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Sütçü M, Kara M, Yıldız F, Kılıç Ö, Tural Kara T, Akkoc G, Büyükçam A, Elmas Bozdemir Ş, Özgür Gündeşlioğlu Ö, Gül D, İseri Nepesov M, Kara A. Hand, foot, and mouth disease: could EPs® 7630 be a treatment option? A prospective randomized open-label multicenter clinical study. Front Pediatr 2024; 12:1274010. [PMID: 38832001 PMCID: PMC11146204 DOI: 10.3389/fped.2024.1274010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 04/09/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose Hand, foot and mouth disease (HFMD) is a viral contagious disease of children caused by human enteroviruses (EVs) and coxsackieviruses (CVs). There is no specific treatment option for HFMD. EPs® 7630's anti-infective and immunomodulatory properties have previously been demonstrated in several in vitro and in vivo studies; however, the use of this herbal medicine in children with HFMD has not previously been investigated. Methods This prospective randomized multicenter clinical study included 208 children with HFMD. The diagnosis was made by pediatricians. The patients who were within the first 48 h of symptom onset (according to the first onset of fever and skin findings) were enrolled. The study participants were assigned into 2 groups as EPs® 7630 and control groups. All patients were followed up twice more, 48 h after the first admission and on the 5th-7th day. Another phone evaluation was conducted for those with continued complaints from the previous visit. Results The median age was 27 (12-112) months. The male-female ratio was 0.98. One hundred thirty one (63%) of 190 patients had no history of household contact. EPs® 7630 group included 94 and control group included 96 patients. A significant difference was found between the groups in terms of complaint scores at the visits made at the 48th h of the treatment and on days 5-7 (p < 0.001). The mean ± SD disease duration of EPs® 7630 users was significantly shorter 6.07 ± 0.70 days (95% CI: 5.92-6.21)] than the control group [8.58 ± 0.94 days (95% CI: 8.39-8.77)] (p < 0.001). Besides, the hospitalization rate among the EPs® 7630 users were significantly lower (p = 0.019). No side effects were observed, except for unpleasant taste, which was reported in 5 patients (EPs® 7630 group). Conclusion Considering its efficacy and safety profile EPs® 7630 may represent a feasible herbal-based treatment option for children with HFMD. Clinical Trial Registration ClinicalTrials.gov, identifier (NCT06353477).
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Affiliation(s)
- Murat Sütçü
- Pediatric Infectious Diseases, Faculty of Medicine, Istinye University, Istanbul, Türkiye
- Pediatrics, Faculty of Medicine, Istinye University, Istanbul, Türkiye
| | - Manolya Kara
- Pediatric Infectious Diseases, Faculty of Medicine, Yeditepe University, Istanbul, Türkiye
| | - Funda Yıldız
- Pediatrics, Faculty of Medicine, Istinye University, Istanbul, Türkiye
| | - Ömer Kılıç
- Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Türkiye
| | - Tugce Tural Kara
- Pediatric Infectious Diseases, Faculty of Medicine, Akdeniz University, Antalya, Türkiye
| | - Gulsen Akkoc
- Pediatric Infectious Diseases, University of Health Sciences Van Research and Training Hospital, Van, Türkiye
| | - Ayşe Büyükçam
- Pediatric Infectious Diseases, Cengiz Gokcek Maternity and Children's Hospital, Gaziantep, Türkiye
| | | | | | - Doruk Gül
- Pediatrics, Faculty of Medicine, Istinye University, Istanbul, Türkiye
| | - Merve İseri Nepesov
- Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Türkiye
| | - Ateş Kara
- Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
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Malek FA, Funk P. Identifying in-market application of Pelargonium root extract EPs 7630 for the treatment of COVID-19: analysis of pharmacovigilance data. Front Pharmacol 2024; 15:1335309. [PMID: 38464728 PMCID: PMC10920291 DOI: 10.3389/fphar.2024.1335309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/01/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction: Phytopharmaceutical products are successfully used for acute respiratory infections and may therefore be promising candidates for adjuvant symptomatic treatment of COVID-19. In vitro and clinical studies suggest that the proprietary Pelargonium sidoides DC. root extract EPs 7630 has antiviral and immunomodulatory properties, and effects on SARS-CoV-2 propagation have been shown in vitro. Medicinal products containing the extract have been approved for the symptomatic treatment of acute viral respiratory tract infections. Methods: We present a retrospective review of case reports submitted spontaneously to the pharmacovigilance database of the manufacturer of EPs 7630 and containing information on the off-label use of the extract for the treatment and prophylaxis of COVID-19 and of post-COVID-19 syndrome. Eligible case reports were identified by automated database searches. Results: Forty-four case reports filed between December 2019 and February 2023 were eligible for analysis. More than ¾ described the use of EPs 7630 for treatment of COVID-19 while the remaining reports referred to the treatment of post-COVID-19 syndrome or to COVID-19 prophylaxis. 