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Gopal R, Tutuncuoglu E, Bakalov V, Wasserloos K, Li H, Lemley D, DeVito LJ, Constantinesco NJ, Reed DS, McHugh KJ, Chinnappan B, Andreas AR, Maloy A, Bain D, Alcorn JF, Pitt BR, Kaynar AM. Zinc deficiency enhances sensitivity to influenza A associated bacterial pneumonia in mice. Physiol Rep 2024; 12:e15902. [PMID: 38163670 PMCID: PMC10758336 DOI: 10.14814/phy2.15902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024] Open
Abstract
Although zinc deficiency (secondary to malnutrition) has long been considered an important contributor to morbidity and mortality of infectious disease (e.g. diarrhea disorders), epidemiologic data (including randomized controlled trials with supplemental zinc) for such a role in lower respiratory tract infection are somewhat ambiguous. In the current study, we provide the first preclinical evidence demonstrating that although diet-induced acute zinc deficiency (Zn-D: ~50% decrease) did not worsen infection induced by either influenza A (H1N1) or methicillin-resistant staph aureus (MRSA), Zn-D mice were sensitive to the injurious effects of superinfection of H1N1 with MRSA. Although the mechanism underlying the sensitivity of ZnD mice to combined H1N1/MRSA infection is unclear, it was noteworthy that this combination exacerbated lung injury as shown by lung epithelial injury markers (increased BAL protein) and decreased genes related to epithelial integrity in Zn-D mice (surfactant protein C and secretoglobins family 1A member 1). As bacterial pneumonia accounts for 25%-50% of morbidity and mortality from influenza A infection, zinc deficiency may be an important pathology component of respiratory tract infections.
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Affiliation(s)
- Radha Gopal
- Department of PediatricsUPMC Children's Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Egemen Tutuncuoglu
- The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Critical Care MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Present address:
Department of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Veli Bakalov
- The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Critical Care MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Present address:
Medicine InstituteAllegheny Health NetworkPittsburghPennsylvaniaUSA
| | - Karla Wasserloos
- Department of Environmental and Occupational HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
- Present address:
R.D. 2PortersvillePennsylvaniaUSA
| | - HuiHua Li
- Department of Environmental and Occupational HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
- Present address:
Department of PathologyUniversity of WisconsinMadisonWisconsinUSA
| | - David Lemley
- Department of Environmental and Occupational HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
- Present address:
R.D. 2PortersvillePennsylvaniaUSA
| | - Louis J. DeVito
- Department of PediatricsUPMC Children's Hospital of PittsburghPittsburghPennsylvaniaUSA
| | | | - Douglas S. Reed
- Center for Vaccine ResearchUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Kevin J. McHugh
- Department of PediatricsUPMC Children's Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Baskaran Chinnappan
- Department of PediatricsUPMC Children's Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Alexis R. Andreas
- Department of Critical Care MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Present address:
Department of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Abigail Maloy
- Department of Critical Care MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Daniel Bain
- Department of Geology and Planetary ScienceUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - John F. Alcorn
- Department of PediatricsUPMC Children's Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Bruce R. Pitt
- Department of Environmental and Occupational HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Ata Murat Kaynar
- The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Critical Care MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Anesthesiology and Perioperative MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
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2
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Ahsan N, Imran M, Mohammed Y, Al Anouti F, Khan MI, Banerjee T, Adnan M, Ashfaq F, Kieliszek M, Ashraf SA, Haq A. Mechanistic Insight into the role of Vitamin D and Zinc in Modulating Immunity Against COVID-19: A View from an Immunological Standpoint. Biol Trace Elem Res 2023; 201:5546-5560. [PMID: 36890344 PMCID: PMC9995175 DOI: 10.1007/s12011-023-03620-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/01/2023] [Indexed: 03/10/2023]
Abstract
The pathophysiology of coronavirus disease-19 (COVID-19) is characterized by worsened inflammation because of weakened immunity, causing the infiltration of immune cells, followed by necrosis. Consequently, these pathophysiological changes may lead to a life-threatening decline in perfusion due to hyperplasia of the lungs, instigating severe pneumonia, and causing fatalities. Additionally, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause mortality due to viral septic shock, resulting from unrestrained and backfiring immune reactions to the pathogen. Sepsis can cause premature organ failure in COVID-19 patients, as well. Notably, vitamin D and its derivatives and minerals, such as zinc and magnesium, have been reported to improve the immune system against respiratory illnesses. This comprehensive review aims to provide updated mechanistic details of vitamin D and zinc as immunomodulators. Additionally, this review also focuses on their role in respiratory illnesses, while specifically delineating the plausibility of employing them as a preventive and therapeutic agent against current and future pandemics from an immunological perspective. Furthermore, this comprehensive review will attract the attention of health professionals, nutritionists, pharmaceuticals, and scientific communities, as it encourages the use of such micronutrients for therapeutic purposes, as well as promoting their health benefits for a healthy lifestyle and wellbeing.
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Affiliation(s)
- Nuzhat Ahsan
- Quantum Biphotonics Division, Quantlase Laboratory LLC, Abu Dhabi, UAE
| | - Mohammad Imran
- Therapeutic Research Group, Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, 4102, Australia
| | - Yousuf Mohammed
- Therapeutic Research Group, Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, 4102, Australia
| | - Fatme Al Anouti
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, UAE
| | - Mohammad Idreesh Khan
- Department of Clinical Nutrition, College of Applied Health Sciences in Ar Rass, Qassim University, Ar Rass, 51921, Saudi Arabia
| | - Tanushree Banerjee
- Infosys Ltd. SEZ Unit VI, Plot No. 1, Rajiv Gandhi Infotech Park, Hinjawadi Phase I, Pune, Maharashtra, 57, India
| | - Mohd Adnan
- Department of Biology, College of Science, University of Ha'il, P.O. Box 2440, Ha'il, Saudi Arabia
| | - Fauzia Ashfaq
- Department of Clinical Nutrition, College of Applied Medical Sciences, Jazan University, Jazan, 45142, Saudi Arabia
| | - Marek Kieliszek
- Department of Food Biotechnology and Microbiology, Institute of Food Sciences, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159 C, 02-776, Warsaw, Poland.
| | - Syed Amir Ashraf
- Department of Clinical Nutrition, College of Applied Medical Sciences, University of Ha'il, Ha'il, Saudi Arabia.
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3
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Bach-Faig A, Ferreres Giménez I, Pueyo Alamán MG. [Immunonutrition and (its impact on) health. Micronutrients and debilitating factors]. NUTR HOSP 2023; 40:3-8. [PMID: 37929894 DOI: 10.20960/nh.04945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Introduction Introduction: the interaction between immunity and nutrition is complex and multifaceted. Micronutrients, including vitamins and minerals, are essential for immune function. In turn, immune function and lifestyle habits can affect nutritional needs and micronutrient utilization, creating an interdependence between nutrition and immunity that can be modulated by both external and internal factors. Objectives: to examine the relationship between micronutrient intake and immune function, and how debilitating factors such as aging, disease, and stress can impact this relationship. Methods: a review of scientific evidence and recommendations from major international scientific societies was conducted to identify the importance of micronutrients in immune function and how debilitating factors can alter their impact. Results: the effect of different micronutrients on immune function is described. Debilitating factors like aging, stress, and chronic diseases can compromise the immune system and make the body more susceptible to infections. However, adequate intake of micronutrients and healthy habits can help to strengthen immunity and mitigate the effects of these debilitating factors. Conclusion: immunonutrition is a critical component for maintaining a strong and healthy immune system. Sufficient intake of micronutrients and healthy lifestyle habits can help improve immunity, especially in the presence of debilitating factors.
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Affiliation(s)
- Anna Bach-Faig
- Grupo de Investigación FoodLab (2017SGR 83), Estudios de Ciencias de la Salud, Universitat Oberta de Catalunya (UOC), Spain
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Myoenzono K, Yasuda J, Takai E, Shinagawa A, Kaneko N, Yoshizaki T, Namma-Motonaga K, Yoshino M, Kondo E, Nakajima K, Hangai M, Kamahara K, Kamihigashi E, Kusano S, Kamei A. Investigation of supplement use and knowledge among Japanese elite athletes for the Tokyo 2020 Olympic/Paralympic games and the Beijing 2022 winter Olympic/Paralympic games. Front Sports Act Living 2023; 5:1258542. [PMID: 37927448 PMCID: PMC10622793 DOI: 10.3389/fspor.2023.1258542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Elite athletes frequently invest in the use of supplements to optimize their dietary regimens and enhance their athletic performance. However, unregulated and unplanned use of supplements can lead to adverse consequences, including anti-doping rule violations or health issues. Thus, athletes should verify their diets, consider scientific evidence, and take necessary precautions regarding supplements before use. To date, no study has explored whether athletes check these factors before using supplements. This study aimed to investigate supplement use using a questionnaire administered to 1,392 athletes (including candidate athletes) who participated in the Tokyo 2020 Olympic/Paralympic and Beijing 2022 Winter Olympic/Paralympic Games. Participants were categorized as follows: 1,040 participants in the Tokyo 2020 Olympic Games, 83 in the Tokyo 2020 Paralympic Games, 239 in the Beijing 2022 Winter Olympic Games, and 30 in the Beijing 2022 Winter Paralympic Games. We collected data on supplement use and gained further knowledge through interviews with the athletes. Approximately 70% of Tokyo 2020 Olympic/Paralympic and Beijing 2022 Winter Olympic athletes and approximately 50% of Beijing 2022 Winter Paralympians used supplements. Over 50% of athletes had not received a doctor's diagnosis or a dietitian's evaluation before supplement use. Moreover, only 50% of the athletes who used dietary supplements reviewed the scientific evidence for the dietary supplements before using them and justified their choice based on their own investigation, while those who did not use dietary supplements cited either a lack of need or fear of an anti-doping rule violation. Considering the holistic health and performance of athletes, as well as the risk associated with unregulated use, such as overdose and anti-doping rule violations, there is a need for nutritional education on supplement use for athletes and their entourages.
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Affiliation(s)
- Kanae Myoenzono
- Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
| | - Jun Yasuda
- Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
- Department of Health Management, Tokai University, Kanagawa, Japan
| | - Eri Takai
- Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
| | - Akiho Shinagawa
- Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
| | - Noburo Kaneko
- Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
| | - Takahiro Yoshizaki
- Department of Food and Life Sciences, Faculty of Food and Nutritional Sciences, Toyo University, Gunma, Japan
| | - Keiko Namma-Motonaga
- Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
| | - Masae Yoshino
- Department of Nutrition, Faculty of Health and Nutrition, Yamanashi Gakuin University, Yamanashi, Japan
| | - Emi Kondo
- Japan Society for the Promotion of Science, Tokyo, Japan
- Institute of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Kohei Nakajima
- Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
| | - Mika Hangai
- Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
| | - Kazuyuki Kamahara
- Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
| | - Etsuko Kamihigashi
- Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
| | - Shusuke Kusano
- Department of Occupational Therapy, Tokyo Professional University of Health Sciences, Tokyo, Japan
| | - Akiko Kamei
- Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
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5
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Ye Q, Devarshi PP, Grant RW, Higgins KA, Mitmesser SH. Lower Intakes of Key Nutrients Are Associated with More School and Workplace Absenteeism in US Children and Adults: A Cross-Sectional Study of NHANES 2003-2008. Nutrients 2023; 15:4356. [PMID: 37892431 PMCID: PMC10609412 DOI: 10.3390/nu15204356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
The influence of individual macro- and micronutrients on absenteeism in the United States is largely unknown. The objective of this study was to determine whether nutritional status or nutrient intake were associated with absenteeism from school and work due to illness or injury. Data from NHANES 2003-2008 were used to assess nutrient intake from food and food plus supplements, nutritional biomarker levels, and school and work absenteeism per year in children and adults. Negative binomial regression models were used to predict mean days of missed work per year and to estimate incidence rate ratios (IRRs) of absenteeism by nutrient biomarker status. Of 7429 children, 77% reported missing school days (mean 4.0 days). Of 8252 adults, 51% reported missing work days (mean 4.9 days). Children and adults who reported more absent days had a significantly lower intake of protein and several essential micronutrients from the diet. When nutrients from supplements were included, this negative association was retained for protein, selenium, choline, and DHA in children and for protein, selenium, vitamin K, choline, potassium, fiber, octadecatrienoic acid, and lycopene in adults. Future studies are needed to ascertain whether dietary interventions, such as access to healthier food options and/or dietary supplements, can reduce absenteeism.
