Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et)

ABSTRACT: Background: It has been proposed that polyphenols can be used in the development of new therapies against COVID-19, given their ability to interfere with the adsorption and entrance processes of the virus, thus disrupting viral replication. Seeds from Caesalpinia spinosa, have been traditi...

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Autores:
Urueña, Claudia Patricia
Ballesteros Ramírez, Ricardo
Gómez Cadena, Alejandra
Barreto, Alfonso
Prieto, Karol
Quijano, Sandra
Aschner, Pablo
Martínez, Carlos
El-Ahanidi, Hajar
Jandus, Camilla
Zapata Cardona, Maria Isabel
Flórez Álvarez, Lizdany
Rugeles López, María Teresa
Zapata Builes, Wildeman
García Peña, Angel Alberto
Fiorentino, Susana
Tipo de recurso:
Article of investigation
Fecha de publicación:
2022
Institución:
Universidad de Antioquia
Repositorio:
Repositorio UdeA
Idioma:
eng
OAI Identifier:
oai:bibliotecadigital.udea.edu.co:10495/35507
Acceso en línea:
https://hdl.handle.net/10495/35507
Palabra clave:
COVID-19
SARS-CoV-2
Medicina de Hierbas
Herbal Medicine
Plantas Medicinales
Plants, Medicinal
Polifenoles
Polyphenols
Inmunomodulación
Immunomodulation
Terapias Complementarias
Complementary Therapies
Rights
openAccess
License
https://creativecommons.org/licenses/by/4.0/
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dc.title.spa.fl_str_mv Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et)
title Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et)
spellingShingle Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et)
COVID-19
SARS-CoV-2
Medicina de Hierbas
Herbal Medicine
Plantas Medicinales
Plants, Medicinal
Polifenoles
Polyphenols
Inmunomodulación
Immunomodulation
Terapias Complementarias
Complementary Therapies
title_short Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et)
title_full Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et)
title_fullStr Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et)
title_full_unstemmed Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et)
title_sort Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et)
dc.creator.fl_str_mv Urueña, Claudia Patricia
Ballesteros Ramírez, Ricardo
Gómez Cadena, Alejandra
Barreto, Alfonso
Prieto, Karol
Quijano, Sandra
Aschner, Pablo
Martínez, Carlos
El-Ahanidi, Hajar
Jandus, Camilla
Zapata Cardona, Maria Isabel
Flórez Álvarez, Lizdany
Rugeles López, María Teresa
Zapata Builes, Wildeman
García Peña, Angel Alberto
Fiorentino, Susana
dc.contributor.author.none.fl_str_mv Urueña, Claudia Patricia
Ballesteros Ramírez, Ricardo
Gómez Cadena, Alejandra
Barreto, Alfonso
Prieto, Karol
Quijano, Sandra
Aschner, Pablo
Martínez, Carlos
El-Ahanidi, Hajar
Jandus, Camilla
Zapata Cardona, Maria Isabel
Flórez Álvarez, Lizdany
Rugeles López, María Teresa
Zapata Builes, Wildeman
García Peña, Angel Alberto
Fiorentino, Susana
dc.contributor.researchgroup.spa.fl_str_mv Inmunovirología
dc.subject.decs.none.fl_str_mv COVID-19
SARS-CoV-2
Medicina de Hierbas
Herbal Medicine
Plantas Medicinales
Plants, Medicinal
Polifenoles
Polyphenols
Inmunomodulación
Immunomodulation
Terapias Complementarias
Complementary Therapies
topic COVID-19
SARS-CoV-2
Medicina de Hierbas
Herbal Medicine
Plantas Medicinales
Plants, Medicinal
Polifenoles
Polyphenols
Inmunomodulación
Immunomodulation
Terapias Complementarias
Complementary Therapies
