Colchicine anti-inflammatory therapy for non-intensive care unit hospitalized COVID-19 patients: results from a pilot open-label, randomized controlled clinical trial

Systemic inflammation is a hallmark of severe coronavirus disease-19 (COVID-19). Anti-inflammatory therapy is considered crucial to modulate the hyperinflammatory response (cytokine storm) in hospitalized COVID-19 patients. There is currently no specific, conclusively proven, cost-efficient, and worldwide available anti-inflammatory therapy available to treat COVID-19 patients with cytokine storm. The present study aimed to investigate the treatment benefit of oral colchicine for hospitalized COVID-19 patients with suspected cytokine storm. Colchicine is an approved drug and possesses multiple anti-inflammatory mechanisms. This was a pilot, open-label randomized controlled clinical trial comparing standard of care (SOC) plus oral colchicine (colchicine arm) vs. SOC alone (control arm) in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. Colchicine treatment was initiated within first 48 hours of admission delivered at 1.5 mg loading dose, followed by 0.5 mg b.i.d. for next 6 days and 0.5 mg q.d. for the second week. A total of 96 patients were randomly allocated to the colchicine (n=48) and control groups (n=48). Both colchicine and control group patients experienced similar clinical outcomes by day 14 of hospitalization. Treatment outcome by day 14 in colchicine vs control arm: recovered and discharged alive: 36 (75.0%) vs. 37 (77.1%), remain admitted after 14-days: 4 (8.3%) vs. 5 (10.4%), ICU transferred: 4 (8.3%) vs. 3 (6.3%), and mortality: 4 (8.3%) vs. 3 (6.3%). The speed of improvement of COVID-19 acute symptoms including shortness of breath, fever, cough, the need of supplementary oxygen, and oxygen saturation level, was almost identical in the two groups. Length of hospitalization was on average 1.5 day shorter in the colchicine group. There was no evidence for a difference between the two groups in the follow-up serum levels of inflammatory biomarkers including C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH), ferritin, interleukin-6 (IL-6), high-sensitivity troponin T (hs-TnT) and N-terminal pro b-type natriuretic peptide (NT pro-BNP). According to the results of our study, oral colchicine does not appear to show clinical benefits in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. It is possible that the anti-inflammatory pathways of colchicine are not crucially involved in the pathogenesis of COVID-19.

Phytochemical and biological evaluation of Buddleja polystachya growing in Saudi Arabia

Several Buddleja species were the target of phytochemical and biological studies; however, nothing was reported concerning the chemistry of Buddleja polystachya Fresen. growing in Saudi Arabia. Sixteen constituents were isolated from the aerial parts of B. polystachya using various chromatographic techniques and were identified by the help of different spectral techniques including 1D, 2D NMR and mass spectrometry. Moreover, the different fractions were evaluated for their anti-inflammatory and hypoglycemic activities. The isobenzofuranone derivative (4-hydroxy-7-methylisobenzofuranone) (4), has been isolated for the first time from this natural source, B. polystachya, along with fifteen known compounds namely; phenolic fatty acid ester, 1'(4-hydroxyphenyl) ethanol ester of docosanoic (1), uvaol (2), sakuranetin (3), kumatakenin (5), cirsimaritin (6), 5-hydroxy-3,7,4'-trimethoxyflavone (7), oleanolic acid (8), herbacetin 3,7,8-trimethyl ether (9), ursolic acid (10), verbascoside (11), linarin (12), luteolin 7-O-β-D-glucoside (13), luteolin 7-(6"-caffeoyl)-O-β-D-glucopyranoside (14), luteolin (15), and 6-O-α-L-(4''-O-trans-cinnamoyl) rhamnopyranosylcatalpol (16). Regarding the biological activities investigated, the ethyl acetate fraction showed the most significant anti-inflammatory activity, followed by the n-butanol and the aqueous fractions. As for the petroleum ether and dichloromethane fractions, their anti-inflammatory effects were moderate. The highest hypoglycemic activity was possessed by the ethyl acetate fraction, followed by the dichloromethane fraction and the n-butanol fraction showed the weakest activity.