15/22 cases which reported on treatment duration indicated an intake of EPs 7630 for up to 7 days. Five case reports indicated the use of EPs 7630 as COVID-19 monotherapy while 14 indicated a combination treatment with other drugs. All 28 cases that reported on treatment outcome characterized the patients as improved. Thirty case reports (68%) did not indicate any complications. The most frequent suspected adverse reactions were gastrointestinal complaints and hypersensitivity reactions, both of which may occur as known adverse effects of EPs 7630. No unexpected adverse reactions were observed. Conclusion: Reported cases confirm that there was a certain off-label use of EPs 7630 for COVID-19 in the market. Even though no formal conclusions about the efficacy of EPs 7630 in COVID-19 can be drawn, a beneficial effect would be explainable by the pharmacological profile of the extract. Further assessment of the effects of EPs 7630 in COVID-19-related indications therefore appears to be both justified and promising, particularly as the available case reports did not give rise to any safety concerns also in this patient group.
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Affiliation(s)
| | - Petra Funk
- Research and Development, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
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Brendler T, Stander MA, van Wyk BE. Stevens' Cure (Umckaloabo)-the vindication of a patent medicine. Front Pharmacol 2024; 14:1294997. [PMID: 38235116 PMCID: PMC10791834 DOI: 10.3389/fphar.2023.1294997] [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: 09/15/2023] [Accepted: 12/08/2023] [Indexed: 01/19/2024] Open
Abstract
Stevens' Cure (Umckaloabo) emerged as a patent medicine claiming to treat tuberculosis in the United Kingdom at the beginning of the 20th century. However, due to its identity being shrouded in secrecy, it was never truly accepted by the medical community. It was "rediscovered" in the 1970s and subsequently developed into a very popular and successful phytopharmaceutical for the treatment of upper respiratory tract infections. Whether Stevens' Cure contained the same ingredient(s) as the modern Umckaloabo has not yet been demonstrated. We attempted to elucidate for the first time the identity of the original ingredient by comparative analysis of historical product samples. Three historical samples of Stevens' Cure were compared with Pelargonium sidoides DC. and P. reniforme Curt. root per UPLC-MS analysis. We confirm that the ingredient-P. sidoides DC.-is indeed the same as used in modern phytotherapy. We also attribute the first ethnopharmacological record of P. sidoides DC. being used for the treatment of tuberculosis to C. H. Stevens, the "creator" of Umckaloabo.
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Affiliation(s)
- T. Brendler
- Department of Botany and Plant Biotechnology, University of Johannesburg, Johannesburg, South Africa
| | - M. A. Stander
- Department of Biochemistry, University of Stellenbosch, Stellenbosch, South Africa
- Mass Spectrometry Unit, Central Analytical Facility, University of Stellenbosch, Stellenbosch, South Africa
| | - B.-E. van Wyk
- Department of Botany and Plant Biotechnology, University of Johannesburg, Johannesburg, South Africa
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Pourova J, Dias P, Pour M, Bittner Fialová S, Czigle S, Nagy M, Tóth J, Balázs VL, Horváth A, Csikós E, Farkas Á, Horváth G, Mladěnka P. Proposed mechanisms of action of herbal drugs and their biologically active constituents in the treatment of coughs: an overview. PeerJ 2023; 11:e16096. [PMID: 37901462 PMCID: PMC10607228 DOI: 10.7717/peerj.16096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/24/2023] [Indexed: 10/31/2023] Open
Abstract
Various medicinal plants find their use in cough treatment, based on traditions and long-term experience. Pharmacological principles of their action, however, are much less known. Herbal drugs usually contain a mixture of potentially active compounds, which can manifest diverse effects. Expectorant or antitussive effects, which can be accompanied by others, such as anti-inflammatory or antibacterial, are probably the most important in the treatment of coughs. The aim of this review is to summarize the current state of knowledge of the effects of medicinal plants or their constituents on cough, based on reliable pharmacological studies. First, a comprehensive description of each effect is provided in order to explain the possible mechanism of action in detail. Next, the results related to individual plants and substances are summarized and critically discussed based on pharmacological in vivo and in vitro investigation.