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Affiliation(s)
- Qian Ye
- Science & Technology, Pharmavite LLC, West Hills, CA 91304, USA; (P.P.D.); (R.W.G.)
| | - Prasad P. Devarshi
- Science & Technology, Pharmavite LLC, West Hills, CA 91304, USA; (P.P.D.); (R.W.G.)
| | - Ryan W. Grant
- Science & Technology, Pharmavite LLC, West Hills, CA 91304, USA; (P.P.D.); (R.W.G.)
| | - Kelly A. Higgins
- Food Components and Health Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD 20705, USA
| | - Susan H. Mitmesser
- Science & Technology, Pharmavite LLC, West Hills, CA 91304, USA; (P.P.D.); (R.W.G.)
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6
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Hemilä H, Chalker E. Pitfalls in choosing data examples for methodological work: Bayesian approaches to a fixed effects meta-analysis of zinc lozenges for the common cold. Res Synth Methods 2023; 14:3-4. [PMID: 36097354 DOI: 10.1002/jrsm.1601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/08/2022] [Accepted: 09/07/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Harri Hemilä
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Elizabeth Chalker
- Biological Data Science Institute, Australian National University, Canberra, Australia
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7
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Rossi RE, Chen J, Caplin ME. The Role of Diet and Supplements in the Prevention and Progression of COVID-19: Current Knowledge and Open Issues. Prev Nutr Food Sci 2022; 27:137-149. [PMID: 35919576 PMCID: PMC9309075 DOI: 10.3746/pnf.2022.27.2.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/22/2022] [Accepted: 03/22/2022] [Indexed: 01/08/2023] Open
Abstract
A healthy diet and dietary supplements have gained attention as potential co-adjuvants in managing and preventing coronavirus disease 2019 (COVID-19). This paper critically reviews the current evidence regarding the impact of diet and supplements on the prevention and progression of COVID-19. According to available data, a healthy diet and normal weight are considered protective factors. Regarding dietary supplementation, the most robust results from human studies are for vitamin C, which appears to decrease inflammatory markers and suppress cytokine storm. A small, randomized trial showed that a high dose of vitamin D significantly reduced the need for intensive care unit treatment of patients requiring hospitalization for COVID-19. According to retrospective human studies, there is limited evidence for vitamin E and selenium supplements. Animal studies have investigated the effects of green tea and curcumin. Xanthohumol and probiotics, interesting for their antiviral, anti-inflammatory, and immunoregulatory properties, need formal clinical study. In summary, there is promising evidence supporting the role of diet and supplements as co-adjuvants in the treatment of COVID-19. Further studies and properly designed clinical trials are necessary to draw more robust conclusions; however, it is not unreasonable to take a pragmatic approach and promote the use of appropriate diet and supplements to counter the effects of COVID-19, ideally with a mechanism to assess outcomes.
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Affiliation(s)
- Roberta Elisa Rossi
- Hepatology and Hepato-Pancreatic-Biliary Surgery and Liver Transplantation, Fondazione IRCCS, Istituto Nazionale Tumori, Milan, MI 20133, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, MI 20122, Italy
| | - Jie Chen
- Department of Gastroenterology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510275, China
| | - Martyn Evan Caplin
- Centre for Gastroenterology, Royal Free Hospital, London NW3 2QG, UK
- Division of Medicine, Faculty of Medical Sciences, University College London, London WC1E 6BT, UK
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8
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Efficacy and Safety of Ganduqing Granules in Treating the Common Cold: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5105503. [PMID: 35722165 PMCID: PMC9203204 DOI: 10.1155/2022/5105503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/26/2022] [Accepted: 05/05/2022] [Indexed: 11/18/2022]
Abstract
Background There is no clear evidence-based medicine that points to the most effective drug treatments for the common cold. In view of its ability to relieve symptoms and shorten the disease course, as well as its minimal side effects, traditional Chinese medicine (TCM) has been widely used to treat the common cold. However, there is a lack of strong evidence to support the clinical efficacy of TCM. This study aimed to evaluate the efficacy and safety of Ganduqing granules in the treatment of the common cold based on the network pharmacology analysis. Methods In this multicenter, randomized, double-blind, placebo-controlled trial, 60 eligible subjects will be randomly assigned to either the intervention group or the placebo group. The intervention group will be treated with Ganduqing granules, while the placebo group will be treated with placebo. After 5 days of intervention, the efficacy and safety of Ganduqing granules in the treatment of the common cold will be observed. The primary outcome is the time to clearance of all symptoms. The secondary outcomes included the levels of IL-6, TNF-α, SOD, and MDA in the peripheral blood, time to disappearance of primary symptoms and secondary symptoms, clinical symptom remission rate, and change in TCM syndrome score. Results Sixty participants completed the study. Ganduqing granules showed a greater effect on the time to clearance of all symptoms (P < 0.0001), nasal discharge (P=0.0124), fatigue and lack of strength (P=0.0138), dryness of the pharynx (P < 0.0001), pharyngalgia or dysphagia (P < 0.0001), and expectoration (P < 0.0431) compared with the placebo group. Participants in the intervention group had a greater decrease of IL-6 levels compared with the placebo group (P < 0.007); similar results were observed for the SOD (P < 0.033). However, the change in TNF-α and MDA levels in the intervention group was not significantly different from the placebo group. In addition, participants in the intervention group had a greater decrease of TCM syndrome score compared with the placebo group (P < 0.040). Conclusion Ganduqing granules could improve common cold symptoms, shorten the disease course, attenuated inflammation and oxidative stress, and provided objective evidence for the efficacy and safety of a Chinese herbal medicine in treating the common cold.
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9
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Tosato M, Ciciarello F, Zazzara MB, Pais C, Savera G, Picca A, Galluzzo V, Coelho-Júnior HJ, Calvani R, Marzetti E, Landi F. Nutraceuticals and Dietary Supplements for Older Adults with Long COVID. Clin Geriatr Med 2022; 38:565-591. [PMID: 35868674 PMCID: PMC9212635 DOI: 10.1016/j.cger.2022.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Matteo Tosato
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, Rome 00168, Italy
| | - Francesca Ciciarello
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, Rome 00168, Italy
| | - Maria Beatrice Zazzara
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, Rome 00168, Italy
| | - Cristina Pais
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, Rome 00168, Italy
| | - Giulia Savera
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, Rome 00168, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, Rome 00168, Italy
| | - Vincenzo Galluzzo
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, Rome 00168, Italy
| | - Hélio José Coelho-Júnior
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, L.go F. Vito 8, Rome 00168, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, Rome 00168, Italy.
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, Rome 00168, Italy; Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, L.go F. Vito 8, Rome 00168, Italy
| | - Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, Rome 00168, Italy; Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, L.go F. Vito 8, Rome 00168, Italy
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10
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Gutiérrez Rodelo C, Salinas RA, Armenta JaimeArmenta E, Armenta S, Galdámez-Martínez A, Castillo-Blum SE, Astudillo-de la Vega H, Nirmala Grace A, Aguilar-Salinas CA, Gutiérrez Rodelo J, Christie G, Alsanie WF, Santana G, Thakur VK, Dutt A. Zinc associated nanomaterials and their intervention in emerging respiratory viruses: Journey to the field of biomedicine and biomaterials. Coord Chem Rev 2022; 457:214402. [PMID: 35095109 PMCID: PMC8788306 DOI: 10.1016/j.ccr.2021.214402] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 12/30/2021] [Indexed: 12/16/2022]
Abstract
Respiratory viruses represent a severe public health risk worldwide, and the research contribution to tackle the current pandemic caused by the SARS-CoV-2 is one of the main targets among the scientific community. In this regard, experts from different fields have gathered to confront this catastrophic pandemic. This review illustrates how nanotechnology intervention could be valuable in solving this difficult situation, and the state of the art of Zn-based nanostructures are discussed in detail. For virus detection, learning from the experience of other respiratory viruses such as influenza, the potential use of Zn nanomaterials as suitable sensing platforms to recognize the S1 spike protein in SARS-CoV-2 are shown. Furthermore, a discussion about the antiviral mechanisms reported for ZnO nanostructures is included, which can help develop surface disinfectants and protective coatings. At the same time, the properties of Zn-based materials as supplements for reducing viral activity and the recovery of infected patients are illustrated. Within the scope of noble adjuvants to improve the immune response, the ZnO NPs properties as immunomodulators are explained, and potential prototypes of nanoengineered particles with metallic cations (like Zn2+) are suggested. Therefore, using Zn-associated nanomaterials from detection to disinfection, supplementation, and immunomodulation opens a wide area of opportunities to combat these emerging respiratory viruses. Finally, the attractive properties of these nanomaterials can be extrapolated to new clinical challenges.
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Affiliation(s)
- Citlaly Gutiérrez Rodelo
- Healthcare Business and Computer Technology, Mexico
- Nanopharmacia Diagnostica, Tlaxcala No. 146/705, Col. Roma Sur, Cuauhtémoc, Cuidad de México, C.P. 06760, Mexico
| | - Rafael A Salinas
- Centro de Investigación en Biotecnología Aplicada del Instituto Politécnico Nacional (CIBA-IPN), Tlaxcala 72197, Mexico
| | - Erika Armenta JaimeArmenta
- Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, DF 04510, México
| | - Silvia Armenta
- Department of Biology, McGill University, 3649 Sir William Osler, Montreal, QC H3G 0B1, Canada
| | - Andrés Galdámez-Martínez
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Coyoacan, México City, C.P. 04510, Mexico
| | - Silvia E Castillo-Blum
- Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, DF 04510, México
| | - Horacio Astudillo-de la Vega
- Healthcare Business and Computer Technology, Mexico
- Nanopharmacia Diagnostica, Tlaxcala No. 146/705, Col. Roma Sur, Cuauhtémoc, Cuidad de México, C.P. 06760, Mexico
| | - Andrews Nirmala Grace
- Centre for Nanotechnology Research, VIT University, Vellore, Tamil Nadu 632 014, India
| | - Carlos A Aguilar-Salinas
- Unidad de Investigación de Enfermedades Metabólicas y Dirección de Nutrición. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico
| | - Juliana Gutiérrez Rodelo
- Instituto Méxicano del Seguro Social, Hospital General de SubZona No. 4, C.P. 80370, Navolato, Sinaloa, México
| | - Graham Christie
- Institute of Biotechnology, Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge CB2 1QT, UK
| | - Walaa F Alsanie
- Department of Clinical Laboratories Sciences, The Faculty of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Guillermo Santana
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Coyoacan, México City, C.P. 04510, Mexico
| | - Vijay Kumar Thakur
- Biorefining and Advanced Materials Research Center, SRUC, Edinburgh EH9 3JG, UK
- Department of Mechanical Engineering, School of Engineering, Shiv Nadar University, Uttar Pradesh 201314, India
- School of Engineering, University of Petroleum & Energy Studies (UPES), Dehradun 248007, Uttarakhand, India
| | - Ateet Dutt
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Coyoacan, México City, C.P. 04510, Mexico
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11
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Jiang M, Zhou B, Chen L. Identification of drug side effects with a path-based method. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:5754-5771. [PMID: 35603377 DOI: 10.3934/mbe.2022269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The study of drug side effects is a significant task in drug discovery. Candidate drugs with unaccepted side effects must be eliminated to prevent risks for both patients and pharmaceutical companies. Thus, all side effects for any candidate drug should be determined. However, this task, which is carried out through traditional experiments, is time-consuming and expensive. Building computational methods has been increasingly used for the identification of drug side effects. In the present study, a new path-based method was proposed to determine drug side effects. A heterogeneous network was built to perform such method, which defined drugs and side effects as nodes. For any drug and side effect, the proposed path-based method determined all paths with limited length that connects them and further evaluated the association between them based on these paths. The strong association indicates that the drug has a side effect with a high probability. By using two types of jackknife test, the method yielded good performance and was superior to some other network-based methods. Furthermore, the effects of one parameter in the method and heterogeneous network was analyzed.
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Affiliation(s)
- Meng Jiang
- College of Information Engineering, Shanghai Maritime University, Shanghai 201306, China
| | - Bo Zhou
- Shanghai University of Medicine & Health Sciences, Shanghai 201318, China
| | - Lei Chen
- College of Information Engineering, Shanghai Maritime University, Shanghai 201306, China
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12
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Baarz BR, Rink L. Rebalancing the unbalanced aged immune system - A special focus on zinc. Ageing Res Rev 2022; 74:101541. [PMID: 34915196 DOI: 10.1016/j.arr.2021.101541] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/18/2021] [Accepted: 12/09/2021] [Indexed: 02/08/2023]
Abstract
Nowadays, aging is understood as a dynamic and multifaceted dysregulation process that spares almost no human organ or cell. The immune system being among the most affected, it has been shown predominantly that its integrity determines the tightrope walk between the difference of escaping or suffering from age-related diseases. Next to drug-based anti-aging strategies, micronutrient intervention may represent an emerging but less radical way to slow immune aging. While a sufficient supply of a variety of micronutrients is undeniably important, adequate intake of the trace element zinc appears to tower over others in terms of reaching old age. Inconveniently, zinc deficiency prevalence among the elderly is high, which in turn contributes to increased susceptibility to infection, decreased anti-tumor immunity as well as attenuated response to vaccination. Driven by this research, this review aims to provide a comprehensive and up-to-date overview of the various rebalancing capabilities of zinc in the unbalanced immune system of the elderly. This includes an in-depth and cell type-centered discussion on the role of zinc in immunosenescence and inflammaging. We further address upcoming translational aspects e.g. how zinc deficiency promotes the flourishing of certain pathogenic taxa of the gut microbiome and how zinc supply counteracts such alterations in a manner that may contribute to longevity. In the light of the ongoing COVID-19 pandemic, we also briefly review current knowledge on the interdependency between age, zinc status, and respiratory infections. Based on two concrete examples and considering the latest findings in the field we conclude our remarks by outlining tremendous parallels between suboptimal zinc status and accelerated aging on the one hand and an optimized zinc status and successful aging on the other hand.