Dibenzocyclooctadiene lignans from Kadsura philippinensis

Lignans with the dibenzocyclooctadiene skeleton, kadsuphilols I-L, and one C(19)-homolignan, kadsuphilol M, were isolated by chromatographic fractionation of an ethyl acetate extract of the aerial parts of Kadsura philippinensis. Their structures were elucidated through extensive spectroscopic methods, including HRESIMS and 2D NMR experiments (HMQC, COSY and HMBC). The stereochemistry at the chiral centers and the biphenyl moist, were determined using NOESY, as well as analysis of CD spectra, respectively. The relative configuration of heteroclitin J was confirmed by single crystal X-ray crystallographic analysis. The in vitro radical-scavenging activities of these compounds by using DPPH were evaluated.

Frajunolides E-K, briarane diterpenes from Junceella fragilis

Chemical investigation of the gorgonian octocoral Junceella fragilis, collected in Taiwan, resulted in the isolation of seven new briarane-type diterpenes, frajunolides E-K (1-7), in addition to 14 known briaranes, praelolide, junceellin, junceellolides A-E, and K, 11a,20a-epoxy-4-deacetoxyjunceelolide D, umbraculolide A, junceellonoid A, and juncins Y, Z, and ZI, as well as ergosterol peroxide. The structures of 1-7 were determined by analysis of HRESIMS and 2D NMR spectroscopic data. Cytotoxicity and in vitro anti-inflammatory activities of compounds 1-7 were also evaluated.

Bioactive marine prostanoids from octocoral Clavularia viridis

Chemical investigation of the nonpolar extract of soft coral Clavularia viridis resulted in isolation of five new prostanoids, designated as claviridic acids A-E (1-5, resp.), in addition to the known clavulones I-III. Their structures were determined on the basis of spectroscopic techniques, especially HR-ESI-MS, CD, and 2D-NMR experiments. The isolated marine prostanoids exhibited potent inhibitory effect on PHA-induced proliferation of peripheral blood mononuclear cells (PBMC), as well as significant cytotoxic activity against human gastric cancer cells (AGS).

Cembrane diterpenoids from the taiwanese soft coral Sarcophyton stolidotum

Investigation of an EtOAc-soluble extract of the soft coral Sarcophyton stolidotum resulted in the isolation of seven new 14-membered carbocyclic cembranes, sarcostolides A-G (1-7), together with two known cembrane diterpenes, isosarcophytoxide and isosarcophine. The structural elucidation of these metabolites was determined on the basis of spectroscopic analyses, particularly 2D NMR techniques. Sarcostolide E (5) exhibited weak to moderate cytotoxic activity against human WiDr and Daoy tumor cell lines. A biogenetic pathway and relationship for compounds 1-7 was also proposed.

Tasumatrols U-Z, taxane diterpene esters from Taxus sumatrana

Phytochemical investigation of the leaves and twigs of Taxus sumatrana afforded six new taxane diterpene esters, tasumatrols U-Z ( 1- 6). Compounds 2 and 5 contained a rare five-membered lactone ring at C-8, C-9, C-10, and C-19. The structures were established on the basis of detailed spectroscopic analyses, particularly HRESIMS and 2D NMR techniques. Compound 5 showed cytotoxicity against a human hepatoma (Hep2) cell line.

Kadsuphilols A-H, oxygenated lignans from Kadsura philippinensis

Eight new oxygenated lignans, kadsuphilols A-H (1-8), were isolated from the leaves and stems of Kadsura philippinensis. Four of the isolated lignans (1-4) possess the normal C18-dibenzocyclooctadiene skeleton, while the other four lignans (5-8) are C19-homolignans possessing a substituted cyclohexadienone ring with a spiro-benzofuranoid moiety. The structures of the isolated metabolites were elucidated through spectroscopic analyses, including 2D NMR experiments. Compounds 1 and 4 are the first report of an R-biphenyl configuration with a beta-oxygenated substituent at the C-9 position. The in vitro radical-scavenging activities of these compounds using DPPH were tested and evaluated. Compound 3 exhibited more potent activity than vitamins C and E.