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Affiliation(s)
- Jana Pourova
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University Prague, Hradec Králové, Czech Republic
| | - Patricia Dias
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University Prague, Hradec Králové, Czech Republic
| | - Milan Pour
- Department of Organic and Bioorganic Chemistry, Faculty of Pharmacy, Charles University Prague, Hradec Králové, Czech Republic
| | - Silvia Bittner Fialová
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovak Republic
| | - Szilvia Czigle
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovak Republic
| | - Milan Nagy
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovak Republic
| | - Jaroslav Tóth
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovak Republic
| | | | - Adrienn Horváth
- Department of Pharmaceutical Biology, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Eszter Csikós
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Ágnes Farkas
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Györgyi Horváth
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University Prague, Hradec Králové, Czech Republic
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Fang L, Zhou L, Kulić Ž, Lehner MD, Tamm M, Roth M. EPs ® 7630 Stimulates Tissue Repair Mechanisms and Modifies Tight Junction Protein Expression in Human Airway Epithelial Cells. Int J Mol Sci 2023; 24:11230. [PMID: 37446408 DOI: 10.3390/ijms241311230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
Airway epithelium repair after infection consists of wound repair, re-synthesis of the extracellular matrix (ECM), and tight junction proteins. In humans, EPs® 7630 obtained from Pelargonium sidoides roots reduces the severity and duration of acute respiratory tract infections. The effect of EPs® 7630 on tissue repair of rhinovirus-16 (RV-16) infected and control human airway epithelial cells was assessed for: (i) epithelial cell proliferation by manual cell counts, (ii) epithelial wound repair by "scratch assay", (iii) ECM composition by Western-blotting and cell-based ELISA, and (iv) epithelial tight junction proteins by Western-blotting. EPs® 7630 stimulated cell proliferation through cAMP, CREB, and p38 MAPK. EPs® 7630 significantly improved wound repair. Pro-inflammatory collagen type-I expression was reduced by EPs® 7630, while fibronectin was increased. Virus-binding tight junction proteins desmoglein2, desmocollin2, ZO-1, claudin1, and claudin4 were downregulated by EPs® 7630. The RV16-induced shift of the ECM towards the pro-inflammatory type was prevented by EPs® 7630. Most of the effects of EPs® 7630 on tissue repair and regeneration were sensitive to inhibition of cAMP-induced signaling. The data suggest that EPs® 7630-dependent modification of epithelial cell metabolism and function might underlie the faster recovery time from viral infections, as reported by others in clinical studies.
