G/10ML Syrup Oral 90 MG/ML Capsule Oral Solution Oral Syrup Oral Syrup Oral 125 MG/5ML Granule, for solution Oral Solution Oral 5.0000 g Suspension Oral 5 g Solution Oral 10 g Powder, for solution Oral 1.35 G Powder, for solution Oral 2.7 G Syrup Oral 450 mg/5ml Syrup Oral 9 % Syrup Oral 9 g/100mL Granule Suspension Oral Gel Oral 7.5 % Granule, for suspension Oral 1.5 G Granule, for suspension Oral 2.25 g Syrup Oral 50 mg/ml Syrup Oral 750 MG/15ML Tablet Oral 1.5 G Suspension Oral 50 mg Capsule Oral 300 MG Granule, for solution Oral 300 mg Granule, for suspension Oral 300 MG Syrup Oral 2 % Syrup Oral 20 MG/ML Syrup Oral 5 % Syrup Oral 7.5 % Syrup Oral 3 g Granule, for solution Oral 1.5 G Syrup Oral 150 ML Granule, for suspension Oral Powder Oral Tablet Oral 250 mg Capsule Oral 250 mg Capsule Oral 375 mg Syrup Oral 100 ml Syrup Oral 2 g Tablet Oral Syrup Oral 2 g/100ml Syrup Oral 5 g/100ml Syrup Oral 100 mg Suspension Oral 250 mg/5ml Tablet, coated Oral 375 mg Syrup Oral 250 mg/5ml Tablet Oral 375 mg Solution Oral 250 mg/5ml Syrup Oral 100 mg/5ml Suspension Oral 200 mg/5ml Suspension Oral 500 mg/5ml Capsule Oral 500 mg - Prices
- Not Available
- Patents
- Not Available
Properties
- State
- Solid
- Experimental Properties
Property Value Source melting point (°C) 185-187 https://www.trc-canada.com/prod-img/MSDS/C178760MSDS.pdf boiling point (°C) 417.3 ± 45.0 http://www.chemspider.com/Chemical-Structure.168055.html water solubility 1.6g/L https://patents.google.com/patent/CN104511025B/en logP -4.24 https://chem.nlm.nih.gov/chemidplus/rn/638-23-3 pKa 1.84 https://hmdb.ca/metabolites/HMDB0029415 - Predicted Properties
Property Value Source Water Solubility 21.6 mg/mL ALOGPS logP -3.2 ALOGPS logP -3.3 Chemaxon logS -0.92 ALOGPS pKa (Strongest Acidic) 1.84 Chemaxon pKa (Strongest Basic) 9.14 Chemaxon Physiological Charge -1 Chemaxon Hydrogen Acceptor Count 5 Chemaxon Hydrogen Donor Count 3 Chemaxon Polar Surface Area 100.62 Å2 Chemaxon Rotatable Bond Count 5 Chemaxon Refractivity 39.11 m3·mol-1 Chemaxon Polarizability 16.69 Å3 Chemaxon Number of Rings 0 Chemaxon Bioavailability 1 Chemaxon Rule of Five Yes Chemaxon Ghose Filter No Chemaxon Veber's Rule No Chemaxon MDDR-like Rule No Chemaxon - Predicted ADMET Features
Property Value Probability Human Intestinal Absorption + 0.7756 Blood Brain Barrier - 0.5616 Caco-2 permeable - 0.7891 P-glycoprotein substrate Non-substrate 0.6275 P-glycoprotein inhibitor I Non-inhibitor 0.9756 P-glycoprotein inhibitor II Non-inhibitor 0.997 Renal organic cation transporter Non-inhibitor 0.9394 CYP450 2C9 substrate Non-substrate 0.8676 CYP450 2D6 substrate Non-substrate 0.8484 CYP450 3A4 substrate Non-substrate 0.7652 CYP450 1A2 substrate Non-inhibitor 0.9091 CYP450 2C9 inhibitor Non-inhibitor 0.9542 CYP450 2D6 inhibitor Non-inhibitor 0.9441 CYP450 2C19 inhibitor Non-inhibitor 0.9462 CYP450 3A4 inhibitor Non-inhibitor 0.9426 CYP450 inhibitory promiscuity Low CYP Inhibitory Promiscuity 0.9973 Ames test Non AMES toxic 0.8896 Carcinogenicity Non-carcinogens 0.8995 Biodegradation Ready biodegradable 0.5294 Rat acute toxicity 1.5786 LD50, mol/kg Not applicable hERG inhibition (predictor I) Weak inhibitor 0.9802 hERG inhibition (predictor II) Non-inhibitor 0.9721
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
- Chromatographic Properties
Collision Cross Sections (CCS)
Adduct CCS Value (Å2) Source type Source [M-H]- 133.7237661 predictedDarkChem Lite v0.1.0 [M-H]- 133.7429661 predictedDarkChem Lite v0.1.0 [M-H]- 127.95926 predictedDeepCCS 1.0 (2019) [M+H]+ 137.8054335 predictedDarkChem Standard v0.1.0 [M+H]+ 133.1212661 predictedDarkChem Lite v0.1.0 [M+H]+ 131.77814 predictedDeepCCS 1.0 (2019) [M+Na]+ 132.6549661 predictedDarkChem Lite v0.1.0 [M+Na]+ 132.6729661 predictedDarkChem Lite v0.1.0 [M+Na]+ 141.1714 predictedDeepCCS 1.0 (2019)