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13
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Kory P, Meduri GU, Iglesias J, Varon J, Cadegiani FA, Marik PE. "MATH+" Multi-Modal Hospital Treatment Protocol for COVID-19 Infection: Clinical and Scientific Rationale. J Clin Med Res 2022; 14:53-79. [PMID: 35317360 PMCID: PMC8912998 DOI: 10.14740/jocmr4658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/08/2022] [Indexed: 11/17/2022] Open
Abstract
In December 2019, coronavirus disease 2019 (COVID-19), a severe respiratory illness caused by the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The greatest impact that COVID-19 had was on intensive care units (ICUs), given that approximately 20% of hospitalized cases developed acute respiratory failure (ARF) requiring ICU admission. Based on the assumption that COVID-19 represented a viral pneumonia and no anti-coronaviral therapy existed, nearly all national and international health care societies recommended "supportive care only" avoiding other therapies outside of randomized controlled trials, with a specific prohibition against the use of corticosteroids in treatment. However, early studies of COVID-19-associated ARF reported inexplicably high mortality rates, with frequent prolonged durations of mechanical ventilation (MV), even from centers expert in such supportive care strategies. These reports led the authors to form a clinical expert panel called the Front-Line COVID-19 Critical Care Alliance (www.flccc.net). The panel collaboratively reviewed the emerging clinical, radiographic, and pathological reports of COVID-19 while initiating multiple discussions among a wide clinical network of front-line clinical ICU experts from initial outbreak areas in China, Italy, and New York. Based on the shared early impressions of "what was working and what wasn't working", the increasing medical journal publications and the rapidly accumulating personal clinical experiences with COVID-19 patients, a treatment protocol was created for the hospitalized patients based on the core therapies of methylprednisolone, ascorbic acid, thiamine, heparin and non-antiviral co-interventions (MATH+). This manuscript reviews the scientific and clinical rationale behind MATH+ based on published in-vitro, pre-clinical, and clinical data in support of each medicine, with a special emphasis of studies supporting their use in the treatment of patients with viral syndromes and COVID-19 specifically.
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Affiliation(s)
- Pierre Kory
- Front Line Critical Care Consortium (FLCCC.org), Washington DC, USA
| | | | - Jose Iglesias
- Jersey Shore University Medical Center, Hackensack School of Medicine at Seton Hall, NJ, USA
| | - Joseph Varon
- University of Texas Health Science Center, Houston, TX, USA
| | | | - Paul E. Marik
- Front Line Critical Care Consortium (FLCCC.org), Washington DC, USA
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14
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Sobczyk MK, Gaunt TR. The Effect of Circulating Zinc, Selenium, Copper and Vitamin K 1 on COVID-19 Outcomes: A Mendelian Randomization Study. Nutrients 2022; 14:233. [PMID: 35057415 PMCID: PMC8780111 DOI: 10.3390/nu14020233] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/22/2022] Open
Abstract
Background & Aims: Previous results from observational, interventional studies and in vitro experiments suggest that certain micronutrients possess anti-viral and immunomodulatory activities. In particular, it has been hypothesized that zinc, selenium, copper and vitamin K1 have strong potential for prophylaxis and treatment of COVID-19. We aimed to test whether genetically predicted Zn, Se, Cu or vitamin K1 levels have a causal effect on COVID-19 related outcomes, including risk of infection, hospitalization and critical illness. Methods: We employed a two-sample Mendelian Randomization (MR) analysis. Our genetic variants derived from European-ancestry GWAS reflected circulating levels of Zn, Cu, Se in red blood cells as well as Se and vitamin K1 in serum/plasma. For the COVID-19 outcome GWAS, we used infection, hospitalization or critical illness. Our inverse-variance weighted (IVW) MR analysis was complemented by sensitivity analyses including a more liberal selection of variants at a genome-wide sub-significant threshold, MR-Egger and weighted median/mode tests. Results: Circulating micronutrient levels show limited evidence of association with COVID-19 infection, with the odds ratio [OR] ranging from 0.97 (95% CI: 0.87-1.08, p-value = 0.55) for zinc to 1.07 (95% CI: 1.00-1.14, p-value = 0.06)-i.e., no beneficial effect for copper was observed per 1 SD increase in exposure. Similarly minimal evidence was obtained for the hospitalization and critical illness outcomes with OR from 0.98 (95% CI: 0.87-1.09, p-value = 0.66) for vitamin K1 to 1.07 (95% CI: 0.88-1.29, p-value = 0.49) for copper, and from 0.93 (95% CI: 0.72-1.19, p-value = 0.55) for vitamin K1 to 1.21 (95% CI: 0.79-1.86, p-value = 0.39) for zinc, respectively. Conclusions: This study does not provide evidence that supplementation with zinc, selenium, copper or vitamin K1 can prevent SARS-CoV-2 infection, critical illness or hospitalization for COVID-19.
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Affiliation(s)
- Maria K. Sobczyk
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK;
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15
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Nabi-Afjadi M, Karami H, Goudarzi K, Alipourfard I, Bahreini E. The effect of vitamin D, magnesium and zinc supplements on interferon signaling pathways and their relationship to control SARS-CoV-2 infection. Clin Mol Allergy 2021; 19:21. [PMID: 34749737 PMCID: PMC8573303 DOI: 10.1186/s12948-021-00161-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/12/2021] [Indexed: 01/08/2023] Open
Abstract
The concern of today's communities is to find a way to prevent or treat COVID-19 and reduce its symptoms in the patients. However, the genetic mutations and more resistant strains of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerge; the designed vaccines and adjuvant therapies would potentially control the symptoms and severity of COVID-19. The most important complication of this viral infection is acute respiratory distress syndrome, which occurs due to the infiltration of leukocytes into the alveoli and the raised cytokine storm. Interferons, as a cytokine family in the host, play an important role in the immune-related antiviral defense and have been considered in the treatment protocols of COVID-19. In addition, it has been indicated that some nutrients, including vitamin D, magnesium and zinc are essential in the modulation of the immune system and interferon (IFN) signaling pathway. Several recent studies have investigated the treatment effect of vitamin D on COVID-19 and reported the association between optimal levels of this vitamin and reduced disease risk. In the present study, the synergistic action of vitamin D, magnesium and zinc in IFN signaling is discussed as a treatment option for COVID-19 involvement.
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Affiliation(s)
- Mohsen Nabi-Afjadi
- Department of Biochemistry, Faculty of Biological Science, Tarbiat Modares University, Tehran, Iran
| | - Hadis Karami
- Department of Molecular Cell Biology and Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | - Kaveh Goudarzi
- Nursing Department, Islamic Azad University, Khorasgan Branch, Isfahan, Iran
| | - Iraj Alipourfard
- Institute of Biology, Biotechnology and Environmental Protection, Faculty of Natural Sciences, University of Silesia, Bankowa 9, 40-007, Katowice, Poland
| | - Elham Bahreini
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, P.O. Box: 1449614525, Tehran, Iran.
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16
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Chiappini E, Santamaria F, Marseglia GL, Marchisio P, Galli L, Cutrera R, de Martino M, Antonini S, Becherucci P, Biasci P, Bortone B, Bottero S, Caldarelli V, Cardinale F, Gattinara GC, Ciarcià M, Ciofi D, D'Elios S, Di Mauro G, Doria M, Indinnimeo L, Lo Vecchio A, Macrì F, Mattina R, Miniello VL, Del Giudice MM, Morbin G, Motisi MA, Novelli A, Palamara AT, Panatta ML, Pasinato A, Peroni D, Perruccio K, Piacentini G, Pifferi M, Pignataro L, Sitzia E, Tersigni C, Torretta S, Trambusti I, Trippella G, Valentini D, Valentini S, Varricchio A, Verga MC, Vicini C, Zecca M, Villani A. Prevention of recurrent respiratory infections : Inter-society Consensus. Ital J Pediatr 2021; 47:211. [PMID: 34696778 PMCID: PMC8543868 DOI: 10.1186/s13052-021-01150-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/09/2021] [Indexed: 12/12/2022] Open
Abstract
Recurrent respiratory infections (RRIs) are a common clinical condition in children, in fact about 25% of children under 1 year and 6% of children during the first 6 years of life have RRIs. In most cases, infections occur with mild clinical manifestations and the frequency of episodes tends to decrease over time with a complete resolution by 12 years of age. However, RRIs significantly reduce child and family quality of life and lead to significant medical and social costs.Despite the importance of this condition, there is currently no agreed definition of the term RRIs in the literature, especially concerning the frequency and type of infectious episodes to be considered. The aim of this consensus document is to propose an updated definition and provide recommendations with the intent of guiding the physician in the complex process of diagnosis, management and prevention of RRIs.
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Affiliation(s)
- Elena Chiappini
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy.
| | - Francesca Santamaria
- Departement of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Gian Luigi Marseglia
- Department of Pediatrics, University of Pavia IRCCS San Matteo foundation, Pavia, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luisa Galli
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Renato Cutrera
- Respiratory Unit, Academic Pediatric Department, Pediatric Hospital Bambino Gesù IRCCS, Rome, Italy
| | - Maurizio de Martino
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Sara Antonini
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Paolo Becherucci
- Family Pediatrician, Local Health Unit, Lastra a Signa, Florence, Italy
| | - Paolo Biasci
- Family Pediatrician, Local Health Unit, Livorno, Italy
| | - Barbara Bortone
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Sergio Bottero
- Airway Surgery Unit, Department of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy
| | - Valeria Caldarelli
- Department of Obstetrics Gynaecology and Pediatrics, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Fabio Cardinale
- Department of Pediatrics, Pediatric Hospital Giovanni XXIII, University of Bari, Bari, Italy
| | | | - Martina Ciarcià
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Daniele Ciofi
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Sofia D'Elios
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Giuseppe Di Mauro
- Pediatric Primary Care, National Pediatric Health Care System, Caserta, Italy
| | - Mattia Doria
- Family Pediatrician, Local Health Unit, Chioggia, Venice, Italy
| | - Luciana Indinnimeo
- Pediatric Department "Sapienza", University of Rome, Policlinico Umberto I, Rome, Italy
| | - Andrea Lo Vecchio
- Departement of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Francesco Macrì
- Department of Pediatrics "Sapienza", University of Rome, Rome, Italy
| | - Roberto Mattina
- Department of Biomedical, Surgical, and Odontoiatric Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Michele Miraglia Del Giudice
- Department of Woman and Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Guido Morbin
- Family Pediatrician, Local Health Unit, Trento, Italy
| | - Marco Antonio Motisi
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Andrea Novelli
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Anna Teresa Palamara
- Department of Public Health and Infectious Diseases, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, Italy
| | - Maria Laura Panatta
- Department of Otorhinolaryngology, IRCCS Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Angela Pasinato
- Family Pediatrician, Local Health Unit, Torri di Quartesolo, Vicenza, Italy
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Katia Perruccio
- Pediatric Oncology Hematology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Giorgio Piacentini
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, Verona, Italy
| | - Massimo Pifferi
- Department of Pediatrics Pulmonology and Allergology Section University Hospital of Pisa, Pisa, Italy
| | - Lorenzo Pignataro
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Emanuela Sitzia
- Department of Otorhinolaryngology, IRCCS Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Chiara Tersigni
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Sara Torretta
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Irene Trambusti
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Giulia Trippella
- Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Diletta Valentini
- Department of Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Sandro Valentini
- Family Pediatrician, Local Health Unit, Colle Val d'Elsa, Siena, Italy
| | | | - Maria Carmen Verga
- Family Pediatrician, Local Health Unit Salerno, Vietri sul Mare, Salerno, Italy
| | - Claudio Vicini
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy
| | - Marco Zecca
- Pediatric Hematology-Oncology, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alberto Villani
- Department of Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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17
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Hall K, Mfone F, Shallcross M, Pathak V. Review of Pharmacotherapy Trialed for Management of the Coronavirus Disease-19. Eurasian J Med 2021; 53:137-143. [PMID: 34177298 DOI: 10.5152/eurasianjmed.2021.20384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, there has been substantial progress in the pharmacologic treatment and supportive care of patients hospitalized with active COVID-19 infections. To date there have been numerous medications trialed for COVID-19 management. In this review, our objective is to provide a comprehensive review of the primary literature and clinical applications surrounding some of the prominent drugs and medication classes that have been utilized in those suffering from COVID-19 infections. The medications reviewed in this article include: hydroxychloroquine, remdesivir, azithromycin, dexamethasone, melatonin, tocilizumab, ascorbic acid, and zinc. The medication classes reviewed include: anticoagulation, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, convalescent plasma, non-steroidal anti-inflammatory drugs, human recombinant soluble ACE2, and the BNT162b2 mRNA COVID-19 vaccine.