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Affiliation(s)
- Lei Fang
- Pulmonary Cell Research, Department of Biomedicine & Clinic of Pneumology, University and University Hospital Basel, CH-4031 Basel, Switzerland
| | - Liang Zhou
- Pulmonary Cell Research, Department of Biomedicine & Clinic of Pneumology, University and University Hospital Basel, CH-4031 Basel, Switzerland
| | - Žarko Kulić
- Preclinical Research and Development, Dr. Willmar Schwabe GmbH & Co. KG, D-76227 Karlsruhe, Germany
| | - Martin D Lehner
- Preclinical Research and Development, Dr. Willmar Schwabe GmbH & Co. KG, D-76227 Karlsruhe, Germany
| | - Michael Tamm
- Pulmonary Cell Research, Department of Biomedicine & Clinic of Pneumology, University and University Hospital Basel, CH-4031 Basel, Switzerland
| | - Michael Roth
- Pulmonary Cell Research, Department of Biomedicine & Clinic of Pneumology, University and University Hospital Basel, CH-4031 Basel, Switzerland
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Matthys H, Funk P, Zimmermann A, Lehmacher W. Effects of EPs 7630 on the duration of inability to work in acute bronchitis - a meta-analysis. Multidiscip Respir Med 2023; 18:914. [PMID: 37476531 PMCID: PMC10355130 DOI: 10.4081/mrm.2023.914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/11/2023] [Indexed: 07/22/2023] Open
Abstract
Background Acute bronchitis (AB) has an enormous economic impact through lost working time. We investigated whether treatment with Pelargonium extract EPs 7630 may reduce the time of inability to work. Methods A meta-analysis of double-blind, randomized, placebo-controlled trials with adult patients suffering from AB was performed. The average number of days of inability to work and the proportion of patients who were still unable to work after one week's treatment were assessed. Results Four clinical trials with a total of 1,011 evaluable patients who received the marketed dosage of EPs 7630 (n=505) or placebo (n=506) for seven days were included in the meta-analysis. At baseline, 845/1,011 patients (83.6%) were unable to work. In the four trials, the proportion decreased to between 19 and 14% for EPs 7630 and to between 41 and 55% for placebo (meta-analysis risk ratio and 95% confidence interval: 0.35; 0.26-0.45; p<0.001). For the number of sick days, a weighted mean difference of 1.73 days (1.17-2.29 days; p<0.001) favoring EPs 7630 was observed. Conclusions For adults suffering from AB, this meta-analysis demonstrates that seven days' treatment with Pelargonium sidoides extract EPs 7630 significantly reduces the average number of sick days and significantly increases the proportion of patients who are able to return to work.
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Affiliation(s)
- Heinrich Matthys
- Medical Director Emeritus, Department of Pneumology, Freiburg University Hospital, Freiburg
| | - Petra Funk
- Research and Development Department, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe
| | - Andrea Zimmermann
- Research and Development Department, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe
| | - Walter Lehmacher
- Emeritus, Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany
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Kamin W, Behre U, Helm K, Reling B, Funk P, Malek FA. Safety of Pelargonium extract EPs 7630 in young children with acute bronchitis. Front Pediatr 2023; 11:1107984. [PMID: 36865690 PMCID: PMC9971625 DOI: 10.3389/fped.2023.1107984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/19/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The efficacy and tolerability of Pelargonium sidoides DC. root extract EPs 7630 in children with acute bronchitis (AB) have been widely demonstrated. We investigated the safety and tolerability of a syrup formulation and an oral solution in pre-school children. METHODS In an open-label, randomized clinical trial (EudraCT number 2011-002652-14), children aged 1-5 years suffering from AB received EPs 7630 syrup or solution for 7 days. Safety was assessed by frequency, severity, and nature of adverse events (AE), vital signs, and laboratory values. Outcome measures for evaluating the health status were the intensity of coughing, pulmonary rales, and dyspnea, measured by the short version of the Bronchitis Severity Scale (BSS-ped), further symptoms of the respiratory infection, general health status according to the Integrative Medicine Outcomes Scale (IMOS), and satisfaction with treatment according to the Integrative Medicine Patient Satisfaction Scale (IMPSS). RESULTS 591 children were randomized and treated with syrup (n = 403) or solution (n = 188) for 7 days. In both treatment groups, the number of adverse events was similarly low and revealed no safety concerns. The most frequently observed events were infections (syrup: 7.2%; solution: 7.4%) or gastrointestinal disorders (syrup: 2.7%; solution: 3.2%). After one week's treatment, more than 90% of the children experienced an improvement or remission of the symptoms of the BSS-ped. Further respiratory symptoms decreased similarly in both groups. At Day 7, more than 80% of the whole study population had completely recovered or showed a major improvement as assessed by the investigator and the proxy, respectively. Parents were "very satisfied" or "satisfied" with the treatment in 86.1% of patients in the combined syrup and solution group. CONCLUSION Both pharmaceutical forms, EPs 7630 syrup and oral solution, were shown to be equally safe and well tolerated in pre-school children suffering from AB. Improvement of health status and of complaints were similar in both groups.
