Acetylcysteine and Sinus Conditions  

by Xrystina Bicoy

What is Acetylcysteine?  

Acetylcysteine is a modified form of cysteine, a dietary amino acid. It has different functions depending on how it is administered. When taken orally acetylcysteine acts as a precursor to glutathione, a potent antioxidant, and can replenish intracellular glutathione stores. When inhaled or used as a nasal rinse, acetylcysteine works more as a mucolytic. Acetylcysteine is able to help dissolve mucous through cleavage of disulfide bonds resulting in decreased mucous viscosity. Additionally, acetylcysteine may have some intrinsic anti-inflammatory and antioxidant effects.   

What is Acetylcysteine used for?  

Acetylcysteine is FDA approved for the treatment of acetaminophen (Tylenol) overdose and also as an inhaled mucolytic in disease states where there is excess mucous buildup in the lungs (i.e. cystic fibrosis, COPD).   

How can Acetylcysteine be used to help treat common sinus conditions?  

Acetylcysteine can be beneficial in sinus conditions when administered nasally because it dissolves and liquifies mucous built up in nasal passages. This results in decreased congestion and increased airflow. Nasal rinses containing acetylcysteine may also contain antibiotics to help fight against sinus infections. Acetylcysteine can increase the efficacy of the antibiotics by clearing out mucous and allowing the antibiotic to penetrate deeper into nasal tissue.   

Some patients may suffer from chronic sinus infections, and this may be due to bacterial biofilms that have developed within the nasal cavities. A biofilm is a film of bacteria that adheres strongly to a surface. Biofilms make it difficult for antibiotics to penetrate through to all bacteria and clear the infection completely. Acetylcysteine nasal rinse can help to increase antibiotic permeation through biofilms by dissolving the mucous surrounding the biofilm. In this way, acetylcysteine nasal rinses may be especially beneficial for patients that suffer from chronic sinus infections.   

References:  

Acetylcysteine. Lexi-Drugs. Lexicomp. UpToDate, Inc,; 2021. Updated Oct 10, 2021. Accessed Dec 8, 2021. https://online.lexi.com   

Saltagi MZ, Comer BT, Hughes S, Ting JY, Higgins TS. Management of recurrent Acute Rhinosinusitis: a systematic review. Am J Rhinol Allergy. 2021;35(6):902-909. 

Smith A, Buchinsky FJ, Post JC. Eradicating chronic ear, nose, and throat infections: a systematically conducted literature review of advances in biofilm treatment. OTO Open. 2010;144(3):338-347.  

Helms S, Miller AL. Natural treatment of chronic rhinosinusitis. Altern Med Rev. 2006;11(3):196-207. 

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