Chemical transformation and biological activities of ambrein, a major product of ambergris from Physeter macrocephalus (sperm whale)

Ten new derivatives (2-11) of ambrein (1), isolated from ambergris, were prepared by chemical transformation. Oxidation and/or cyclization were effected by reactions with selenium oxide or p-toluenesulfonyl chloride or with the use of shortwave UV light. The structures of 2-12 were elucidated by spectroscopic analysis, with the structure and relative configuration of 9 confirmed by single-crystal X-ray crystallography. The cytotoxic activities of 1-12 were investigated against human liver carcinoma (Hepa59T/VGH), colon adenocarcinoma (WiDr), lung carcinoma (A-549), and human breast adenocarcinoma (MCF-7) cell lines. The anti-inflammatory activities of 1-11, in terms of the inhibition of human neutrophil function, were also evaluated.

Benzylamides from Salvadora persica

A phytochemical investigation of stems from Salvadora persica resulted in the first isolation of four benzylamides from a natural source. The isolated compounds were identified as butanediamide, N1,N4-bis(phenylmethyl)-2(S)-hydroxy-butanediamide (1), N-benzyl-2-phenylacetamide (2), N-benzylbenzamide (3) and benzylurea (4). The structure elucidation was accomplished using spectroscopic methods, especially 2D NMR and HREIMS. Compound 2 revealed a significant inhibitory effect on human collagen-induced platelet aggregation, and a moderate antibacterial activity against Escherichia coli.

Isolation of aureol from Smenospongia sp. and cytotoxic activity of some aureol derivatives

The sesquiterpene aureol (1) was isolated by chromatographic fractionation of a non-polar extract from Smenospongia sp. Methylation of aureol yielded 5'-O-methyl-aureol (2) while the prepared acylation products of aureol were 5'-O-acetyl-aureol (3), 5'-O-benzoyl-aureol (4), 5'-O-(4-fluoro-benzoyl)-aureol (5), 5'-O-(4-chlorobenzoyl)-aureol (6), 5'-O-(4-methylbenzoyl)-aureol (7), 5'-O-nicotinoyl-aureol (8), aureol-N,N-dimethylthiocarbamate (9), 5'-O-(2-furoylcarbonyl)-aureol (10), 5'-O-(2-thienoylcarbonyl-aureol (11). The structures of aureol as well as its ten derivatives were established through spectral analysis. The in vitro cytotoxic activities of the eleven compounds were evaluated against Hepa59T/VGH, KB and Hela tumor cell lines.

Bioactive Sesquiterpene Lactones from Eupatorium Kiirunense

Four new sesquiterpene lactones, two heliangolides, one eudesmanolide and one germacranolide, were isolated by chromatographic fractionation of an acetone extract of Eupatorium kiirunense and named eupakirunsins F, G H and I (1–4). They were identified as 8β-(3-hydroxy-2-methylen-butanoyloxy)-1β,10α-epoxy-3α-hydroxy-6βH,7αH-heliang-4Z,11(13)-dien-6,12-olide (1), 8β-tigloyloxy-1β,10α-epoxy-3β,15-dihydroxy-6βH,7αH-heliang-4Z,11(13)-dien-6,12-olide (2), 8β-tigloyloxy-1 β,3β-dihydroxy-6βH,7αH-eudesman-4(15),11(13)-dien-6,12-olide (3) and 8βtigloyloxy-3βhydroxy-1β,10β-epoxy-14-oxo-6βH,7αH-germacra-4E,11(13)-dien-6,12-olide (4). The structures and the relative configurations of the new metabolites were elucidated through extensive spectral analysis and by comparison with known spectral data. Among the isolated compounds, 1 and 3 exhibited potent cytotoxicity against WiDr and MCF-7 human tumor cell lines.