description ABSTRACT: Background: It has been proposed that polyphenols can be used in the development of new therapies against COVID-19, given their ability to interfere with the adsorption and entrance processes of the virus, thus disrupting viral replication. Seeds from Caesalpinia spinosa, have been traditionally used for the treatment of inflammatory pathologies and respiratory diseases. Our team has obtained an extract called P2Et, rich in polyphenols derived from gallic acid with significant antioxidant activity, and the ability to induce complete autophagy in tumor cells and reduce the systemic inflammatory response in animal models. Methods: In this work, a phase II multicenter randomized double-blind clinical trial on COVID-19 patients was designed to evaluate the impact of the P2Et treatment on the clinical outcome and the immunological parameters related to the evolution of the disease. The Trial was registered with the number No. NCT04410510∗. A complementary study in an animal model of lung fibrosis was carried out to evaluate in situ lung changes after P2Et in vivo administration. The ability of P2Et to inhibit the viral load of murine and human coronaviruses in cellular models was also evaluated. Results: Patients treated with P2Et were discharged on average after 7.4 days of admission vs. 9.6 days in the placebo group. Although a decrease in proinflammatory cytokines such as G-CSF, IL-15, IL-12, IL-6, IP10, MCP-1, MCP-2 and IL-18 was observed in both groups, P2Et decreased to a greater extent G-CSF, IL-6 and IL-18 among others, which are related to lower recovery of patients in the long term. The frequency of T lymphocytes (LT) CD3+, LT double negative (CD3+CD4-CD8-), NK cells increased in the P2Et group where the population of eosinophils was also significantly reduced. In the murine bleomycin model, P2Et also reduced lung inflammation and fibrosis. P2Et was able to reduce the viral replication of murine and human coronaviruses in vitro, showing its dual antiviral and anti-inflammatory role, key in disease control. Conclusions: Taken together these results suggest that P2Et could be consider as a good co-adjuvant in the treatment of COVID-19.
publishDate 2022
dc.date.issued.none.fl_str_mv 2022
dc.date.accessioned.none.fl_str_mv 2023-06-14T20:46:34Z
dc.date.available.none.fl_str_mv 2023-06-14T20:46:34Z
dc.type.spa.fl_str_mv Artículo de investigación
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dc.identifier.citation.spa.fl_str_mv Urueña C, Ballesteros-Ramírez R, Gomez-Cadena A, Barreto A, Prieto K, Quijano S, Aschner P, Martínez C, Zapata-Cardona MI, El-Ahanidi H, Jandus C, Florez-Alvarez L, Rugeles MT, Zapata-Builes W, Garcia AA, Fiorentino S. Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et). Front Med (Lausanne). 2022 Sep 8;9:991873. doi: 10.3389/fmed.2022.991873. PMID: 36160152; PMCID: PMC9494348.
dc.identifier.issn.none.fl_str_mv 2296-858X
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/10495/35507
dc.identifier.doi.none.fl_str_mv 10.3389/fmed.2022.991873
dc.identifier.eissn.none.fl_str_mv 2296-858X
identifier_str_mv Urueña C, Ballesteros-Ramírez R, Gomez-Cadena A, Barreto A, Prieto K, Quijano S, Aschner P, Martínez C, Zapata-Cardona MI, El-Ahanidi H, Jandus C, Florez-Alvarez L, Rugeles MT, Zapata-Builes W, Garcia AA, Fiorentino S. Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et). Front Med (Lausanne). 2022 Sep 8;9:991873. doi: 10.3389/fmed.2022.991873. PMID: 36160152; PMCID: PMC9494348.