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Affiliation(s)
- Wolfgang Kamin
- Children's Hospital, Evangelic Hospital, Hamm, Germany.,Faculty of Medicine, Pomeranian Medical University, Szczecin, Poland
| | | | | | | | - Petra Funk
- Research and Development, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
| | - Fathi Abdul Malek
- Research and Development, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
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Investigation of the prevalence of non-COVID-19 infectious diseases during the COVID-19 pandemic. Public Health 2021; 203:53-57. [PMID: 35032915 PMCID: PMC8664655 DOI: 10.1016/j.puhe.2021.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/03/2021] [Accepted: 12/08/2021] [Indexed: 12/30/2022]
Abstract
Objectives This study aimed to investigate non-COVID-19-related upper respiratory tract infections (URTIs), gastrointestinal infections (GIIs) and urinary tract infections (UTIs) during the COVID-19 pandemic in Germany. Study design Cross-sectional study. Methods Patients with diagnoses of URTIs, GIIs and UTIs from 994 general practitioners (GP) and 192 paediatric practices that routinely send anonymous data to the Disease Analyzer database (IQVIA) were investigated. We studied the differences in recorded URTIs, GIIs and UTIs between April 2019–March 2020 (non-pandemic period) and April 2020–March 2021 (pandemic period) in terms of rates and baseline characteristics by comparing absolute frequencies. Results Compared with the non-pandemic period, the total number of patients with defined diagnoses was lower in the pandemic period (URTIs: 810,324 vs 520,800; GIIs: 253,029 vs 142,037; UTIs: 132,425 vs 117,932). The number of patients per practice with URTIs (683 vs 439, –36%, P < 0.001) and GIIs (213 vs 120, –44%, P < 0.001) decreased significantly during the pandemic period; the decrease in the number of recorded UTIs was smaller (112 vs 99, –11%, P < 0.05). The decrease in diagnoses was more pronounced among paediatricians than GPs (URTIs: −39% vs −35%; GIIs: −57% vs −39%; UTIs: −15% vs −9%). The decrease in URTIs varied between −35% and −40% depending on the age group. Conclusions Measures introduced during the COVID-19 pandemic to reduce transmission of the virus also helped to reduce the spread of non-COVID-19-related URTIs and GIIs. UTIs were impacted to a lesser extent, with rates seeing a slight decrease. An increase in awareness of infectious diseases may have also contributed to the reduction in recorded diagnoses.
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Keck T, Strobl A, Weinhaeusel A, Funk P, Michaelis M. Pelargonium Extract EPs 7630 in the Treatment of Human Corona Virus-Associated Acute Respiratory Tract Infections - A Secondary Subgroup-Analysis of an Open-Label, Uncontrolled Clinical Trial. Front Pharmacol 2021; 12:666546. [PMID: 33995094 PMCID: PMC8120433 DOI: 10.3389/fphar.2021.666546] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/14/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Experience in treating human coronavirus (HCoV) infections might help to identify effective compounds against novel coronaviruses. We therefore performed a secondary subgroup-analysis of data from an open-label, uncontrolled clinical trial published in 2015 investigating the proanthocyanidin-rich Pelargonium sidoides extract EPs 7630 in patients with the common cold. Methods: 120 patients with common cold and at least 2 out of 10 common cold symptoms received one film-coated 20 mg tablet EPs 7630 thrice daily for 10 days in an uncontrolled, interventional multicentre trial (ISRCTN65790556). At baseline, viral nucleic acids were detected by polymerase chain reaction. Common cold-associated symptoms and treatment satisfaction were evaluated after 5 days and at treatment end. Based on the data of patients with proof of viral nucleic acids, we compared the course of the disease in patients with or without HCoV infection. Results: In 61 patients, viral nucleic acids were detected. Of these, 23 (37.7%) were tested positive for at least one HCoV (HCoV subset) and 38 (62.3%) for other viruses only (non-HCoV subset). Patients of both subsets showed a significant improvement of common cold symptoms already after 5 days of treatment, although the observed change tended to be more pronounced in the HCoV subset. At treatment end, more than 80% of patients of both groups were completely recovered or majorly improved. In both subsets, less than 22% of patients took concomitant paracetamol for antipyresis. The mean number of patients’ days off work or school/college was similar (0.9 ± 2.6 days in HCoV subset vs 1.3 ± 2.8 days in non-HCoV subset). In both groups, most patients were satisfied or very satisfied with EPs 7630 treatment. Conclusion: EPs 7630 treatment outcomes of common cold patients with confirmed HCoV infection were as favourable as in patients with other viral infections. As this trial was conducted before the pandemic, there is currently no evidence from clinical trials for the efficacy of EPs 7630 in patients with SARS-CoV-2 infection. Dedicated non-clinical studies and clinical trials are required to elucidate the potential of EPs 7630 in the early treatment of HCoV infections.
