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Roncati L, Marra C, Gravina D, Di Massa G, Della Rosa N, Adani R. Ultramicronized Palmitoylethanolamide and Luteolin: Drug Candidates in Post-COVID-19 Critical Illness Neuropathy and Positioning-Related Peripheral Nerve Injury of the Upper Extremity. J Hand Microsurg 2024; 16:100028. [PMID: 38855524 PMCID: PMC11144630 DOI: 10.1055/s-0043-1764161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is the most dramatic pandemic of the new millennium and patients with serious infection can stay in intensive care unit (ICU) for weeks in a clinical scenario of systemic inflammatory response syndrome, likely related to the subsequent development of critical illness polyneuropathy (CIP). It is in fact now accepted that COVID-19 ICU surviving patients can develop CIP; moreover, prone positioning-related stretch may favor the onset of positioning-related peripheral nerve injuries (PNI). Therefore, the urgent need to test drug candidates for the treatment of these debilitating sequelae is emerged even more. For the first time in medical literature, we have successfully treated after informed consent a 71-year-old Italian man suffering from post-COVID-19 CIP burdened with positioning-related PNI of the left upper extremity by means of ultramicronized palmitoylethanolamide 400 mg plus ultramicronized luteolin 40 mg (Glìalia), two tablets a day 12 hours apart for 6 months. In the wake of our pilot study, a larger clinical trial to definitively ascertain the advantages of this neuroprotective, neurotrophic, and anti-inflammatory therapy is advocated.
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Affiliation(s)
- Luca Roncati
- Department of Surgery, Medicine, Dentistry, and Morphological Sciences with interest in Transplantation, Oncology and Regenerative Medicine, Institute of Pathology, University of Modena and Reggio Emilia, Polyclinic Hospital, Modena, Italy
| | - Caterina Marra
- Department of General Surgery and Surgical Specialties, Unit of Plastic and Reconstructive Surgery, University Hospital of Modena, Modena, Italy
| | - Davide Gravina
- Department of Musculoskeletal System, Unit of Orthopedics and Traumatology, University Hospital of Modena, Modena, Italy
| | - Gianluca Di Massa
- Department of Surgery, Medicine, Dentistry, and Morphological Sciences with interest in Transplantation, Oncology and Regenerative Medicine, Institute of Pathology, University of Modena and Reggio Emilia, Polyclinic Hospital, Modena, Italy
| | - Norman Della Rosa
- Department of Musculoskeletal System, Unit of Hand Surgery and Microsurgery, University Hospital of Modena, Modena, Italy
| | - Roberto Adani
- Department of Musculoskeletal System, Unit of Hand Surgery and Microsurgery, University Hospital of Modena, Modena, Italy
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Di Stadio A, Cantone E, De Luca P, Di Nola C, Massimilla EA, Motta G, La Mantia I, Motta G. Parosmia COVID-19 Related Treated by a Combination of Olfactory Training and Ultramicronized PEA-LUT: A Prospective Randomized Controlled Trial. Biomedicines 2023; 11:biomedicines11041109. [PMID: 37189728 DOI: 10.3390/biomedicines11041109] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/29/2023] [Accepted: 04/05/2023] [Indexed: 04/09/2023] Open
Abstract
During COVID-19 pandemic, clinicians have had to deal with an ever-increasing number of cases of olfactory disturbances after SARS-CoV-2 infections and in some people this problem persisted for long time after negativization from virus. This a prospective randomized controlled trial aims at evaluating the efficacy of ultramicronized palmitoylethanolamide (PEA) and Luteolin (LUT) (umPEA-LUT) and olfactory training (OT) compared to OT alone for the treatment of smell disorders in Italian post-COVID population. We included patients with smell loss and parosmia who were randomized and assigned to Group 1 (intervention group; daily treatment with umPEA-LUT oral supplement and OT) or Group 2 (control group; daily treatment with placebo and OT). All subjects were treated for 90 consecutive days. The Sniffin’ Sticks identification test was used to assess the olfactory functions at the baseline (T0) and the end of the treatment (T1). Patients were queried regarding any perception of altered olfaction (parosmia) or aversive smell, such as cacosmia, gasoline-type smell, or otherwise at the same observational points. This study confirmed the efficacy of combination of umPEA-LUT and olfactory training as treatment of quantitative smell alteration COVID-19 related, but the efficacy of the supplement for parosmia was limited. UmpEA-LUT is useful for the treatment of brain neuro-inflammation (origin of quantity smell disorders) but has limited/no effect on peripheral damage (olfactory nerve, neuro-epithelium) that is responsible of quality disorders.