2296-858X
10.3389/fmed.2022.991873
url https://hdl.handle.net/10495/35507
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.ispartofjournalabbrev.spa.fl_str_mv Front Med
dc.relation.citationendpage.spa.fl_str_mv 22
dc.relation.citationstartpage.spa.fl_str_mv 1
dc.relation.citationvolume.spa.fl_str_mv 9
dc.relation.ispartofjournal.spa.fl_str_mv Frontiers in medicine
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dc.publisher.place.spa.fl_str_mv Lausanne, Suiza
institution Universidad de Antioquia
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spelling Urueña, Claudia PatriciaBallesteros Ramírez, RicardoGómez Cadena, AlejandraBarreto, AlfonsoPrieto, KarolQuijano, SandraAschner, PabloMartínez, CarlosEl-Ahanidi, HajarJandus, CamillaZapata Cardona, Maria IsabelFlórez Álvarez, LizdanyRugeles López, María TeresaZapata Builes, WildemanGarcía Peña, Angel AlbertoFiorentino, SusanaInmunovirología2023-06-14T20:46:34Z2023-06-14T20:46:34Z2022Urueña C, Ballesteros-Ramírez R, Gomez-Cadena A, Barreto A, Prieto K, Quijano S, Aschner P, Martínez C, Zapata-Cardona MI, El-Ahanidi H, Jandus C, Florez-Alvarez L, Rugeles MT, Zapata-Builes W, Garcia AA, Fiorentino S. Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et). Front Med (Lausanne). 2022 Sep 8;9:991873. doi: 10.3389/fmed.2022.991873. PMID: 36160152; PMCID: PMC9494348.2296-858Xhttps://hdl.handle.net/10495/3550710.3389/fmed.2022.9918732296-858XABSTRACT: Background: It has been proposed that polyphenols can be used in the development of new therapies against COVID-19, given their ability to interfere with the adsorption and entrance processes of the virus, thus disrupting viral replication. Seeds from Caesalpinia spinosa, have been traditionally used for the treatment of inflammatory pathologies and respiratory diseases. Our team has obtained an extract called P2Et, rich in polyphenols derived from gallic acid with significant antioxidant activity, and the ability to induce complete autophagy in tumor cells and reduce the systemic inflammatory response in animal models. Methods: In this work, a phase II multicenter randomized double-blind clinical trial on COVID-19 patients was designed to evaluate the impact of the P2Et treatment on the clinical outcome and the immunological parameters related to the evolution of the disease. The Trial was registered with the number No. NCT04410510∗. A complementary study in an animal model of lung fibrosis was carried out to evaluate in situ lung changes after P2Et in vivo administration. The ability of P2Et to inhibit the viral load of murine and human coronaviruses in cellular models was also evaluated. Results: Patients treated with P2Et were discharged on average after 7.4 days of admission vs. 9.6 days in the placebo