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Affiliation(s)
- Kimberly Hall
- Department of Pharmacy, Riverside Health System, Newport News, VA, USA
| | - Fuhbe Mfone
- Department of Internal Medicine, Riverside Health System, Newport News, VA, USA
| | - Michael Shallcross
- Department of Family Medicine, Riverside Health System, Newport News, VA, USA
| | - Vikas Pathak
- Department of Pulmonary and Critical Care Medicine, Riverside Health System, Newport News, VA, USA
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18
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Karl JP. Gut Microbiota-targeted Interventions for Reducing the Incidence, Duration, and Severity of Respiratory Tract Infections in Healthy Non-elderly Adults. Mil Med 2021; 186:e310-e318. [PMID: 33137200 PMCID: PMC7665594 DOI: 10.1093/milmed/usaa261] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Respiratory tract infections (RTI), such as those caused by influenza viruses and, more recently, the severe acute respiratory syndrome coronavirus-2, pose a significant burden to military health care systems and force readiness. The gut microbiota influences immune function, is malleable, and may provide a target for interventions aiming to reduce RTI burden. This narrative review summarizes existing evidence regarding the effectiveness of probiotics, prebiotics, and synbiotics, all of which are gut microbiota-targeted interventions, for reducing the burden of RTI in military-relevant populations (i.e., healthy non-elderly adults). MATERIALS AND METHODS A systematic search strategy was used to identify recent meta-analyses and systematic reviews of randomized controlled trials conducted in healthy non-elderly adults which examined effects of probiotics, prebiotics, or synbiotics on the incidence, duration, and/or severity of RTI, or on immune responses to vaccinations against viruses that cause RTI. Relevant randomized controlled clinical trials not included in those reports were also identified. RESULTS Meta-analyses and multiple randomized controlled trials have demonstrated that certain probiotic strains may reduce the incidence, duration, and/or severity of RTI and improve immune responses to vaccination against RTI-causing pathogens in various populations including healthy non-elderly adults. Fewer randomized controlled trials have examined the effects of prebiotics or synbiotics on RTI-related outcomes in healthy non-elderly adults. Nevertheless, some studies conducted within that population and other populations have observed that certain prebiotics and synbiotics reduce the incidence, duration, and/or severity of RTI or improve immune responses to vaccinations against RTI-causing viruses. However, across all product classes, not all product formulations have shown benefit, and most have not been tested in multiple randomized controlled trials in military-relevant populations. CONCLUSION Dietary supplementation with certain gut microbiota-targeted interventions, and certain probiotics in particular, may provide viable strategies for reducing RTI-related illness in military personnel. Research in military populations is warranted to fully understand the magnitude of any military health and cost benefits, and to establish definitive recommendations for use.
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Affiliation(s)
- J Philip Karl
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
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19
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Akhtar S, Das JK, Ismail T, Wahid M, Saeed W, Bhutta ZA. Nutritional perspectives for the prevention and mitigation of COVID-19. Nutr Rev 2021; 79:289-300. [PMID: 33570583 PMCID: PMC7454773 DOI: 10.1093/nutrit/nuaa063] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/15/2020] [Indexed: 02/06/2023] Open
Abstract
Worldwide, there is an array of clinical trials under way to evaluate treatment options against coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2. Concurrently, several nutritional therapies and alternative supportive treatments are also being used and tested to reduce the mortality associated with acute respiratory distress in patients with COVID-19. In the context of COVID-19, improved nutrition that includes micronutrient supplementation to augment the immune system has been recognized as a viable approach to both prevent and alleviate the severity of the infection. The potential role of micronutrients as immune-boosting agents is particularly relevant for low- and middle-income countries, which already have an existing high burden of undernutrition and micronutrient deficiencies. A systematic literature review was performed to identify nutritional interventions that might prevent or aid in the recovery from COVID-19. The PubMed, ScienceDirect, Cochrane, Scopus, Web of Science, and Google Scholar databases were searched electronically from February to April 2020. All abstracts and full-text articles were examined for their relevance to this review. The information gathered was collated under various categories. Deficiencies of micronutrients, especially vitamins A, B complex, C, and D, zinc, iron, and selenium, are common among vulnerable populations in general and among COVID-19 patients in particular and could plausibly increase the risk of mortality. Judicious use of need-based micronutrient supplementation, alongside existing micronutrient fortification programs, is warranted in the current global pandemic, especially in low- and middle-income economies.
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Affiliation(s)
- Saeed Akhtar
- Institute of Food Science and Nutrition, Bahauddin Zakariya University, Multan, Pakistan
| | - Jai K Das
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tariq Ismail
- Institute of Food Science and Nutrition, Bahauddin Zakariya University, Multan, Pakistan
| | - Muqeet Wahid
- Division of Woman and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Wisha Saeed
- Institute of Food Science and Nutrition, Bahauddin Zakariya University, Multan, Pakistan
| | - Zulfiqar A Bhutta
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
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20
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Samad N, Sodunke TE, Abubakar AR, Jahan I, Sharma P, Islam S, Dutta S, Haque M. The Implications of Zinc Therapy in Combating the COVID-19 Global Pandemic. J Inflamm Res 2021; 14:527-550. [PMID: 33679136 PMCID: PMC7930604 DOI: 10.2147/jir.s295377] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/27/2021] [Indexed: 12/15/2022] Open
Abstract
The global pandemic from COVID-19 infection has generated significant public health concerns, both health-wise and economically. There is no specific pharmacological antiviral therapeutic option to date available for COVID-19 management. Also, there is an urgent need to discover effective medicines, prevention, and control methods because of the harsh death toll from this novel coronavirus infection. Acute respiratory tract infections, significantly lower respiratory tract infections, and pneumonia are the primary cause of millions of deaths worldwide. The role of micronutrients, including trace elements, boosted the human immune system and was well established. Several vitamins such as vitamin A, B6, B12, C, D, E, and folate; microelement including zinc, iron, selenium, magnesium, and copper; omega-3 fatty acids as eicosapentaenoic acid and docosahexaenoic acid plays essential physiological roles in promoting the immune system. Furthermore, zinc is an indispensable microelement essential for a thorough enzymatic physiological process. It also helps regulate gene-transcription such as DNA replication, RNA transcription, cell division, and cell activation in the human biological system. Subsequently, zinc, together with natural scavenger cells and neutrophils, are also involved in developing cells responsible for regulating nonspecific immunity. The modern food habit often promotes zinc deficiency; as such, quite a few COVID-19 patients presented to hospitals were frequently diagnosed as zinc deficient. Earlier studies documented that zinc deficiency predisposes patients to a viral infection such as herpes simplex, common cold, hepatitis C, severe acute respiratory syndrome coronavirus (SARS-CoV-1), the human immunodeficiency virus (HIV) because of reducing antiviral immunity. This manuscript aimed to discuss the various roles played by zinc in the management of COVID-19 infection.
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Affiliation(s)
- Nandeeta Samad
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | | | - Abdullahi Rabiu Abubakar
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University, Kano, 700233, Nigeria
| | - Iffat Jahan
- Department of Physiology, Eastern Medical College, Cumilla, Bangladesh
| | - Paras Sharma
- Department of Pharmacognosy, BVM College of Pharmacy, Gwalior, India
| | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Dhaka, 1342, Bangladesh
| | - Siddhartha Dutta
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia
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21
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Akhtar S, Das JK, Ismail T, Wahid M, Saeed W, Bhutta ZA. Nutritional perspectives for the prevention and mitigation of COVID-19. Nutr Rev 2021. [PMID: 33570583 DOI: 10.1093/nutrit/nuaa063018-1355-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
Worldwide, there is an array of clinical trials under way to evaluate treatment options against coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2. Concurrently, several nutritional therapies and alternative supportive treatments are also being used and tested to reduce the mortality associated with acute respiratory distress in patients with COVID-19. In the context of COVID-19, improved nutrition that includes micronutrient supplementation to augment the immune system has been recognized as a viable approach to both prevent and alleviate the severity of the infection. The potential role of micronutrients as immune-boosting agents is particularly relevant for low- and middle-income countries, which already have an existing high burden of undernutrition and micronutrient deficiencies. A systematic literature review was performed to identify nutritional interventions that might prevent or aid in the recovery from COVID-19. The PubMed, ScienceDirect, Cochrane, Scopus, Web of Science, and Google Scholar databases were searched electronically from February to April 2020. All abstracts and full-text articles were examined for their relevance to this review. The information gathered was collated under various categories. Deficiencies of micronutrients, especially vitamins A, B complex, C, and D, zinc, iron, and selenium, are common among vulnerable populations in general and among COVID-19 patients in particular and could plausibly increase the risk of mortality. Judicious use of need-based micronutrient supplementation, alongside existing micronutrient fortification programs, is warranted in the current global pandemic, especially in low- and middle-income economies.
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Affiliation(s)
- Saeed Akhtar
- Institute of Food Science and Nutrition, Bahauddin Zakariya University, Multan, Pakistan
| | - Jai K Das
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tariq Ismail
- Institute of Food Science and Nutrition, Bahauddin Zakariya University, Multan, Pakistan
| | - Muqeet Wahid
- Division of Woman and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Wisha Saeed
- Institute of Food Science and Nutrition, Bahauddin Zakariya University, Multan, Pakistan
| | - Zulfiqar A Bhutta
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
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22
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Abstract
A wide variety of symptoms is associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, and these symptoms can overlap with other conditions and diseases. Knowing the distribution of symptoms across diseases and individuals can support clinical actions on timelines shorter than those for drug and vaccine development. Here, we focus on zinc deficiency symptoms, symptom overlap with other conditions, as well as zinc effects on immune health and mechanistic zinc deficiency risk groups. There are well-studied beneficial effects of zinc on the immune system including a decreased susceptibility to and improved clinical outcomes for infectious pathogens including multiple viruses. Zinc is also an anti-inflammatory and anti-oxidative stress agent, relevant to some severe Coronavirus Disease 2019 (COVID-19) symptoms. Unfortunately, zinc deficiency is common worldwide and not exclusive to the developing world. Lifestyle choices and preexisting conditions alone can result in zinc deficiency, and we compile zinc risk groups based on a review of the literature. It is also important to distinguish chronic zinc deficiency from deficiency acquired upon viral infection and immune response and their different supplementation strategies. Zinc is being considered as prophylactic or adjunct therapy for COVID-19, with 12 clinical trials underway, highlighting the relevance of this trace element for global pandemics. Using the example of zinc, we show that there is a critical need for a deeper understanding of essential trace elements in human health, and the resulting deficiency symptoms and their overlap with other conditions. This knowledge will directly support human immune health for decreasing susceptibility, shortening illness duration, and preventing progression to severe cases in the current and future pandemics.
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Affiliation(s)
- Marcin P. Joachimiak
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA, United States of America
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23
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Arentz S, Hunter J, Yang G, Goldenberg J, Beardsley J, Myers SP, Mertz D, Leeder S. Zinc for the prevention and treatment of SARS-CoV-2 and other acute viral respiratory infections: a rapid review. ADVANCES IN INTEGRATIVE MEDICINE 2020; 7:252-260. [PMID: 32837895 PMCID: PMC7395818 DOI: 10.1016/j.aimed.2020.07.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The global COVID-19 pandemic has prompted an urgent search for interventions to prevent and treat SARS-CoV-2. Higher risk of infection and adverse outcomes coincide with populations with chronic diseases and elderly who are at risk of zinc deficiency. Through several mechanisms zinc may prevent, reduce severity and duration of symptoms. METHOD An a priori protocol was registered with PROSPERO on 27th April 2020 (CRD42020182044). Eight databases (one Chinese) and four clinical trial registries (one Chinese) were searched for randomised and quasi-randomised controlled trials (RCTs), evaluating single or adjunct zinc against placebo or active controls, for prevention and/or treatment of SARS-CoV-2, other coronaviruses or related infections. RR constraints included not searching bibliographies or contacting authors, single reviewers with calibration and second reviewer checking, meta-analyses and quality appraisal of critical and study primary outcomes only and reporting results as they became available. RESULTS 118 publications of 1,627 records met the inclusion criteria (35 Chinese and 83 English publications), 32 for prevention, 78 for treatment and 8 for both. Four RCTs specific to SARS-CoV-2 are ongoing; two are investigating zinc for prevention and two for treatment. As of 7 July 2020, no results were available. A wide range of zinc forms, including nasal spray/gel, lozenges, liquid, tablets and intramuscular were investigated. CONCLUSION Currently, indirect evidence suggests zinc may potentially reduce the risk, duration and severity of SARS-CoV-2 infections, particularly for populations at risk of zinc deficiency including people with chronic disease co-morbidities and older adults. Direct evidence to determine if zinc is effective for either prevention or treatment of SARS-CoV-2 is pending. In the interim, assessing zinc status of people with chronic diseases and older adults, as part of a SARS-CoV-2 clinical work-up, is reasonable as both groups have a higher risk of zinc deficiency/insufficiency and poorer outcomes from SARS-CoV-2.