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Affiliation(s)
- Arianna Di Stadio
- Department GF Ingrassia, Otolaryngology Unit, University of Catania, 95131 Catania, Italy
| | - Elena Cantone
- Department of Otolaryngology, Federico II University, 80131 Naples, Italy
| | - Pietro De Luca
- Department of Otolaryngology, San-Giovanni Addolorata Hospital, 00100 Rome, Italy
| | - Claudio Di Nola
- Department of Otolaryngology, Federico II University, 80131 Naples, Italy
| | - Eva A. Massimilla
- Department of Otolaryngology, Volvatellid University, 81055 Naples, Italy
| | - Giovanni Motta
- Department of Otolaryngology, Volvatellid University, 81055 Naples, Italy
| | - Ignazio La Mantia
- Department GF Ingrassia, Otolaryngology Unit, University of Catania, 95131 Catania, Italy
| | - Gaetano Motta
- Department of Otolaryngology, Volvatellid University, 81055 Naples, Italy
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Asvapoositkul V, Samuthpongtorn J, Aeumjaturapat S, Snidvongs K, Chusakul S, Seresirikachorn K, Kanjanaumporn J. Therapeutic options of post-COVID-19 related olfactory dysfunction: a systematic review and meta-analysis. Rhinology 2023; 61:2-11. [PMID: 36173148 DOI: 10.4193/rhin22.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Olfactory dysfunction is a typical post-COVID-19 presentation, affecting patients' quality of life. There are currently multiple treatment options in this group of patients such as oral and intranasal corticosteroids, olfactory training, oral vitamin-mineral supplementation, amongst others. This meta-analysis aims to consolidate existing evidence for current therapies in patients with persistent olfactory dysfunction related to COVID-19 infection and evaluate the possible role of corticosteroid add-on therapy in olfactory training. METHODOLOGY A systematic review and meta-analysis to study current treatments/interventions for olfactory dysfunction in post-COVID-19 infection were conducted. Data were pooled for the meta-analysis. The outcomes include subjective or objective olfactory assessment major and minor adverse reactions. RESULTS Eleven studies (1414 participants) were included in this review, with six studies (916 participants) then assessed for the meta-analysis. Combined treatment of intranasal corticosteroid (INCS) with olfactory training (OT) has no benefit over OT monotherapy from both a VAS score improvement and identification component of Sniffin' Sticks test standpoint. In addition, there were no differences in improvement of TDI score between combined oral corticosteroid (OCS) with OT therapy compared to OT alone. Olfactory function was, however, significantly improved after OT. CONCLUSION There were no significant differences in the improvement of olfactory scores in combination INCS+OT or OCS+OT therapies compared to OT monotherapy. However, there is improvement in olfactory function after OT.
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Affiliation(s)
- V Asvapoositkul
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Samuthpongtorn
- Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - S Aeumjaturapat
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - K Snidvongs
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - S Chusakul
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - K Seresirikachorn
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - J Kanjanaumporn
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Shchukin IA, Fidler MS, Koltsov IA, Suvorov AY. COVID-19-Associated Stroke. NEUROSCIENCE AND BEHAVIORAL PHYSIOLOGY 2022; 52:649-656. [PMID: 36119649 PMCID: PMC9468522 DOI: 10.1007/s11055-022-01291-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022]
Abstract
The COVID-19 pandemic has had significant influences on the incidence of acute cerebrovascular accidents and the structure of mortality. SARS-CoV-2 increases the risks of developing both ischemic and hemorrhagic stroke. The key pathogenetic element underlying the development of cerebral stroke in COVID-19 consists of impairments to the operation of angiotensin 2 receptors, which are accompanied by accumulation of excess quantities of angiotensin 2, endothelial dysfunction, hypercoagulation, overproduction of proinflammatory cytokines, and an oxidative storm. In patients with stroke and COVID-19, lesion severity is associated with dual mechanisms of ischemia – systemic and cerebral. The possibilities of medication-based correction of both systemic impairments associated with coronavirus infection and local impairments due to ischemic or hemorrhagic brain damage, are limited. Substances with antioxidant activity may potentially be effective in patients with stroke and COVID-19. Data from a number of clinical rials indicate that Mexidol significantly improves functional outcomes in ischemic stroke. Use of Mexidol in patients with stroke and COVID-19 is advised.