group. Although a decrease in proinflammatory cytokines such as G-CSF, IL-15, IL-12, IL-6, IP10, MCP-1, MCP-2 and IL-18 was observed in both groups, P2Et decreased to a greater extent G-CSF, IL-6 and IL-18 among others, which are related to lower recovery of patients in the long term. The frequency of T lymphocytes (LT) CD3+, LT double negative (CD3+CD4-CD8-), NK cells increased in the P2Et group where the population of eosinophils was also significantly reduced. In the murine bleomycin model, P2Et also reduced lung inflammation and fibrosis. P2Et was able to reduce the viral replication of murine and human coronaviruses in vitro, showing its dual antiviral and anti-inflammatory role, key in disease control. Conclusions: Taken together these results suggest that P2Et could be consider as a good co-adjuvant in the treatment of COVID-19.COL001244422application/pdfengFrontiers Media S.ALausanne, Suizahttps://creativecommons.org/licenses/by/4.0/http://creativecommons.org/licenses/by/2.5/co/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Randomized double-blind clinical study in patients with COVID-19 to evaluate the safety and efficacy of a phytomedicine (P2Et)Artículo de investigaciónhttp://purl.org/coar/resource_type/c_2df8fbb1https://purl.org/redcol/resource_type/ARThttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionCOVID-19SARS-CoV-2Medicina de HierbasHerbal MedicinePlantas MedicinalesPlants, MedicinalPolifenolesPolyphenolsInmunomodulaciónImmunomodulationTerapias ComplementariasComplementary TherapiesFront Med2219Frontiers in medicinePublicationORIGINALRugelesMaria_2022_COVID19SafetyEfficacyPhytomedicine.pdfRugelesMaria_2022_COVID19SafetyEfficacyPhytomedicine.pdfArtículo de investigaciónapplication/pdf3039473https://bibliotecadigital.udea.edu.co/bitstreams/d1ee18e5-e67a-47d5-8b6d-0c610ffae544/download0f5db162155945648d3c9584c5a00ee8MD51trueAnonymousREADCC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8927https://bibliotecadigital.udea.edu.co/bitstreams/6a55628a-58bf-4381-8c97-ff47a50490fe/download1646d1f6b96dbbbc38035efc9239ac9cMD52falseAnonymousREADLICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://bibliotecadigital.udea.edu.co/bitstreams/d162da15-81f4-4d93-b57e-10b3e0d8d394/download8a4605be74aa9ea9d79846c1fba20a33MD53falseAnonymousREADTEXTRugelesMaria_2022_COVID19SafetyEfficacyPhytomedicine.pdf.txtRugelesMaria_2022_COVID19SafetyEfficacyPhytomedicine.pdf.txtExtracted texttext/plain94565https://bibliotecadigital.udea.edu.co/bitstreams/a797907a-57dd-4b72-a476-eab7fae5972f/downloadde8cb82a23770c6a64bb988dd4d2dd35MD54falseAnonymousREADTHUMBNAILRugelesMaria_2022_COVID19SafetyEfficacyPhytomedicine.pdf.jpgRugelesMaria_2022_COVID19SafetyEfficacyPhytomedicine.pdf.jpgGenerated