Xenicane-type diterpenes with cytotoxicity from Xenia florida

Chromatographic investigation of an acetone extract of the octocoral Xenia florida afforded three new xenicane diterpenes, namely, florxenilide A (1), florxenilide B (2), and florxenilide C (3), in addition to seven known xenicane diterpenes and two known cadinene sesquiterpenes. Structures were elucidated through spectroscopic analysis, especially 2D NMR, and chemical derivatization. The absolute configuration of 1 was determined by NOESY, CD, and Mosher's methods. Florxenilides A (1) and B (2) exhibited cytotoxicity against human colon cancer (WiDr) cells at 4.5 and 3.7 muM, respectively.

Bioactive pyranoxanthones from the roots of Calophyllum blancoi

Phytochemical investigation of the roots of Calophyllum blancoi growing in Taiwan resulted in the isolation of three new pyranoxanthones, blancoxanthone (1), acetyl blancoxanthone (2) and 3-hydroxyblancoxanthone (3), in addition to two known pyranoxanthones, pyranojacaeubin (4) and caloxanthone (5). Structural characterization of the isolated compounds was determined by spectral analyses especially 2-D NMR. Biological study of the isolated xanthones revealed that blancoxanthone (1) exhibited significant anti-coronavirus activity.

Cytotoxic sesquiterpene lactones from Eupatorium kiirunense, a coastal plant of Taiwan

Phytochemical investigation of Eupatorium kiirunense has resulted in the isolation of eight new sesquiterpene lactones, constituted by five germacranolides, eupakirunsins A-E (1-5), and three heliangolides, eupaheliangolide A (6), 15-acetoxyheliangin (7), and 3-epi-heliangin (8), in addition to the known heliangin (9) and 8,10-epoxy-9-acetoxythymol angelate (10). The structures of the new compounds were established through detailed analysis of their spectroscopic data. Compounds 6, 8, and 9 exhibited cytotoxicity against human oral epidermoid (KB), cervical epitheloid (Hela), and liver (hepa59T/VGH) carcinoma cells.

New Gemacranolides fromEupatorium hualienense

Phytochemical investigation of Eupatorium hualienense (C. H. Ou, S. W. Chung, C. I. Peng) has resulted in the isolation of the new sesquiterpene lactones 1-5, named eupahualins A-E, along with the known heliangolide eupasimplicin B (6). The structures of the isolated compounds were established through detailed spectral analyses, especially by means of 2D-NMR techniques. Compounds 1-4 and 6 showed significant activities against cell lines of human chronic myelogenous leukemia (K562) and human bone cancer (U2OS).

Juncenolides F and G, Two New Briarane Diterpenoids from Taiwanese Gorgonian Junceella juncea

Chemical investigation of the gorgonian coral Junceella juncea collected in Taiwan has resulted in the isolation of the two novel briarane-type diterpenoid compounds, juncenolides F (1) and G (2). The structures were determined on the basis of spectral studies, especially 1D and 2D NMR.

Two New Sesquiterpene Lactones from Ixeris chinensis

Phytochemical investigation of Ixeris chinensis NAKAI (Asteraceae) has resulted in the isolation of a new guaianolide-type sesquiterpene lactone, ixerochinolide (1) as well as the related glucoside, ixerochinoside (2). In addition, the known guaianolides, 8beta-hydroxy-3-oxo-guaia-4(15),10(14),11(13)-trien-1alpha,5alpha,6beta,7alphaH-12,6-olide (8beta-hydroxydehydrozaluzanin), 8beta,15-dihydroxy-2-oxo-guaia-1(10),3,11(13)-trien-5alpha,6beta,7alphaH-12,6-olide (lactucin), 3beta,8alpha,10alpha-trihydroxy-guaia-4(15),11(13)-dien-1alpha,5alpha,6beta,7alphaH-12,6-olide (10alpha-hydroxy-10,14-dihydro-desacylcynaropicrin) and 3beta-D-glucopyranosyloxy-8beta-(p-hydroxyphenylacetyloxy)-guaia-4(15),10(14),11(13)-trien-1alpha,5alpha,6beta,7alphaH-12,6-olide (8-epicrepioside) were identified. The structures were determined on the basis of spectral analyses, especially 1- and 2D NMR. Compound 1 exhibited significant cytotoxicity against human PC-3 tumor cells.