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Affiliation(s)
- Tilman Keck
- Department of ENT Medicine, Head and Neck Surgery, Hansa Private Hospital, Graz, Austria
| | - Andreas Strobl
- Department of ENT Medicine, Head and Neck Surgery, Ordensklinikum Linz, Krankenhaus Barmherzige Schwestern, Linz, Austria
| | - Andreas Weinhaeusel
- Health and Environment Department, Molecular Diagnostics, AIT Austrian Institute of Technology GmbH, Wien, Austria
| | - Petra Funk
- Medical Scientific Services, Dr. Willmar Schwabe GmbH and Co. KG, Karlsruhe, Germany
| | - Martin Michaelis
- Industrial Biotechnology Centre and School of Biosciences, University of Kent, Canterbury, United Kingdom
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Roth M, Sun Q, Tamm M. Up-Regulated Vitamin D Receptor by Pelargonium sidoides Extract EPs ® 7630 Contributes to Rhinovirus Defense in Bronchial Epithelial Cells. Pharmaceuticals (Basel) 2021; 14:ph14020172. [PMID: 33671804 PMCID: PMC7926416 DOI: 10.3390/ph14020172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/19/2021] [Accepted: 02/19/2021] [Indexed: 12/26/2022] Open
Abstract
EPs®7630, extracted from Pelargonium sidoides, reduces the severity of viral upper respiratory tract infections. Vitamin D also improves anti-viral host defense through similar signaling pathways. This study assessed if EPs®7630 modifies vitamin D receptor (VDR) expression and function by human bronchial epithelial cells. Bronchial epithelial cells were incubated with EPs®7630 over 48 h before calcitriol stimulation and/or infection with Rhinovirus (RV)-16. Protein expression was determined by Western-blotting. Intracellular signaling of mitogen activated protein kinases (MAPK) was studied by chemical inhibitors. The anti-viral effect was assessed by immunofluorescence for RV-16 protein. EPs®7630 upregulated VDR expression through Erk1/2 MAPK and thereby increased the cell's sensitivity to calcitriol. Compared ton untreated cells, the shift of the VDR into the nucleus at 5.3 times lower calcitriol concentration. EPs®7630 increased Erk1/2 MAPK signaling, but reduced p38 phosphorylation, and had no effect on Jun N-terminal kinase (JNK). EPs®7630 improved the anti-viral effect of vitamin D on RV-16 infection by 2.1 folds compared to vitamin D alone or to untreated cells. Furthermore, EPs®7630 improved the differentiation of epithelial cells by upregulating E-cadherin expression through Erk1/2. In conclusion, EPs®7630 increased host defense against Rhinovirus infection by upregulating the VDR and the differentiation of epithelial cells.
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Affiliation(s)
- Michael Roth
- Pulmonary Cell Research & Pneumology, Department Biomedicine & Internal Medicine, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland; (Q.S.); (M.T.)
- Correspondence: ; Tel.: +41-61-265-2337
| | - Qingzhu Sun
- Pulmonary Cell Research & Pneumology, Department Biomedicine & Internal Medicine, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland; (Q.S.); (M.T.)
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China
| | - Michael Tamm
- Pulmonary Cell Research & Pneumology, Department Biomedicine & Internal Medicine, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland; (Q.S.); (M.T.)
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Seifert G, Funk P, Reineke T, Lehmacher W. Influence of EPs 7630 on Antipyretic Comedication and Recovery from Acute Tonsillopharyngitis in Children: A Meta-analysis of Randomized, Placebo-Controlled, Clinical Trials. J PEDIAT INF DIS-GER 2021. [DOI: 10.1055/s-0040-1722205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Abstract
Objective Acute tonsillopharyngitis (ATP) is a common, seasonal infection of predominantly viral origin. Management is aimed at shortening the course of the disease and restoring the comfort of the patient. We performed a meta-analysis to investigate whether treatment with the Pelargonium sidoides extract EPs 7630 reduces the use of antipyretic comedication (i.e., acetaminophen) in children suffering from ATP.