Thumbnailimage/jpeg12351https://bibliotecadigital.udea.edu.co/bitstreams/440ba96b-2530-4491-8b86-3735df12fe3e/download438ec85ad9234deef3d6aeb5f20ba4e1MD55falseAnonymousREAD10495/35507oai:bibliotecadigital.udea.edu.co:10495/355072025-03-26 19:57:37.462https://creativecommons.org/licenses/by/4.0/open.accesshttps://bibliotecadigital.udea.edu.coRepositorio Institucional de la Universidad de Antioquiaaplicacionbibliotecadigitalbiblioteca@udea.edu.coTk9URTogUExBQ0UgWU9VUiBPV04gTElDRU5TRSBIRVJFClRoaXMgc2FtcGxlIGxpY2Vuc2UgaXMgcHJvdmlkZWQgZm9yIGluZm9ybWF0aW9uYWwgcHVycG9zZXMgb25seS4KCk5PTi1FWENMVVNJVkUgRElTVFJJQlVUSU9OIExJQ0VOU0UKCkJ5IHNpZ25pbmcgYW5kIHN1Ym1pdHRpbmcgdGhpcyBsaWNlbnNlLCB5b3UgKHRoZSBhdXRob3Iocykgb3IgY29weXJpZ2h0Cm93bmVyKSBncmFudHMgdG8gRFNwYWNlIFVuaXZlcnNpdHkgKERTVSkgdGhlIG5vbi1leGNsdXNpdmUgcmlnaHQgdG8gcmVwcm9kdWNlLAp0cmFuc2xhdGUgKGFzIGRlZmluZWQgYmVsb3cpLCBhbmQvb3IgZGlzdHJpYnV0ZSB5b3VyIHN1Ym1pc3Npb24gKGluY2x1ZGluZwp0aGUgYWJzdHJhY3QpIHdvcmxkd2lkZSBpbiBwcmludCBhbmQgZWxlY3Ryb25pYyBmb3JtYXQgYW5kIGluIGFueSBtZWRpdW0sCmluY2x1ZGluZyBidXQgbm90IGxpbWl0ZWQgdG8gYXVkaW8gb3IgdmlkZW8uCgpZb3UgYWdyZWUgdGhhdCBEU1UgbWF5LCB3aXRob3V0IGNoYW5naW5nIHRoZSBjb250ZW50LCB0cmFuc2xhdGUgdGhlCnN1Ym1pc3Npb24gdG8gYW55IG1lZGl1bSBvciBmb3JtYXQgZm9yIHRoZSBwdXJwb3NlIG9mIHByZXNlcnZhdGlvbi4KCllvdSBhbHNvIGFncmVlIHRoYXQgRFNVIG1heSBrZWVwIG1vcmUgdGhhbiBvbmUgY29weSBvZiB0aGlzIHN1Ym1pc3Npb24gZm9yCnB1cnBvc2VzIG9mIHNlY3VyaXR5LCBiYWNrLXVwIGFuZCBwcmVzZXJ2YXRpb24uCgpZb3UgcmVwcmVzZW50IHRoYXQgdGhlIHN1Ym1pc3Npb24gaXMgeW91ciBvcmlnaW5hbCB3b3JrLCBhbmQgdGhhdCB5b3UgaGF2ZQp0aGUgcmlnaHQgdG8gZ3JhbnQgdGhlIHJpZ2h0cyBjb250YWluZWQgaW4gdGhpcyBsaWNlbnNlLiBZb3UgYWxzbyByZXByZXNlbnQKdGhhdCB5b3VyIHN1Ym1pc3Npb24gZG9lcyBub3QsIHRvIHRoZSBiZXN0IG9mIHlvdXIga25vd2xlZGdlLCBpbmZyaW5nZSB1cG9uCmFueW9uZSdzIGNvcHlyaWdodC4KCklmIHRoZSBzdWJtaXNzaW9uIGNvbnRhaW5zIG1hdGVyaWFsIGZvciB3aGljaCB5b3UgZG8gbm90IGhvbGQgY29weXJpZ2h0LAp5b3UgcmVwcmVzZW50IHRoYXQgeW91IGhhdmUgb2J0YWluZWQgdGhlIHVucmVzdHJpY3RlZCBwZXJtaXNzaW9uIG9mIHRoZQpjb3B5cmlnaHQgb3duZXIgdG8gZ3JhbnQgRFNVIHRoZSByaWdodHMgcmVxdWlyZWQgYnkgdGhpcyBsaWNlbnNlLCBhbmQgdGhhdApzdWNoIHRoaXJkLXBhcnR5IG93bmVkIG1hdGVyaWFsIGlzIGNsZWFybHkgaWRlbnRpZmllZCBhbmQgYWNrbm93bGVkZ2VkCndpdGhpbiB0aGUgdGV4dCBvciBjb250ZW50IG9mIHRoZSBzdWJtaXNzaW9uLgoKSUYgVEhFIFNVQk1JU1NJT04gSVMgQkFTRUQgVVBPTiBXT1JLIFRIQVQgSEFTIEJFRU4gU1BPTlNPUkVEIE9SIFNVUFBPUlRFRApCWSBBTiBBR0VOQ1kgT1IgT1JHQU5JWkFUSU9OIE9USEVSIFRIQU4gRFNVLCBZT1UgUkVQUkVTRU5UIFRIQVQgWU9VIEhBVkUKRlVMRklMTEVEIEFOWSBSSUdIVCBPRiBSRVZJRVcgT1IgT1RIRVIgT0JMSUdBVElPTlMgUkVRVUlSRUQgQlkgU1VDSApDT05UUkFDVCBPUiBBR1JFRU1FTlQuCgpEU1Ugd2lsbCBjbGVhcmx5IGlkZW50aWZ5IHlvdXIgbmFtZShzKSBhcyB0aGUgYXV0aG9yKHMpIG9yIG93bmVyKHMpIG9mIHRoZQpzdWJtaXNzaW9uLCBhbmQgd2lsbCBub3QgbWFrZSBhbnkgYWx0ZXJhdGlvbiwgb3RoZXIgdGhhbiBhcyBhbGxvd2VkIGJ5IHRoaXMKbGljZW5zZSwgdG8geW91ciBzdWJtaXNzaW9uLgo=