Three new taxane diterpenoids from Taxus sumatrana

Phytochemical investigation of taxane diterpenoidal content of an acetone extract of the leaves and twigs of Taxus sumatrana has resulted in the isolation of three new taxoid compounds, tasumatrols E (1), F (2), and G (3) together with 13 known taxanes (5-16). The structures of these taxanes as well as their derivatives were established on the basis of spectroscopic analyses, especially 1D and 2D NMR. Compounds 1, 2, 12, and 16 exhibited significant cytotoxicity against human A-498, NCI-H226, A549, and PC-3 tumor cells.

New regio- and stereoselective O-deacetylated and epoxy products of taxanes isolated from Taxus mairei

Deacylation of a taxoid mixture isolated from the roots of Taxus mairei followed by chromatographic fractionation resulted in the isolation of three new taxoid derivatives, 2alpha,9alpha,10beta-triacetoxy-5alpha,14beta-dihydroxy-4(20),11(12)-taxadiene (1), 9alpha,10beta-diacetoxy-2alpha,5alpha,14beta-trihydroxy-4(20),11(12)-taxadiene (2), and 9alpha,10beta-diacetoxy-2alpha,5alpha,14beta-trihydroxy-4,20-epoxy,11(12)-taxene (3). Epoxidation of 2 afforded 9alpha,10beta-diacetoxy-2alpha,5alpha,14beta-trihydroxy-4,20:11,12-diepoxytaxane (6), while epoxidation of 4 yielded 9alpha,10beta-diacetoxy-5alpha,13alpha-dihydroxy-4,20-epoxy,11(12)-taxene (7) and 9alpha,10beta-diacetoxy-5alpha,13alpha-dihydroxy-4,20:11,12-diepoxytaxane (8). The structures were elucidated by detailed analysis of their NMR spectra. The structure and relative stereochemistry of 7 was confirmed by X-ray crystallography.

New cytotoxic clerodane diterpenoids from the leaves and twigs of Casearia membranacea

Bioassay-guided fractionation of an EtOAc-soluble extract of Casearia membranacea has resulted in the isolation of six new clerodane diterpenes, caseamembrins A-F (1-6), and a known compound, rel-(2S,5R,6R,8S,9S,10R,18S,19R)-diacetoxy-18,19-epoxy-6-hydroxy-2-(2-methylbutanoyloxy)cleroda-3,13(16),14-triene (7). The structures of 1-6 were established on the basis of extensive 1D and 2D NMR spectroscopic analysis. In addition, the new derivatives, 8 and 9, were prepared by acylation of 7 and 3, respectively. The isolated diterpenoids and their derivatives were tested against human prostate (PC-3) and hepatoma (Hep3B) cancer cells. Compounds 1, 3-5, and 7 exhibited cytotoxicity against both tumor cells, with IC(50) values below 3 micromicro, while compounds 2, 6, 8, and 9 were less effective.

Two New Cytotoxic Clerodane Diterpenoids from Casearia membranacea

In addition to casearlucin A (3), two new clerodane diterpenes, caseamembrols A (1) and B (2) have been isolated from the leaves and twigs of Casearia membranacea by bioassay-guided fractionation. The structures of the new compounds were established on the basis of extensive 1D- and 2D-NMR spectroscopic analysis. Compounds 1-3 exhibited significant cytotoxicity against human prostate (PC-3) cancer cells.