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Affiliation(s)
- Susan Arentz
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Jennifer Hunter
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Guoyan Yang
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Joshua Goldenberg
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, United States
| | - Jennifer Beardsley
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, United States
| | - Stephen P Myers
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- NatMed Research Unit, Division of Research, Southern Cross University, Lismore, New South Wales, Australia
| | - Dominik Mertz
- Division of Infectious Diseases, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Stephen Leeder
- Menzies Centre for Health Policy, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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24
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Deitrick K, Adams J, Davis J. Emergency Nursing Care of Patients With Novel Coronavirus Disease 2019. J Emerg Nurs 2020; 46:748-759. [PMID: 32972766 PMCID: PMC7368907 DOI: 10.1016/j.jen.2020.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/06/2020] [Accepted: 07/13/2020] [Indexed: 12/19/2022]
Abstract
Novel coronavirus disease 2019 is the disease caused by the novel coronavirus originally from Wuhan, China. Its pathophysiology is poorly understood, but it is known to be contagious and deadly. Multiple symptoms and complications from the disease have been described, with the most common complaints being respiratory. Nursing care of patients with novel coronavirus disease 2019 is largely supportive, but it should include a strong focus on mitigating the spread of infection to staff, other patients, and the community.
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25
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Collins J, Maughan RJ, Gleeson M, Bilsborough J, Jeukendrup A, Morton JP, Phillips SM, Armstrong L, Burke LM, Close GL, Duffield R, Larson-Meyer E, Louis J, Medina D, Meyer F, Rollo I, Sundgot-Borgen J, Wall BT, Boullosa B, Dupont G, Lizarraga A, Res P, Bizzini M, Castagna C, Cowie CM, D'Hooghe M, Geyer H, Meyer T, Papadimitriou N, Vouillamoz M, McCall A. UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research. Br J Sports Med 2020; 55:416. [PMID: 33097528 DOI: 10.1136/bjsports-2019-101961] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2020] [Indexed: 01/09/2023]
Abstract
Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.
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Affiliation(s)
- James Collins
- Intra Performance Group, London, UK.,Performance and Research Team, Arsenal Football Club, London, UK
| | | | - Michael Gleeson
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Johann Bilsborough
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia.,New England Patriots, Foxboro, MA, USA
| | - Asker Jeukendrup
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK.,MySport Science, Birmingham, UK
| | - James P Morton
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - S M Phillips
- Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence Armstrong
- Human Performance Laboratory, University of Connecticut, Storrs, CT, USA
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Graeme L Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Rob Duffield
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia.,Medical Department, Football Federation Australia, Sydney, New South Wales, Australia
| | - Enette Larson-Meyer
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Julien Louis
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Daniel Medina
- Athlete Care and Performance, Monumental Sports & Entertainment, Washington, DC, USA
| | - Flavia Meyer
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ian Rollo
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK.,PepsiCo Life Sciences, Global R&D, Gatorade Sports Science Institute, Birmingham, UK
| | | | - Benjamin T Wall
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | | | - Gregory Dupont
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | | | - Peter Res
- Dutch Olympic Team, Amsterdam, Netherlands
| | - Mario Bizzini
- Research and Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
| | - Carlo Castagna
- University of Rome Tor Vergata, Rome, Italy.,Technical Department, Italian Football Federation (FIGC), Florence, Italy.,Italian Football Referees Association, Bologna, Italy
| | - Charlotte M Cowie
- Technical Directorate, Football Association, Burton upon Trent, UK.,Medical Committee, UEFA, Nyon, Switzerland
| | - Michel D'Hooghe
- Medical Committee, UEFA, Nyon, Switzerland.,Medical Centre of Excelence, Schulthess Clinic, Zurich, Switzerland
| | - Hans Geyer
- Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
| | - Tim Meyer
- Medical Committee, UEFA, Nyon, Switzerland.,Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | | | | | - Alan McCall
- Performance and Research Team, Arsenal Football Club, London, UK .,Medical Department, Football Federation Australia, Sydney, New South Wales, Australia.,Sport, Exercise and Health Sciences, School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
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26
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Leiner A, Sammon M, Perry H, Dunavant S. Facing COVID-19 and Refugee Camps on the U.S. Border. J Emerg Med 2020; 59:143-145. [PMID: 32900460 PMCID: PMC7474578 DOI: 10.1016/j.jemermed.2020.04.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/09/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Andrea Leiner
- Director of Strategic Plans, Global Response Management, Yulee, Florida
| | - Maura Sammon
- Department of Clinical Emergency Medicine, Temple University Hospital and School of Medicine, Philadelphia, Pennsylvania; Medical Director, Global Response Management, Yulee, Florida
| | - Helen Perry
- Executive Director, Global Response Management, Yulee, Florida
| | - Scott Dunavant
- Deputy Medical Director, Global Response Management, Yulee, Florida
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27
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Fernandes ACL, Vale AJM, Guzen FP, Pinheiro FI, Cobucci RN, de Azevedo EP. Therapeutic Options Against the New Coronavirus: Updated Clinical and Laboratory Evidences. Front Med (Lausanne) 2020; 7:546. [PMID: 33043030 PMCID: PMC7522372 DOI: 10.3389/fmed.2020.00546] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/31/2020] [Indexed: 12/15/2022] Open
Abstract
The pandemic caused by the new coronavirus (SARS-Cov-2) has encouraged numerous in vitro studies and clinical trials around the world, with research groups testing existing drugs, novel drug candidates and vaccines that can prevent or treat infection caused by this virus. The urgency for an effective therapy is justified by the easy and fast viral transmission and the high number of patients with severe respiratory distress syndrome who have increasingly occupied intensive care hospital beds, leading to a collapse in health systems in several countries. However, to date, there is no sufficient evidence of the effectiveness of any researched therapy. The off-label or compassionate use of some drugs by health professionals is a reality in all continents, whose permission by regulatory agencies has been based on the results of some clinical trials. In order to guide decision-making for the treatment of COVID-19, this review aims to present studies and guidelines on the main therapies that have been and are currently being tested against SARS-CoV-2 and to critically analyze the reported evidences.
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Affiliation(s)
| | - Adson José Martins Vale
- Tocogynecology Department, Medical School, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Brazil
- Graduate Program of Biotechnology, Laureate International Universities - Universidade Potiguar (UnP), Natal, Brazil
| | - Fausto Pierdoná Guzen
- Graduate Program of Biotechnology, Laureate International Universities - Universidade Potiguar (UnP), Natal, Brazil
| | - Francisco Irochima Pinheiro
- Graduate Program of Biotechnology, Laureate International Universities - Universidade Potiguar (UnP), Natal, Brazil
- Medical School, Laureate International Universities - Universidade Potiguar (UnP), Natal, Brazil
| | - Ricardo Ney Cobucci
- Graduate Program of Biotechnology, Laureate International Universities - Universidade Potiguar (UnP), Natal, Brazil
- Medical School, Laureate International Universities - Universidade Potiguar (UnP), Natal, Brazil
| | - Eduardo Pereira de Azevedo
- Graduate Program of Biotechnology, Laureate International Universities - Universidade Potiguar (UnP), Natal, Brazil
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28
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Gbinigie OA, Akyea RK. Should zinc be used for COVID-19 prophylaxis or treatment? A rapid review. Wellcome Open Res 2020. [DOI: 10.12688/wellcomeopenres.16173.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: There have been intensive efforts worldwide to establish effective treatments for coronavirus disease 2019 (COVID-19), with recent interest in the use of zinc as a potential therapeutic agent. The aim of this rapid review was therefore to critically appraise and evaluate the evidence for using zinc as prophylaxis and/or treatment for COVID-19. Methods: We conducted electronic searches on 20th and 21st May 2020 of PubMed, TRIP, EPPI COVID Living Map, MedRxiv, Google Scholar and Google. All searches were updated on 11th July 2020 to check for new relevant studies. We included in vivo studies assessing the safety and effectiveness of zinc, alone or combined with other interventions, as treatment or prophylaxis for COVID-19. Studies assessing the activity of zinc against SARS-CoV-2 in vitro were also included. Results: We identified one observational study with a high risk of bias that was suitable for inclusion. The study authors found that treatment with a combination of zinc, azithromycin and hydroxychloroquine in patients hospitalised with COVID-19 resulted in increased odds of being discharged home (adjusted odds ratio (OR) 1.53; 95% CI 1.12 to 2.09; p = 0.008) and reduced odds of death or being transferred to a hospice (adjusted OR 0.559; 95% CI 0.385 to 0.811; p = 0.002), compared with treatment with hydroxychloroquine and azithromycin. Conclusions: We identified extremely limited evidence from a study with methodological problems of an association between improvement in certain outcomes when COVID-19 patients are treated with a combination of zinc, hydroxychloroquine and azithromycin, compared with treatment with hydroxychloroquine and azithromycin. The results of randomised clinical trials in this area should provide robust evidence of the effectiveness of zinc as treatment/prophylaxis for COVID-19.
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29
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van der Gaag EJ, Hummel TZ. Food or medication? The therapeutic effects of food on the duration and incidence of upper respiratory tract infections: a Review of the literature. Crit Rev Food Sci Nutr 2020; 61:2691-2704. [PMID: 32648776 DOI: 10.1080/10408398.2020.1784087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE Upper respiratory tract infections are common in children and adults. Antiviral treatments are only available for specific groups of patients, stimulating the distribution of over-the-counter medication to relieve the symptoms for the other patients. Studies about whole foods and their effect on the incidence and duration of upper respiratory tract infections were reviewed. METHODS Randomized controlled trials and case-control studies available on MEDLINE, Web of Science, Cochrane Library and Embase were included. RESULTS AND CONCLUSIONS Thirty-three studies were included. The incidence of respiratory infections or symptoms was shown to be reduced in some studies when probiotics, prebiotics, growing-up milk, fish oil, kiwi, garlic and xylitol were taken. Duration was favorably influenced by the intake of elderberry, kiwi, probiotics and fish oil. When the risk of bias and repetition is taken into account, probiotics and elderberry repeatedly show favorable effects. Prudent conclusions can be made in selective patient groups. However, the studies were diverse and were only performed by a few study groups.
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Affiliation(s)
- Ellen José van der Gaag
- Pediatrics, Hospital Group Twente, Almelo, SZ, Netherlands.,Behaviourial Management and Social Sciences, University of Twente, Enschede, AE, Netherlands
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30
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Wessels I, Rolles B, Rink L. The Potential Impact of Zinc Supplementation on COVID-19 Pathogenesis. Front Immunol 2020; 11:1712. [PMID: 32754164 PMCID: PMC7365891 DOI: 10.3389/fimmu.2020.01712] [Citation(s) in RCA: 190] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/26/2020] [Indexed: 01/08/2023] Open
Abstract
During the current corona pandemic, new therapeutic options against this viral disease are urgently desired. Due to the rapid spread and immense number of affected individuals worldwide, cost-effective, globally available, and safe options with minimal side effects and simple application are extremely warranted. This review will therefore discuss the potential of zinc as preventive and therapeutic agent alone or in combination with other strategies, as zinc meets all the above described criteria. While a variety of data on the association of the individual zinc status with viral and respiratory tract infections are available, study evidence regarding COVID-19 is so far missing but can be assumed as was indicated by others and is detailed in this perspective, focusing on re-balancing of the immune response by zinc supplementation. Especially, the role of zinc in viral-induced vascular complications has barely been discussed, so far. Interestingly, most of the risk groups described for COVID-19 are at the same time groups that were associated with zinc deficiency. As zinc is essential to preserve natural tissue barriers such as the respiratory epithelium, preventing pathogen entry, for a balanced function of the immune system and the redox system, zinc deficiency can probably be added to the factors predisposing individuals to infection and detrimental progression of COVID-19. Finally, due to its direct antiviral properties, it can be assumed that zinc administration is beneficial for most of the population, especially those with suboptimal zinc status.