Targets
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Use our structured and evidence-based datasets to unlock newinsights and accelerate drug research.
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- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Yes
- Actions
- Modulator
- General Function
- Substrate-specific adapter of a BCR (BTB-CUL3-RBX1) E3 ubiquitin ligase complex that regulates the response to oxidative stress by targeting NFE2L2/NRF2 for ubiquitination (PubMed:14585973, PubMed:15379550, PubMed:15572695, PubMed:15601839, PubMed:15983046, PubMed:37339955). KEAP1 acts as a key sensor of oxidative and electrophilic stress: in normal conditions, the BCR(KEAP1) complex mediates ubiquitination and degradation of NFE2L2/NRF2, a transcription factor regulating expression of many cytoprotective genes (PubMed:15601839, PubMed:16006525). In response to oxidative stress, different electrophile metabolites trigger non-enzymatic covalent modifications of highly reactive cysteine residues in KEAP1, leading to inactivate the ubiquitin ligase activity of the BCR(KEAP1) complex, promoting NFE2L2/NRF2 nuclear accumulation and expression of phase II detoxifying enzymes (PubMed:16006525, PubMed:17127771, PubMed:18251510, PubMed:19489739, PubMed:29590092). In response to selective autophagy, KEAP1 is sequestered in inclusion bodies following its interaction with SQSTM1/p62, leading to inactivation of the BCR(KEAP1) complex and activation of NFE2L2/NRF2 (PubMed:20452972). The BCR(KEAP1) complex also mediates ubiquitination of SQSTM1/p62, increasing SQSTM1/p62 sequestering activity and degradation (PubMed:28380357). The BCR(KEAP1) complex also targets BPTF and PGAM5 for ubiquitination and degradation by the proteasome (PubMed:15379550, PubMed:17046835)
- Specific Function
- disordered domain specific binding
- Gene Name
- KEAP1
- Uniprot ID
- Q14145
- Uniprot Name
- Kelch-like ECH-associated protein 1
- Molecular Weight
- 69665.765 Da
References
- Zhou Y, Zhang Y, Zhao D, Yu X, Shen X, Zhou Y, Wang S, Qiu Y, Chen Y, Zhu F: TTD: Therapeutic Target Database describing target druggability information. Nucleic Acids Res. 2024 Jan 5;52(D1):D1465-D1477. doi: 10.1093/nar/gkad751. [Article]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Yes
- Actions
- Activator
- General Function
- Transcription factor that plays a key role in the response to oxidative stress: binds to antioxidant response (ARE) elements present in the promoter region of many cytoprotective genes, such as phase 2 detoxifying enzymes, and promotes their expression, thereby neutralizing reactive electrophiles (PubMed:11035812, PubMed:19489739, PubMed:29018201, PubMed:31398338). In normal conditions, ubiquitinated and degraded in the cytoplasm by the BCR(KEAP1) complex (PubMed:11035812, PubMed:15601839, PubMed:29018201). In response to oxidative stress, electrophile metabolites inhibit activity of the BCR(KEAP1) complex, promoting nuclear accumulation of NFE2L2/NRF2, heterodimerization with one of the small Maf proteins and binding to ARE elements of cytoprotective target genes (PubMed:19489739, PubMed:29590092). The NFE2L2/NRF2 pathway is also activated in response to selective autophagy: autophagy promotes interaction between KEAP1 and SQSTM1/p62 and subsequent inactivation of the BCR(KEAP1) complex, leading to NFE2L2/NRF2 nuclear accumulation and expression of cytoprotective genes (PubMed:20452972). May also be involved in the transcriptional activation of genes of the beta-globin cluster by mediating enhancer activity of hypersensitive site 2 of the beta-globin locus control region (PubMed:7937919). Also plays an important role in the regulation of the innate immune response and antiviral cytosolic DNA sensing. It is a critical regulator of the innate