Chromanones and Dihydrocoumarins from Calophyllum blancoi

Chromatographic fractionation of the acetone extract of the seeds of Calophyllum blancoi yielded six pyranochromanone derivatives; apetalic acid (1), isoapetalic acid (2), apetalic acid methyl ester (3), apetalic acid 5-O-acetate (4), isoapetalic methyl ester (5), and isoapetalic acid 5-O-acetate (6). In addition, one new dihydrocoumarin derivative, isorecedensolide (7), was also isolated together with recedensolide (8). The structures of the isolated compounds were established through analysis of NMR spectral data including 2D techniques as well as other physical and spectroscopic methods. Compounds 3, 4, 5, 7, and 8 showed mild activity against KB (human oral epidermoid carcinoma) and Hela (human cervical epitheloid carcinoma) tumor cell lines.

Vibsane diterpenoids from the leaves and flowers of Viburnum odoratissimum

In addition to the five known compounds 5-epi-vibsanin H, vibsanins C, H, and G, and aldovibsanin B, four new diterpenes, 5-epi-vibsanin G (1), 18-O-methylvibsanin G (2), vibsanin M (3), and aldovibsanin C (4), were isolated from an acetone extract of the leaves and flowers of Viburnum odoratissimum by bioassay-directed fractionation. In addition, two acetyl derivatives 5 and 6 were obtained from the naturally occurring diterpenes. The structures of the new compounds were established on the basis of NMR spectral analysis, including COSY, HMQC, HMBC, and NOESY correlations. The compounds were evaluated for cytotoxicity against human nasopharyngeal carcinoma (HONE-1) tumor cells and human gastric cancer (NUGC-3) cells.

Antiplatelet and anti-HIV constituents from Euchresta formosana

Phytochemical investigation of the methanol extract of Euchresta formosana resulted in the isolation of thirty-four compounds. Compounds 1, 3-12, 15, 27, 29 and 32-24 were isolated from this species for the first time. These compounds were identified by spectral analyses and tested for antiplatelet aggregation and anti-HIV activities. Among these compounds, tectorigenin (1), 3',4',5-trihydroxyisoflavone (3), and euchretin F (19) were the most effective antiplatelet aggregation compounds; they inhibited both AA- (arachidonic acid) and collagen-induced platelet aggregation. Meanwhile, flemiphyllin (B), quercetin (13), euchretin M (23), and formosanatin C (26) inhibited HIV replication in H9 lymphocyte cells.

Chemical constituents from the Hydrangea chinensis

Two quinazolone alkaloids, (+)-febrifugine (1) and isofebrifugine (2), along with three coumarin derivatives, 6-hydroxy coumarin (3), skimmin (5), and umbelliferone-7-O-alpha-L-rhamnopyranosyl(1-->4)-beta-D-glucopyranoside (6), were isolated from the roots of Hydrangea chinensis. Compound 6 is a new compound. In addition, umbelliferone (4), linoleic acid (7), two steroidal glycosides (8, 9), three furfural derivatives (10-12), and butyl-beta-D-fructofuranoside (13) were isolated from the leaves of the same plant. The structures of all isolates were elucidated by spectral methods.

Pregnane glycosides from Caralluma retrospiciens

Two pregnane ester glycosides were isolated and identified from the alcohol extract of the aerial parts of Caralluma retrospiciens. Their structures were established as 12 beta-benzoyloxy-20-isovaleroyloxy-8 beta,14 beta-dihydroxypregnane-3-O -[beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranosyl -(1-->4)-beta-D-(3-O-methyl-6-deoxy)-galactopyranoside] (caretroside A) and the bioside 12 beta-benzoyloxy-8 beta,14 beta-dihydroxypregn-20-one-3-O-[beta -D-oleandropyranosyl-(1-->4)-beta-D-cymaropyranoside]. They were characterized through physical and chemical methods in addition to standard spectroscopic techniques especially 2D NMR (COSY, HMQC and HMBC). This is the first report of the isolation of these compounds from a natural source.

Guaianolides from Lactuca saligna

The phytochemical investigation of the aerial parts of LACTUCA SALIGNA L. revealed the presence of lactucin, lactucopicrin, and a new guaianolide named 11beta,13-dihydrolactucopicrin. The structural configuration was established through spectral data.