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Affiliation(s)
- Inga Wessels
- Institute of Immunology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Benjamin Rolles
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Lothar Rink
- Institute of Immunology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
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31
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Skalny AV, Rink L, Ajsuvakova OP, Aschner M, Gritsenko VA, Alekseenko SI, Svistunov AA, Petrakis D, Spandidos DA, Aaseth J, Tsatsakis A, Tinkov AA. Zinc and respiratory tract infections: Perspectives for COVID‑19 (Review). Int J Mol Med 2020; 46:17-26. [PMID: 32319538 PMCID: PMC7255455 DOI: 10.3892/ijmm.2020.4575] [Citation(s) in RCA: 211] [Impact Index Per Article: 52.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/13/2020] [Indexed: 01/08/2023] Open
Abstract
In view of the emerging COVID‑19 pandemic caused by SARS‑CoV‑2 virus, the search for potential protective and therapeutic antiviral strategies is of particular and urgent interest. Zinc is known to modulate antiviral and antibacterial immunity and regulate inflammatory response. Despite the lack of clinical data, certain indications suggest that modulation of zinc status may be beneficial in COVID‑19. In vitro experiments demonstrate that Zn2+ possesses antiviral activity through inhibition of SARS‑CoV RNA polymerase. This effect may underlie therapeutic efficiency of chloroquine known to act as zinc ionophore. Indirect evidence also indicates that Zn2+ may decrease the activity of angiotensin‑converting enzyme 2 (ACE2), known to be the receptor for SARS‑CoV‑2. Improved antiviral immunity by zinc may also occur through up‑regulation of interferon α production and increasing its antiviral activity. Zinc possesses anti‑inflammatory activity by inhibiting NF‑κB signaling and modulation of regulatory T‑cell functions that may limit the cytokine storm in COVID‑19. Improved Zn status may also reduce the risk of bacterial co‑infection by improving mucociliary clearance and barrier function of the respiratory epithelium, as well as direct antibacterial effects against S. pneumoniae. Zinc status is also tightly associated with risk factors for severe COVID‑19 including ageing, immune deficiency, obesity, diabetes, and atherosclerosis, since these are known risk groups for zinc deficiency. Therefore, Zn may possess protective effect as preventive and adjuvant therapy of COVID‑19 through reducing inflammation, improvement of mucociliary clearance, prevention of ventilator‑induced lung injury, modulation of antiviral and antibacterial immunity. However, further clinical and experimental studies are required.
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Affiliation(s)
- Anatoly V. Skalny
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146 Moscow
- Yaroslavl State University, 150003 Yaroslavl, Russia
| | - Lothar Rink
- Institute of Immunology, Medical Faculty, RWTH Aachen University, D-52062 Aachen, Germany
| | - Olga P. Ajsuvakova
- Yaroslavl State University, 150003 Yaroslavl, Russia
- Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, 460000 Orenburg, Russia
| | - Michael Aschner
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146 Moscow
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Viktor A. Gritsenko
- Institute of Cellular and Intracellular Symbiosis, Russian Academy of Sciences, 460000 Orenburg
| | - Svetlana I. Alekseenko
- I.I. Mechnikov North-Western State Medical University, 191015 St. Petersburg
- K.A. Rauhfus Children's City Multidisciplinary Clinical Center for High Medical Technologies, 191000 St. Petersburg, Russia
| | - Andrey A. Svistunov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146 Moscow
| | | | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71409 Heraklion, Greece
| | - Jan Aaseth
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146 Moscow
- Research Department, Innlandet Hospital Trust, 3159894 Brumunddal, Norway
| | - Aristidis Tsatsakis
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146 Moscow
- Center of Toxicology Science and Research
| | - Alexey A. Tinkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146 Moscow
- Yaroslavl State University, 150003 Yaroslavl, Russia
- Institute of Cellular and Intracellular Symbiosis, Russian Academy of Sciences, 460000 Orenburg
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32
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Hunter J, Arentz S, Goldenberg J, Yang G, Beardsley J, Mertz D, Leeder S. Rapid review protocol: Zinc for the prevention or treatment of COVID-19 and other coronavirus-related respiratory tract infections. Integr Med Res 2020; 9:100457. [PMID: 32690999 PMCID: PMC7308745 DOI: 10.1016/j.imr.2020.100457] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 01/14/2023] Open
Abstract
Background The global COVID-19 pandemic has prompted an urgent search for effective interventions. SARS-CoV-2 mortality/morbidity risk increases with age and for those chronic disease co-morbidities, both of which are associated with lower zinc status, as is the risk of infection. Methods Rapid review methods will be applied to a systematic review of zinc for the prevention or treatment of SARS-CoV-2 and viral respiratory tract infections in humans. Included are published studies reporting randomised and quasi-randomised controlled trials that compare zinc intervention to placebo and/or other comparator interventions. English and Chinese language databases will be searched for primary studies of viral respiratory tract infections and clinical trial registries for SARS-CoV-2 infections. Due to concerns about indirectness, studies evaluating non-SARS-CoV-2 coronavirus infections will be rated down by one level, and non-specific or confirmed non-coronavirus viral infections will be rated down by two levels. Review constraints include (1) using Google translate when screening articles published in languages other than English or Chinese and limited translation (2) following calibration, only one reviewer will screen articles, extract data, appraise quality and conduct the analysis, (3) prioritising data extraction and meta-analyses of SARS-CoV-2 studies and critical outcomes of other viral infections, followed by high risk groups and (4) reporting important preliminary findings prior to peer review if necessary. Discussion The application of these rapid review methods and broadening the inclusion criteria to include other coronavirus-related viral respiratory tract infections aims to enable a timely evidence appraisal of priority research questions and dissemination of results. Study registration PROSPERO CRD42020182044.
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Affiliation(s)
- Jennifer Hunter
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Susan Arentz
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Joshua Goldenberg
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Guoyan Yang
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Jennifer Beardsley
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.,Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA.,Division of Infectious Diseases, Department of Medicine, McMaster University, Hamilton, ON, Canada.,Menzies Centre for Health Policy, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Dominik Mertz
- Division of Infectious Diseases, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Stephen Leeder
- Menzies Centre for Health Policy, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Hoang BX, Hoang HQ, Han B. Zinc Iodide in combination with Dimethyl Sulfoxide for treatment of SARS-CoV-2 and other viral infections. Med Hypotheses 2020; 143:109866. [PMID: 32473509 PMCID: PMC7245270 DOI: 10.1016/j.mehy.2020.109866] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/04/2020] [Accepted: 05/21/2020] [Indexed: 12/16/2022]
Abstract
Zinc Iodide and Dimethyl Sulfoxide compositions are proposed as therapeutic agents to treat and prevent chronic and acute viral infections including SARS-CoV-2 infected patients. The therapeutic combinations have a wide range of virucidal effects on DNA and RNA containing viruses. The combinations also exhibit anti-inflammatory, immunomodulating, antifibrotic, antibacterial, antifungal and antioxidative effects. Given the fact that Zinc Iodide has been used as an oral antiseptic agent and DMSO has been already proven as a safe pharmaceutical solvent and therapeutic agent, we hypothesize that the combination of these two agents can be applied as an effective, safe and inexpensive treatment for SARS-CoV-2 and other viral infection. The therapeutic compound can be applied as both etiological and pathogenesis therapy and used as an effective and safe antiseptic (disinfectant) for human and animals as well.
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Affiliation(s)
- Ba X Hoang
- Nimni-Cordoba Tissue Engineering and Drug Discovery Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1333 San Pablo Street, BMT-302, Los Angeles, CA 90033, USA.
| | - Huy Q Hoang
- Natural Health Medical Center, 4469 Redondo Beach Boulevard, Lawndale 90260, CA, USA
| | - Bo Han
- Nimni-Cordoba Tissue Engineering and Drug Discovery Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1333 San Pablo Street, BMT-302, Los Angeles, CA 90033, USA
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Stockert K. Allergie, Mikrobiom und weitere epigenetische Faktoren. ALLERGIEPRÄVENTION 2020. [PMCID: PMC7123400 DOI: 10.1007/978-3-662-58140-7_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mináriková D, Fazekaš T, Minárik P, Jurišová E. Assessment of patient counselling on the common cold treatment at Slovak community pharmacies using mystery shopping. Saudi Pharm J 2019; 27:574-583. [PMID: 31061627 PMCID: PMC6488828 DOI: 10.1016/j.jsps.2019.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/09/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Up to now, there have been no data on patient counselling in the Slovak community pharmacies. The literature provides a wide range of activities for which mystery shopping methodology be used, including assessment of patient counselling. AIMS AND OBJECTIVES To assess patient counselling on the common cold treatment with OTC medicine containing zinc provided by Slovak community pharmacists. To analyse this counselling considering the set scenarios, counsellors and their age. METHODS 54 pharmacy students visited 270 different community pharmacies throughout Slovakia in 2 weeks in October 2016 to conduct mystery shopping with set scenarios. For assessment of patient counselling, we defined Counselling Performance. It was conceptualised as weighted mean percentage counselling successes rate of its three categories (Identification, Information and Communication) and their weights. Individual perception of counselling evaluated separately. Student t-test and Person's chi-squared test (p < 0.05) and Cohen delta were used for comparing outcomes and effect size of counselling. A simple linear regression was used to find relationships. RESULTS The total Counselling Performance was 39.0 ± 22.4%, Identification 30.6 ± 28.7%, Information 39.8 ± 25.1% and Communication 74.3 ± 11.5%. 26.3% pharmacies achieved the average Counselling Performance (41-60%). Subjective Perception had a success rate of 73.4 ± 21.2%, but it could be predicted by the Counselling Performance and the success rate of the three categories only in 1/5 pharmacies. Spontaneous counselling was provided more by pharmacy technicians (p = 0.0009). The duration of counselling was similar when comparing both scenarios, counsellors and their age. The product-requested scenario achieved a higher success rate in the Information category (p = 0.0304; d = 0.27). Pharmacists achieved a higher Counselling Performance (p < 0.0001; d = 0.48) and success rate in categories Identification (p = 0.0001, d = 0.46), Information (p = 0.0004, d = 0.37), and Perception (p = 0.0007; d = 0.54). The estimated age of counsellors did not have any impact on the counselling. CONCLUSION Patient counselling on the common cold showed a suboptimal level, particularly considering its content. In the study, we found a significant relationship between the success of counselling and counsellors.
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Affiliation(s)
- Daniela Mináriková
- Department of Organisation and Management in Pharmacy, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-83232 Bratislava, Slovak Republic
| | - Tomáš Fazekaš
- Department of Physical Chemistry of Drugs, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-83232 Bratislava, Slovak Republic
| | - Peter Minárik
- St. Elisabeth University of Health and Social Work, Palackeho 1, 811 02 Bratislava, Slovak Republic
| | - Erika Jurišová
- Department of Languages, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-83232 Bratislava, Slovak Republic
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Maughan RJ, Burke LM, Dvorak J, Larson-Meyer DE, Peeling P, Phillips SM, Rawson ES, Walsh NP, Garthe I, Geyer H, Meeusen R, van Loon LJC, Shirreffs SM, Spriet LL, Stuart M, Vernec A, Currell K, Ali VM, Budgett RG, Ljungqvist A, Mountjoy M, Pitsiladis YP, Soligard T, Erdener U, Engebretsen L. IOC consensus statement: dietary supplements and the high-performance athlete. Br J Sports Med 2018; 52:439-455. [PMID: 29540367 PMCID: PMC5867441 DOI: 10.1136/bjsports-2018-099027] [Citation(s) in RCA: 327] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2018] [Indexed: 12/24/2022]
Abstract
Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition programme. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including (1) the management of micronutrient deficiencies, (2) supply of convenient forms of energy and macronutrients, and (3) provision of direct benefits to performance or (4) indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can benefit the athlete, but others may harm the athlete's health, performance, and/or livelihood and reputation (if an antidoping rule violation results). A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome and habitual diet. Supplements intended to enhance performance should be thoroughly trialled in training or simulated competition before being used in competition. Inadvertent ingestion of substances prohibited under the antidoping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete's health and awareness of the potential for harm must be paramount; expert professional opinion and assistance is strongly advised before an athlete embarks on supplement use.