immune response and survival during sepsis by maintaining redox homeostasis and restraint of the dysregulation of pro-inflammatory signaling pathways like MyD88-dependent and -independent and TNF-alpha signaling (By similarity). Suppresses macrophage inflammatory response by blocking pro-inflammatory cytokine transcription and the induction of IL6 (By similarity). Binds to the proximity of pro-inflammatory genes in macrophages and inhibits RNA Pol II recruitment. The inhibition is independent of the NRF2-binding motif and reactive oxygen species level (By similarity). Represses antiviral cytosolic DNA sensing by suppressing the expression of the adapter protein STING1 and decreasing responsiveness to STING1 agonists while increasing susceptibility to infection with DNA viruses (PubMed:30158636). Once activated, limits the release of pro-inflammatory cytokines in response to human coronavirus SARS-CoV-2 infection and to virus-derived ligands through a mechanism that involves inhibition of IRF3 dimerization. Also inhibits both SARS-CoV-2 replication, as well as the replication of several other pathogenic viruses including Herpes Simplex Virus-1 and-2, Vaccinia virus, and Zika virus through a type I interferon (IFN)-independent mechanism (PubMed:33009401)
- Specific Function
- DNA binding
- Gene Name
- NFE2L2
- Uniprot ID
- Q16236
- Uniprot Name
- Nuclear factor erythroid 2-related factor 2
- Molecular Weight
- 67825.9 Da
References
- Zhou Y, Zhang Y, Zhao D, Yu X, Shen X, Zhou Y, Wang S, Qiu Y, Chen Y, Zhu F: TTD: Therapeutic Target Database describing target druggability information. Nucleic Acids Res. 2024 Jan 5;52(D1):D1465-D1477. doi: 10.1093/nar/gkad751. [Article]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Inhibitor
- General Function
- Not Available
- Specific Function
- phosphoric diester hydrolase activity
- Gene Name
- PLCXD3
- Uniprot ID
- Q63HM9
- Uniprot Name
- PI-PLC X domain-containing protein 3
- Molecular Weight
- 36312.46 Da
References
- Ishibashi Y, Imai S, Inouye Y, Okano T, Taniguchi A: Effects of carbocisteine on sialyl-Lewis x expression in an airway carcinoma cell line stimulated with tumor necrosis factor-alpha. Eur J Pharmacol. 2006 Jan 20;530(3):223-8. doi: 10.1016/j.ejphar.2005.11.017. Epub 2006 Jan 4. [Article]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Inducer
- General Function
- Transfers the sialyl group (N-acetyl-alpha-neuraminyl or NeuAc) from CMP-NeuAc to the non-reducing terminal galactose (Gal) of glycosphingolipids forming gangliosides (important molecules involved in the regulation of multiple cellular processes, including cell proliferation and differentiation, apoptosis, embryogenesis, development, and oncogenesis) (PubMed:16934889, PubMed:9822625). Mainly involved in the biosynthesis of ganglioside GM3 but can also use different glycolipids as substrate acceptors such as D-galactosylceramide (GalCer), asialo-GM2 (GA2) and asialo-GM1 (GA1), although less preferentially than beta-D-Gal-(1->4)-beta-D-Glc-(1<->1)-Cer (LacCer) (PubMed:16934889)
- Specific Function
- beta-galactoside (CMP) alpha-2,3-sialyltransferase activity
- Gene Name
- ST3GAL5
- Uniprot ID
- Q9UNP4
- Uniprot Name
- Lactosylceramide alpha-2,3-sialyltransferase
- Molecular Weight
- 47989.385 Da
References
- Balsamo R, Lanata L, Egan CG: Mucoactive drugs. Eur Respir Rev. 2010 Jun;19(116):127-33. doi: 10.1183/09059180.00003510. [Article]
- Hooper C, Calvert J: The role for S-carboxymethylcysteine (carbocisteine) in the management of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2008;3(4):659-69. [Article]
Enzymes
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Substrate
- Curator comments
- Contradictory information exists in the literature regarding the involvement of this enzyme in the metabolism of carbocisteine.