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Affiliation(s)
- I. A. Shchukin
- Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia
| | - M. S. Fidler
- Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia
| | - I. A. Koltsov
- Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia
| | - A. Yu. Suvorov
- Federal Center for the Brain and Neurotechnology, Federal Medical Biological Agency of Russia, Moscow, Russia
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Oyeyinka SA, Gbashi S, A. Onarinde B, Adebo OA, Njobeh PB. Metabolite profile of raw and cooked pasta from whole wheat grain enriched with Bambara groundnut. J FOOD PROCESS PRES 2022. [DOI: 10.1111/jfpp.17152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Samson A. Oyeyinka
- Centre of Excellence in Agr‐food Technologies, National Centre for Food Manufacturing University of Lincoln Holbeach, PE12 7PT UK
- Department of Biotechnology and Food Technology, Faculty of Science University of Johannesburg P.O. Box 17011, Doornfontein Campus Gauteng South Africa
| | - Sefater Gbashi
- Department of Biotechnology and Food Technology, Faculty of Science University of Johannesburg P.O. Box 17011, Doornfontein Campus Gauteng South Africa
| | - Bukola A. Onarinde
- Centre of Excellence in Agr‐food Technologies, National Centre for Food Manufacturing University of Lincoln Holbeach, PE12 7PT UK
| | - Oluwafemi A. Adebo
- Department of Biotechnology and Food Technology, Faculty of Science University of Johannesburg P.O. Box 17011, Doornfontein Campus Gauteng South Africa
| | - Patrick B. Njobeh
- Department of Biotechnology and Food Technology, Faculty of Science University of Johannesburg P.O. Box 17011, Doornfontein Campus Gauteng South Africa
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Raciti L, Arcadi FA, Calabrò RS. Could Palmitoylethanolamide Be an Effective Treatment for Long-COVID-19? Hypothesis and Insights in Potential Mechanisms of Action and Clinical Applications. INNOVATIONS IN CLINICAL NEUROSCIENCE 2022; 19:19-25. [PMID: 35382075 PMCID: PMC8970234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
COVID-19 is highly transmissive and contagious disease with a wide spectrum of clinicopathological issues, including respiratory, vasculo-coagulative, and immune disorders. In some cases of COVID-19, patients can be characterized by clinical sequelae with mild-to-moderate symptoms that persist long after the resolution of the acute infection, known as long-COVID, potentially affecting their quality of life. The main symptoms of long-COVID include persistent dyspnea, fatigue and weakness (that are typically out of proportion, to the degree of ongoing lung damage and gas exchange impairment), persistence of anosmia and dysgeusia, neuropsychiatric symptoms, and cognitive dysfunctions (such as brain fog or memory lapses). The appropriate management and prevention of potential long-COVID sequelae is still lacking. It is also believed that long-term symptoms of COVID-19 are related to an immunity over-response, namely a cytokine storm, involving the release of pro-inflammatory interleukins, monocyte chemoattractant proteins, and tissue necrosis factors. Palmitoylethanolamide (PEA) shows affinity for vanilloid receptor 1 and for cannabinoid-like G protein-coupled receptors, enhancing anandamide activity by means of an entourage effect. Due to its anti-inflammatory properties, PEA has been recently used as an early add-on therapy for respiratory problems in patients with COVID-19. It is believed that PEA mitigates the cytokine storm modulating cell-mediated immunity, as well as counteracts pain and oxidative stress. In this article, we theorize that PEA could be a potentially effective nutraceutical to treat long-COVID, with regard to fatigue and myalgia, where a mythocondrial dysfunction is hypothesizable.
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Affiliation(s)
- Loredana Raciti
- Drs. Raciti, Arcadi, and Calabrò are with IRCCS Centro Neurolesi "Bonino Pulejo" in Messina, Italy
| | - Francesca Antonia Arcadi
- Drs. Raciti, Arcadi, and Calabrò are with IRCCS Centro Neurolesi "Bonino Pulejo" in Messina, Italy
| | - Rocco Salvatore Calabrò
- Drs. Raciti, Arcadi, and Calabrò are with IRCCS Centro Neurolesi "Bonino Pulejo" in Messina, Italy
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Roncati L, Gianotti G, Gravina D, Attolini G, Zanelli G, Rosa ND, Adani R. Carpal, cubital or tarsal tunnel syndrome after SARS-CoV-2 infection: A causal link? Med Hypotheses 2021; 153:110638. [PMID: 34217126 PMCID: PMC8223113 DOI: 10.1016/j.mehy.2021.110638] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022]
Abstract
COVID-19 is a complex disease with many clinicopathological issues, including respiratory, gastrointestinal, neurological, renal, cutaneous, and coagulative ones; in addition, reactive arthritis has been reported by different authors. Here, we hypothesize that a peripheral microangiopathy involving nerve supply, a viral demyelination, or an immune-mediated irritating antigenic stimulus on synovial sheaths after SARS-CoV-2 infection may all induce a carpal, cubital or tarsal tunnel syndrome of variable entity in genetically predisposed subjects associated with myxoid nerve degeneration.