Methods Studies were identified from clinical trial registries and medical literature. Randomized, placebo-controlled, clinical trials investigating EPs 7630 in children with ATP and reporting the coadministration of paracetamol were eligible. Based on the raw data of eligible trials, we analyzed cumulative paracetamol use, as well as the ability to attend school at the end of treatment. Three trials including a total of 345 children aged 6 to 10 years and suffering from non-β-hemolytic streptococcal ATP were identified and eligible. Children were administered EPs 7630 or placebo for 6 days.
Results Compared with placebo, EPs 7630 reduced the cumulative paracetamol dose by an average of 449 mg (95% confidence interval [CI]: 252–646 mg; p < 0.001). A total of 19.1% (EPs 7630) and 71.5% (placebo) of children were still unable to attend school at the end of the treatment (risk ratio = 0.28; 95% CI: 0.16–0.48; p < 0.001).
Conclusion Our meta-analysis demonstrates that EPs 7630 reduced the use of antipyretic comedication and accelerated recovery.
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Affiliation(s)
- Georg Seifert
- Department of Paediatric Oncology/Haematology, Otto-Heubner Centre for Paediatric and Adolescent Medicine (OHC), Charité–Universitätsmedizin Berlin, Berlin, Germany
- Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Petra Funk
- Department of Clinical Research, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
| | - Thorsten Reineke
- Department of Clinical Research, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
| | - Walter Lehmacher
- Institute for Medical Statistics, Unit of Informatics and Epidemiology, University of Cologne, Cologne, Germany
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Hubert M. [Not Available]. MMW Fortschr Med 2020; 162:66. [PMID: 32016748 DOI: 10.1007/s15006-020-0120-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Schapowal A, Dobos G, Cramer H, Ong KC, Adler M, Zimmermann A, Brandes-Schramm J, Lehmacher W. Treatment of signs and symptoms of the common cold using EPs 7630 - results of a meta-analysis. Heliyon 2019; 5:e02904. [PMID: 31844762 PMCID: PMC6888731 DOI: 10.1016/j.heliyon.2019.e02904] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/07/2019] [Accepted: 11/18/2019] [Indexed: 02/03/2023] Open
Abstract
The efficacy of Pelargonium sidoides preparation EPs 7630 in the common cold (CC) was assessed by performing meta-analyses of randomized, double-blind, placebo-controlled trials. Mean differences (MD) and risk ratios (RR) with their 95% confidence intervals (CI) were computed. Five trials with a total of 833 patients were included. All trials had a treatment period of ten days with visits at days 3, 5, and 10 after baseline and used a ten-symptom Cold Intensity Score (CIS) as the primary outcome. Significant differences favoring EPs 7630 were observed for total CIS reduction (day 5: MD = -2·30; 95%CI = -4·12,-0·49; day 10: MD = -1·16; 95%CI = -2·22,-0·10), proportion of patients with substantial improvement (day 5: RR = 1·73; day 10: RR = 1·06) and complete remission (day 5: RR = 2·52; day 10: RR = 2·13). Subjects treated with EPs 7630 missed fewer days at work, used less paracetamol and had an improved sleep quality. No serious adverse reactions to EPs 7630 were reported. The results support the efficacy of EPs 7630 in adults with CC.
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Affiliation(s)
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany
| | - Kian Chung Ong
- KC Ong Chest & Medical Clinic, 3 Mount Elizabeth #12-03, Mount Elizabeth Medical Centre, Singapore 228510
| | - Martin Adler
- Institute of Integrative Medicine Siegen, University of Münster, Lärchenweg 27, 57078 Siegen, Germany
| | - Andrea Zimmermann
- Clinical Research, Dr. Willmar Schwabe GmbH & Co. KG, Willmar-Schwabe-Straβe 4, 76227 Karlsruhe, Germany
| | - Juliette Brandes-Schramm
- Clinical Research, Dr. Willmar Schwabe GmbH & Co. KG, Willmar-Schwabe-Straβe 4, 76227 Karlsruhe, Germany
| | - Walter Lehmacher
- Emeritus, University of Cologne, Institute of Medical Statistics, Informatics and Epidemiology, Kerpener Straβe 62, 50931 Cologne, Germany
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