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Affiliation(s)
| | - Louise M Burke
- Sports Nutrition, Australian Institute of Sport, Canberra, Australia
- Mary MacKillop Institute for Health Research, Melbourne, Australia
| | - Jiri Dvorak
- Department of Neurology, Schulthess Clinic, Zurich, Switzerland
| | - D Enette Larson-Meyer
- Department of Family & Consumer Sciences (Human Nutrition), University of Wyoming, Laramie, Wyoming, USA
| | - Peter Peeling
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Australia
- Western Australian Institute of Sport, Mount Claremont, Australia
| | | | - Eric S Rawson
- Department of Health, Nutrition, and Exercise Science, Messiah College, Mechanicsburg, Pennsylvania, USA
| | - Neil P Walsh
- College of Health and Behavioural Sciences, Bangor University, Bangor, UK
| | - Ina Garthe
- The Norwegian Olympic and Paralympic Committee and Confederation of Sport, Oslo, Norway
| | - Hans Geyer
- Institute of Biochemistry, Center for Preventive Doping Research, German Sport University, Cologne, Germany
| | - Romain Meeusen
- Human Physiology Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Lucas J C van Loon
- Mary MacKillop Institute for Health Research, Melbourne, Australia
- Department of Human Biology and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Lawrence L Spriet
- Human Health & Nutritional Sciences, University of Guelph, Ontario, Canada
| | | | - Alan Vernec
- Department of Science and Medicine, World Anti-Doping Agency (WADA), Montreal, Canada
| | | | - Vidya M Ali
- Medical and Scientific Commission, International Olympic Committee, Lausanne, Switzerland
| | - Richard Gm Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | | | - Margo Mountjoy
- Human Health and Nutritional Sciences, Health and Performance, Centre University of Guelph, Guelph, Ontario, Canada
- Medical and Scientific Commission Games Group, International Olympic Committee, Lausanne, Switzerland
| | - Yannis P Pitsiladis
- Medical and Scientific Commission, International Olympic Committee, Lausanne, Switzerland
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Uğur Erdener
- Medical and Scientific Commission, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
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Domínguez Islas C, Rice KM. Addressing the estimation of standard errors in fixed effects meta-analysis. Stat Med 2018; 37:1788-1809. [PMID: 29574827 PMCID: PMC6001579 DOI: 10.1002/sim.7625] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 12/27/2017] [Accepted: 01/14/2018] [Indexed: 01/20/2023]
Abstract
Standard methods for fixed effects meta-analysis assume that standard errors for study-specific estimates are known, not estimated. While the impact of this simplifying assumption has been shown in a few special cases, its general impact is not well understood, nor are general-purpose tools available for inference under more realistic assumptions. In this paper, we aim to elucidate the impact of using estimated standard errors in fixed effects meta-analysis, showing why it does not go away in large samples and quantifying how badly miscalibrated standard inference will be if it is ignored. We also show the important role of a particular measure of heterogeneity in this miscalibration. These developments lead to confidence intervals for fixed effects meta-analysis with improved performance for both location and scale parameters.
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Affiliation(s)
- Clara Domínguez Islas
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,MRC Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Kenneth M Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
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Öncel S. Soğuk Algınlığı Ve Klinik Yaklaşımlar. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2018. [DOI: 10.30934/kusbed.348505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Malesker MA, Callahan-Lyon P, Ireland B, Irwin RS. Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold: CHEST Expert Panel Report. Chest 2017; 152:1021-1037. [PMID: 28837801 PMCID: PMC6026258 DOI: 10.1016/j.chest.2017.08.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/26/2017] [Accepted: 08/05/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Acute cough associated with the common cold (CACC) causes significant impairment in quality of life. Effective treatment approaches are needed for CACC. We conducted a systematic review on the management of CACC to update the recommendations and suggestions of the CHEST 2006 guideline on this topic. METHODS This systematic review of randomized controlled trials (RCTs) asked the question: Is there evidence of clinically relevant treatment effects for pharmacologic or nonpharmacologic therapies in reducing the duration/severity of acute CACC? Studies of adults and pediatric patients with CACC were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on using the American College of Chest Physicians organization methodology. RESULTS Six systematic reviews and four primary studies identified from updated literature searches for each of the reviews or from hand searching were included and reported data on 6,496 participants with CACC who received one or more of a variety of interventions. The studies used an assortment of descriptors and assessments to identify CACC. CONCLUSIONS The evidence supporting the management of CACC is overall of low quality. This document provides treatment suggestions based on the best currently available evidence and identifies gaps in our knowledge and areas for future research.
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Affiliation(s)
- Mark A Malesker
- Pharmacy Practice Department, Creighton University, Omaha, NE.
| | | | | | - Richard S Irwin
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA
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40
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Affiliation(s)
- Harri Hemilä
- University of Helsinki; Department of Public Health, POB 20; Tukholmankatu 8 B 2B Helsinki Finland FIN-00014
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Liu X, Fu J, Fan T, Liu W, Jiang H, Zhang R, Ding H, Yang H, Hu S, Huang Y, Li G, Lan Y, She B, Mao B. The Efficacy and Safety of Shen Guo Lao Nian Granule for Common Cold of Qi-Deficiency Syndrome: Study Protocol for a Randomized, Double-Blind, Placebo-Controlled, Multicenter, Phase II Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2017; 2017:1806461. [PMID: 29430253 PMCID: PMC5753015 DOI: 10.1155/2017/1806461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 08/08/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Common cold is one of the most frequently occurring illnesses in primary healthcare services and represents considerable disease burden. Common cold of Qi-deficiency syndrome (CCQDS) is an important but less addressed traditional Chinese medicine (TCM) pattern. We designed a protocol to explore the efficacy, safety, and optimal dose of Shen Guo Lao Nian Granule (SGLNG) for treating CCQDS. METHODS/DESIGN This is a multicenter, randomized, double-blind, placebo-controlled, phase II clinical trial. A total of 240 eligible patients will be recruited from five centers. Patients are randomly assigned to high-dose group, middle-dose group, low-dose group, or control group in a 1 : 1 : 1 : 1 ratio. All drugs are required to be taken 3 times daily for 5 days with a 5-day follow-up period. Primary outcomes are duration of all symptoms, total score reduction on Jackson's scale, and TCM symptoms scale. Secondary outcomes include every single TCM symptom duration and score reduction, TCM main symptoms disappearance rate, curative effects, and comparison between Jackson's scale and TCM symptom scale. ETHICS AND TRIAL REGISTRATION This study protocol was approved by the Ethics Committee of Clinical Trials and Biomedicine of West China Hospital of Sichuan University (number IRB-2014-12) and registered with the Chinese Clinical Trial Registry (ChiCTR-IPR-15006349).
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Affiliation(s)
- Xuemei Liu
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Juanjuan Fu
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Tao Fan
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Wei Liu
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Hongli Jiang
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ruiming Zhang
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Hong Ding
- Department of National Good Clinical Practice, The Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu 610041, China
| | - Haimiao Yang
- Department of Respiratory Medicine, The Affiliated Hospital, Changchun University of Traditional Chinese Medicine, Changchun 130051, China
| | - Siyuan Hu
- Department of Good Clinical Practice, The First Affiliated Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Yuhong Huang
- Center of Good Clinical Practice, The Second Affiliated Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin 300150, China
| | - Guanhong Li
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ying Lan
- College of Acupuncture and Tuina, Traditional Chinese Medicine of Chengdu University, Chengdu 610041, China
| | - Bin She
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Bing Mao
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
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Angeles-Agdeppa I, Magsadia CR, Aaron GJ, Lloyd BB, Hilmers DC, Bhutta ZA. A Micronutrient Fortified Beverage Given at Different Dosing Frequencies Had Limited Impact on Anemia and Micronutrient Status in Filipino Schoolchildren. Nutrients 2017; 9:E1002. [PMID: 28895887 PMCID: PMC5622762 DOI: 10.3390/nu9091002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/22/2017] [Accepted: 08/24/2017] [Indexed: 01/11/2023] Open
Abstract
This study evaluated the effects of a multi-micronutrient fortified juice drink given in different frequencies of consumption on hemoglobin (Hb) concentration of schoolchildren. Hb was measured in 2423 schoolchildren aged 6- to 9-years-old at baseline. All anemic children (n = 246) were randomly allocated into groups: Daily dose (HD: high dose), 5X/week (MD: Moderate Dose), 3X/week (LD: Low Dose) and unfortified (Control). Pre- and post-study measurements of micronutrients were collected from 228 children. At the endpoint, significant Hb increases were observed in all groups, but there was no significant difference between groups. There was a significant reduction in anemia prevalence in all groups from 100% to 36% (Control), 30% (LD), 23% (MD) and 26% (HD). No dose-response effect was observed in Hb in this population. Most likely, this resulted from better than expected micronutrient status and lower than expected severity of anemia and micronutrient deficiencies in this cohort. It is unlikely that the addition of a fortified beverage to school feeding programs in this population would have a positive impact. Whether such an intervention would be cost-effective as a preventative approach needs to be assessed. This study demonstrates the importance of targeting such interventions to appropriate populations.
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Affiliation(s)
- Imelda Angeles-Agdeppa
- Food and Nutrition Research Institute, Department of Science and Technology, 1632 Taguig, Philippines.
| | - Clarita R Magsadia
- Food and Nutrition Research Institute, Department of Science and Technology, 1632 Taguig, Philippines.
| | - Grant J Aaron
- Formerly with the Global Alliance for Improved Nutrition (GAIN), Rue de Varembre 7, 1202 Geneve, Switzerland.
| | - Beate B Lloyd
- Global Scientific and Regulatory Affairs, The Coca-Cola Company, Atlanta, GA 30301, USA.
| | - David C Hilmers
- Baylor College of Medicine, Departments of Internal Medicine, Pediatrics, Global Initiatives, and Center for Space Medicine, Houston, TX 77030, USA.
| | - Zulfiqar A Bhutta
- University of Toronto, Center for Global Child Health, The Hospital for Sick Children, Toronto, ON M6S 1S6, Canada.
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Gammoh NZ, Rink L. Zinc in Infection and Inflammation. Nutrients 2017; 9:E624. [PMID: 28629136 PMCID: PMC5490603 DOI: 10.3390/nu9060624] [Citation(s) in RCA: 385] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 06/09/2017] [Accepted: 06/11/2017] [Indexed: 12/26/2022] Open
Abstract
Micronutrient homeostasis is a key factor in maintaining a healthy immune system. Zinc is an essential micronutrient that is involved in the regulation of the innate and adaptive immune responses. The main cause of zinc deficiency is malnutrition. Zinc deficiency leads to cell-mediated immune dysfunctions among other manifestations. Consequently, such dysfunctions lead to a worse outcome in the response towards bacterial infection and sepsis. For instance, zinc is an essential component of the pathogen-eliminating signal transduction pathways leading to neutrophil extracellular traps (NET) formation, as well as inducing cell-mediated immunity over humoral immunity by regulating specific factors of differentiation. Additionally, zinc deficiency plays a role in inflammation, mainly elevating inflammatory response as well as damage to host tissue. Zinc is involved in the modulation of the proinflammatory response by targeting Nuclear Factor Kappa B (NF-κB), a transcription factor that is the master regulator of proinflammatory responses. It is also involved in controlling oxidative stress and regulating inflammatory cytokines. Zinc plays an intricate function during an immune response and its homeostasis is critical for sustaining proper immune function. This review will summarize the latest findings concerning the role of this micronutrient during the course of infections and inflammatory response and how the immune system modulates zinc depending on different stimuli.
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Affiliation(s)
- Nour Zahi Gammoh
- Institute of Immunology, Faculty of Medicine, RWTH Aachen University, University Hospital, Pauwelstrasse 30, 52074 Aachen, Germany.
| | - Lothar Rink
- Institute of Immunology, Faculty of Medicine, RWTH Aachen University, University Hospital, Pauwelstrasse 30, 52074 Aachen, Germany.
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Hemilä H. Duration of the common cold and similar continuous outcomes should be analyzed on the relative scale: a case study of two zinc lozenge trials. BMC Med Res Methodol 2017; 17:82. [PMID: 28494765 PMCID: PMC5427521 DOI: 10.1186/s12874-017-0356-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 05/02/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The relative scale has been used for decades in analysing binary data in epidemiology. In contrast, there has been a long tradition of carrying out meta-analyses of continuous outcomes on the absolute, original measurement, scale. The biological rationale for using the relative scale in the analysis of binary outcomes is that it adjusts for baseline variations; however, similar baseline variations can occur in continuous outcomes and relative effect scale may therefore be often useful also for continuous outcomes. The aim of this study was to determine whether the relative scale is more consistent with empirical data on treating the common cold than the absolute scale. METHODS Individual patient data was available for 2 randomized trials on zinc lozenges for the treatment of the common cold. Mossad (Ann Intern Med 125:81-8, 1996) found 4.0 days and 43% reduction, and Petrus (Curr Ther Res 59:595-607, 1998) found 1.77 days and 25% reduction, in the duration of colds. In both trials, variance in the placebo group was significantly greater than in the zinc lozenge group. The effect estimates were applied to the common cold distributions of the placebo groups, and the resulting distributions were compared with the actual zinc lozenge group distributions. RESULTS When the absolute effect estimates, 4.0 and 1.77 days, were applied to the placebo group common cold distributions, negative and zero (i.e., impossible) cold durations were predicted, and the high level variance remained. In contrast, when the relative effect estimates, 43 and 25%, were applied, impossible common cold durations were not predicted in the placebo groups, and the cold distributions became similar to those of the zinc lozenge groups. CONCLUSIONS For some continuous outcomes, such as the duration of illness and the duration of hospital stay, the relative scale leads to a more informative statistical analysis and more effective communication of the study findings. The transformation of continuous data to the relative scale is simple with a spreadsheet program, after which the relative scale data can be analysed using standard meta-analysis software. The option for the analysis of relative effects of continuous outcomes directly from the original data should be implemented in standard meta-analysis programs.