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Affiliation(s)
- Luca Roncati
- Institute of Pathology, University of Modena and Reggio Emilia, Modena, Italy.
| | - Greta Gianotti
- Institute of Pathology, University of Modena and Reggio Emilia, Modena, Italy
| | - Davide Gravina
- Unit of Orthopedics and Traumatology, University Hospital of Modena, Modena, Italy
| | - Giovanna Attolini
- Institute of Pathology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuliana Zanelli
- Institute of Pathology, University of Modena and Reggio Emilia, Modena, Italy
| | - Norman Della Rosa
- Unit of Hand Surgery and Microsurgery, University Hospital of Modena, Modena, Italy
| | - Roberto Adani
- Unit of Hand Surgery and Microsurgery, University Hospital of Modena, Modena, Italy
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Peritore AF, D’Amico R, Siracusa R, Cordaro M, Fusco R, Gugliandolo E, Genovese T, Crupi R, Di Paola R, Cuzzocrea S, Impellizzeri D. Management of Acute Lung Injury: Palmitoylethanolamide as a New Approach. Int J Mol Sci 2021; 22:ijms22115533. [PMID: 34073872 PMCID: PMC8197255 DOI: 10.3390/ijms22115533] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 12/12/2022] Open
Abstract
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are common and devastating clinical disorders with high mortality and no specific therapy. Lipopolysaccharide (LPS) is usually used intratracheally to induce ALI in mice. The aim of this study was to examine the effects of an ultramicronized preparation of palmitoylethanolamide (um-PEA) in mice subjected to LPS-induced ALI. Histopathological analysis reveals that um-PEA reduced alteration in lung after LPS intratracheal administration. Besides, um-PEA decreased wet/dry weight ratio and myeloperoxidase, a marker of neutrophils infiltration, macrophages and total immune cells number and mast cells degranulation in lung. Moreover, um-PEA could also decrease cytokines release of interleukin (IL)-6, interleukin (IL)-1β, tumor necrosis factor (TNF)-α and interleukin (IL)-18. Furthermore, um-PEA significantly inhibited the phosphorylation of nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor, alpha (IκBα) and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) activation in ALI, and at the same time decreased extracellular signal-regulated kinase 1/2 (ERK1/2), c-Jun N-terminal kinase (JNK) and p38 mitogen-activated protein kinase (p38/MAPK) expression, that was increased after LPS administration. Our study suggested that um-PEA contrasted LPS-induced ALI, exerting its potential role as an adjuvant anti-inflammatory therapeutic for treating lung injury, maybe also by p38/NF-κB pathway.
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Affiliation(s)
- Alessio Filippo Peritore
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98122 Messina, Italy; (A.F.P.); (R.D.); (R.S.); (R.F.); (T.G.); (D.I.)
| | - Ramona D’Amico
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98122 Messina, Italy; (A.F.P.); (R.D.); (R.S.); (R.F.); (T.G.); (D.I.)
| | - Rosalba Siracusa
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98122 Messina, Italy; (A.F.P.); (R.D.); (R.S.); (R.F.); (T.G.); (D.I.)
| | - Marika Cordaro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy;
| | - Roberta Fusco
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98122 Messina, Italy; (A.F.P.); (R.D.); (R.S.); (R.F.); (T.G.); (D.I.)
| | - Enrico Gugliandolo
- Department of Veterinary Science, University of Messina, 98122 Messina, Italy; (E.G.); (R.C.)
| | - Tiziana Genovese
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98122 Messina, Italy; (A.F.P.); (R.D.); (R.S.); (R.F.); (T.G.); (D.I.)
| | - Rosalia Crupi
- Department of Veterinary Science, University of Messina, 98122 Messina, Italy; (E.G.); (R.C.)
| | - Rosanna Di Paola
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98122 Messina, Italy; (A.F.P.); (R.D.); (R.S.); (R.F.); (T.G.); (D.I.)
- Correspondence: (R.D.P.); (S.C.); Tel.: +39-90-6765208 (S.C.)
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98122 Messina, Italy; (A.F.P.); (R.D.); (R.S.); (R.F.); (T.G.); (D.I.)
- Department of Pharmacological and Physiological Science, Saint Louis University School of Medicine, Saint Louis, MO 63104, USA
- Correspondence: (R.D.P.); (S.C.); Tel.: +39-90-6765208 (S.C.)
| | - Daniela Impellizzeri
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98122 Messina, Italy; (A.F.P.); (R.D.); (R.S.); (R.F.); (T.G.); (D.I.)
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Shchukin I, Fidler M, Koltsov I, Suvorov A. COVID-19 related stroke. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:69-76. [DOI: 10.17116/jnevro202112112269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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