- General Function
- Catalyzes the oxidation of cysteine to cysteine sulfinic acid with addition of molecular dioxygen
- Specific Function
- cysteine dioxygenase activity
- Gene Name
- CDO1
- Uniprot ID
- Q16878
- Uniprot Name
- Cysteine dioxygenase type 1
- Molecular Weight
- 22971.745 Da
References
- Prasanta Raghab Mohapatra, Deepak Aggarwal: Carbocisteine for acute exacerbations of COPD . 2008 Nov 8;372(9650):1630-1631. [Article]
- Steventon GB, Mitchell SC, Angulo S, Barbas C: An investigation into possible xenobiotic-endobiotic inter-relationships involving the amino acid analogue drug, S-carboxymethyl-L-cysteine and plasma amino acids in humans. Amino Acids. 2012 May;42(5):1967-73. doi: 10.1007/s00726-011-0926-y. Epub 2011 May 11. [Article]
- Steventon GB, Khan S, Mitchell SC: Comparison of the sulfur-oxygenation of cysteine and S-carboxymethyl-l-cysteine in human hepatic cytosol and the role of cysteine dioxygenase. J Pharm Pharmacol. 2018 Aug;70(8):1069-1077. doi: 10.1111/jphp.12944. Epub 2018 Jun 8. [Article]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Substrate
- General Function
- Catalyzes the hydroxylation of L-phenylalanine to L-tyrosine
- Specific Function
- iron ion binding
- Gene Name
- PAH
- Uniprot ID
- P00439
- Uniprot Name
- Phenylalanine-4-hydroxylase
- Molecular Weight
- 51861.565 Da
References
- Prasanta Raghab Mohapatra, Deepak Aggarwal: Carbocisteine for acute exacerbations of COPD . 2008 Nov 8;372(9650):1630-1631. [Article]
- Boonyapiwat B, Forbes B, Steventon GB: Phenylalanine hydroxylase: possible involvement in the S-oxidation of S-carboxymethyl-l-cysteine. Anal Biochem. 2004 Dec 1;335(1):91-7. doi: 10.1016/j.ab.2004.08.003. [Article]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Inducer
- General Function
- Transfers the sialyl group (N-acetyl-alpha-neuraminyl or NeuAc) from CMP-NeuAc to the non-reducing terminal galactose (Gal) of glycosphingolipids forming gangliosides (important molecules involved in the regulation of multiple cellular processes, including cell proliferation and differentiation, apoptosis, embryogenesis, development, and oncogenesis) (PubMed:16934889, PubMed:9822625). Mainly involved in the biosynthesis of ganglioside GM3 but can also use different glycolipids as substrate acceptors such as D-galactosylceramide (GalCer), asialo-GM2 (GA2) and asialo-GM1 (GA1), although less preferentially than beta-D-Gal-(1->4)-beta-D-Glc-(1<->1)-Cer (LacCer) (PubMed:16934889)
- Specific Function
- beta-galactoside (CMP) alpha-2,3-sialyltransferase activity
- Gene Name
- ST3GAL5
- Uniprot ID
- Q9UNP4
- Uniprot Name
- Lactosylceramide alpha-2,3-sialyltransferase
- Molecular Weight
- 47989.385 Da
References
- Hooper C, Calvert J: The role for S-carboxymethylcysteine (carbocisteine) in the management of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2008;3(4):659-69. [Article]
- Balsamo R, Lanata L, Egan CG: Mucoactive drugs. Eur Respir Rev. 2010 Jun;19(116):127-33. doi: 10.1183/09059180.00003510. [Article]
Drug created at June 13, 2005 13:24 / Updated at August 26, 2024 19:24