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Affiliation(s)
- Harri Hemilä
- Department of Public Health, POB 20 University of Helsinki, Tukholmankatu 8 B, FI-00014, Helsinki, Finland.
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45
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Hemilä H. Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage. JRSM Open 2017; 8:2054270417694291. [PMID: 28515951 PMCID: PMC5418896 DOI: 10.1177/2054270417694291] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To compare the efficacy of zinc acetate lozenges with zinc gluconate lozenges in common cold treatment and to examine the dose-dependency of the effect. DESIGN Meta-analysis. SETTING Placebo-controlled zinc lozenge trials, in which the zinc dose was > 75 mg/day. The pooled effect of zinc lozenges on common cold duration was calculated by using inverse-variance random-effects method. PARTICIPANTS Seven randomised trials with 575 participants with naturally acquired common colds. MAIN OUTCOME MEASURE Duration of the common cold. RESULTS The mean common cold duration was 33% (95% CI 21% to 45%) shorter for the zinc groups of the seven included trials. Three trials that used lozenges composed of zinc acetate found that colds were shortened by 40% and four trials that used zinc gluconate by 28%. The difference between the two salts was not significant: 12 percentage points (95% CI: -12 to + 36). Five trials used zinc doses of 80-92 mg/day, common cold duration was reduced by 33%, and two trials used zinc doses of 192-207 mg/day and found an effect of 35%. The difference between the high-dose and low-dose zinc trials was not significant: 2 percentage points (95% CI: -29 to + 32). CONCLUSIONS Properly composed zinc gluconate lozenges may be as effective as zinc acetate lozenges. There is no evidence that zinc doses over 100 mg/day might lead to greater efficacy in the treatment of the common cold. Common cold patients may be encouraged to try zinc lozenges for treating their colds. The optimal lozenge composition and dosage scheme need to be investigated further.
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Affiliation(s)
- Harri Hemilä
- Department of Public Health, University of Helsinki, Helsinki FI-00014, Finland
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46
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Hemilä H, Fitzgerald JT, Petrus EJ, Prasad A. Zinc Acetate Lozenges May Improve the Recovery Rate of Common Cold Patients: An Individual Patient Data Meta-Analysis. Open Forum Infect Dis 2017; 4:ofx059. [PMID: 28480298 PMCID: PMC5410113 DOI: 10.1093/ofid/ofx059] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/28/2017] [Indexed: 01/30/2023] Open
Abstract
Background A previous meta-analysis of 3 zinc acetate lozenge trials estimated that colds were on average 40% shorter for the zinc groups. However, the duration of colds is a time outcome, and survival analysis may be a more informative approach. The objective of this individual patient data (IPD) meta-analysis was to estimate the effect of zinc acetate lozenges on the rate of recovery from colds. Methods We analyzed IPD for 3 randomized placebo-controlled trials in which 80–92 mg/day of elemental zinc were administered as zinc acetate lozenges to 199 common cold patients. We used mixed-effects Cox regression to estimate the effect of zinc. Results Patients administered zinc lozenges recovered faster by rate ratio 3.1 (95% confidence interval, 2.1–4.7). The effect was not modified by age, sex, race, allergy, smoking, or baseline common cold severity. On the 5th day, 70% of the zinc patients had recovered compared with 27% of the placebo patients. Accordingly, 2.6 times more patients were cured in the zinc group. The difference also corresponds to the number needed to treat of 2.3 on the 5th day. None of the studies observed serious adverse effects of zinc. Conclusions The 3-fold increase in the rate of recovery from the common cold is a clinically important effect. The optimal formulation of zinc lozenges and an ideal frequency of their administration should be examined. Given the evidence of efficacy, common cold patients may be instructed to try zinc acetate lozenges within 24 hours of onset of symptoms.
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Affiliation(s)
- Harri Hemilä
- Department of Public Health, University of Helsinki, Finland
| | - James T Fitzgerald
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor
| | | | - Ananda Prasad
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
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Knapik JJ, Jean RT, Austin KG, Steelman RA, Farina EK, Lieberman HR. Demographic factors associated with dietary supplement prescriptions filled by United States Military Service Members 2005-2013. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:84. [PMID: 28148262 PMCID: PMC5286846 DOI: 10.1186/s12906-017-1590-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/17/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Dietary supplements (DSs) can be purchased over-the-counter but may also be prescribed by medical personnel for specific therapeutic reasons. Few studies have examined this latter source of DSs despite the fact that 79% of physicians and 82% of nurses have recommended DSs to their patients. This investigation examined demographic factors associated with temporal trends in oral DS prescriptions filled by all United States (US) service members (SMs) from 2005 to 2013 (n = 1,427,080 ± 22,139, mean ± standard deviation per year). METHODS The Food and Drug Administration National Drug Code database and the formularies of the US Defense Health Agency's Pharmacoeconomic Center were queried to identify DSs available to SMs. The number of these DS prescriptions filled by all SMs from 2005 through 2013 was then obtained from the US Department of Defense Pharmacy Data Transaction System. Data were grouped by American Hospital Formulary System (AHFS) pharmacologic-therapeutic classifications and examined over time. Denominators (number of SMs each year) were obtained from the Defense Health Agency. RESULTS Major findings included 1) generally greater prevalence of prescriptions filled by women and older SMs for most AHFS categories; 2) a temporal decline in total prescriptions filled by Marine Corps personnel accounted for by a decline in the prevalence of zinc preparations filled by younger male Marines; 3) a temporal decline in the prevalence of iron preparations filled by women; 4) a temporal increase in the prevalence of prescriptions for replacement preparations filled by women accounted for largely by more prescriptions for calcium compounds; and 5) a temporal decline in the prevalence of prescriptions filled for cathartics/laxatives in older SMs accounted for largely by a decline in prescriptions for sodium/potassium compounds. CONCLUSIONS These temporal trends may be associated with the greater health care utilization of women and older SMs as well as the perceptions of prescribers and/or patients on appropriate roles of these substances in medicine and public health.
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Affiliation(s)
- Joseph J Knapik
- US Army Research Institute of Environmental Medicine, Natick, MA, USA.
- US Army Public Health Center, Aberdeen Proving Ground, MD, USA.
- Oak Ridge Institute for Science and Education, Belcamp, MD, USA.
- Research Physiologist, (USARIEM), 10 General Greene Ave, Natick, MA, 01760, USA.
| | - Rosenie T Jean
- Office of The US Army Surgeon's General Pharmacovigilance Center, Falls Church, VA, USA
| | - Krista G Austin
- US Army Research Institute of Environmental Medicine, Natick, MA, USA
- Oak Ridge Institute for Science and Education, Belcamp, MD, USA
| | | | - Emily K Farina
- US Army Research Institute of Environmental Medicine, Natick, MA, USA
- Oak Ridge Institute for Science and Education, Belcamp, MD, USA
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Rotter N. Evidence and evidence gaps in therapies of nasal obstruction and rhinosinusitis. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2016; 15:Doc06. [PMID: 28025606 PMCID: PMC5169079 DOI: 10.3205/cto000133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Therapeutic decisions in otorhinolaryngology are based on clinical experience, surgical skills, and scientific evidence. Recently, evidence-based therapies have gained increased attention and importance due to their potential to improve the individual patient's treatment and their potential at the same time to reduce treatment costs. In clinical practice, it is almost impossible to stay ahead of the increasing mass of literature and on the other hand critically assess the presented data. A solid scientific and statistical knowledge as well as a significant amount of spare time are required to detect systematic bias and other errors in study designs, also with respect to assessing whether or not a study should be part of an individual therapeutic decision. Meta-analyses, reviews, and clinical guidelines are, therefore, of increasing importance for evidence-based therapy in clinical practice. This review is an update of the availability of external evidence for the treatment of nasal obstruction and rhinosinusitis. It becomes evident that both groups of diseases differ significantly in the availability of external evidence. Furthermore, it becomes obvious that surgical treatment options are normally based on evidence of significantly lower quality than medical treatment options.
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Affiliation(s)
- Nicole Rotter
- Department of Otolaryngology, Head and Neck Surgery, Ulm University Medical Centre, Ulm, Germany
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Hemilä H, Petrus EJ, Fitzgerald JT, Prasad A. Zinc acetate lozenges for treating the common cold: an individual patient data meta-analysis. Br J Clin Pharmacol 2016; 82:1393-1398. [PMID: 27378206 PMCID: PMC5061795 DOI: 10.1111/bcp.13057] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/17/2016] [Accepted: 06/18/2016] [Indexed: 11/29/2022] Open
Abstract
AIMS The aim of this study was to determine whether the allergy status and other characteristics of common cold patients modify the effects of zinc acetate lozenges. METHODS We had available individual patient data for three randomized placebo-controlled trials in which zinc acetate lozenges were administered to common cold patients. We used both one stage and two stage meta-analysis to estimate the effects of zinc lozenges. RESULTS The total number of common cold patients was 199, the majority being females. Eighty percent of them fell into the age range 20-50 years. One third of the patients had allergies. The one stage meta-analysis gave an overall estimate of 2.73 days (95% CI 1.8, 3.3 days) shorter colds by zinc acetate lozenge usage. The two stage meta-analysis gave an estimate of 2.94 days (95% CI 2.1, 3.8 days) reduction in common cold duration. These estimates are to be compared with the 7 day average duration of colds in the three trials. The effect of zinc lozenges was not modified by allergy status, smoking, baseline severity of the common cold, age, gender or ethnic group. CONCLUSION Since the effects of zinc acetate lozenges were consistent between the compared subgroups, the overall estimates for effect seemed applicable over a wide range of common cold patients. While the optimal composition of zinc lozenges and the best frequency of their administration should be further investigated, given the current evidence of efficacy, common cold patients may be encouraged to try zinc lozenges for treating their colds.
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Affiliation(s)
- Harri Hemilä
- Department of Public Health, University of Helsinki, Helsinki, Finland.
| | | | - James T Fitzgerald
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan
| | - Ananda Prasad
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA
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Community acquired respiratory virus infections in cancer patients-Guideline on diagnosis and management by the Infectious Diseases Working Party of the German Society for haematology and Medical Oncology. Eur J Cancer 2016; 67:200-212. [PMID: 27681877 PMCID: PMC7125955 DOI: 10.1016/j.ejca.2016.08.015] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 08/17/2016] [Accepted: 08/17/2016] [Indexed: 01/11/2023]
Abstract
Background Community acquired viruses (CRVs) may cause severe disease in cancer patients. Thus, efforts should be made to diagnose CRV rapidly and manage CRV infections accordingly. Methods A panel of 18 clinicians from the Infectious Diseases Working Party of the German Society for Haematology and Medical Oncology have convened to assess the available literature and provide recommendations on the management of CRV infections including influenza, respiratory syncytial virus, parainfluenza virus, human metapneumovirus and adenovirus. Results CRV infections in cancer patients may lead to pneumonia in approximately 30% of the cases, with an associated mortality of around 25%. For diagnosis of a CRV infection, combined nasal/throat swabs or washes/aspirates give the best results and nucleic acid amplification based-techniques (NAT) should be used to detect the pathogen. Hand hygiene, contact isolation and face masks have been shown to be of benefit as general infection management. Causal treatment can be given for influenza, using a neuraminidase inhibitor, and respiratory syncytial virus, using ribavirin in addition to intravenous immunoglobulins. Ribavirin has also been used to treat parainfluenza virus and human metapneumovirus, but data are inconclusive in this setting. Cidofovir is used to treat adenovirus pneumonitis. Conclusions CRV infections may pose a vital threat to patients with underlying malignancy. This guideline provides information on diagnosis and treatment to improve the outcome. Community acquired viral respiratory tract infections can be life-threatening in cancer patients. Respiratory virus infections need early and appropriate management to improve outcome and avoid outbreaks. This guideline summarises recommendations by the AGIHO on community acquired respiratory viruses in cancer patients.
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