The Potential of Spirulina platensis to Ameliorate the Adverse Effects of Highly Active Antiretroviral Therapy (HAART)

Comprehensive Review of the Latest Investigations of the Health-Enhancing Effects of Selected Properties of Arthrospira and Spirulina Microalgae on Skin

Arthospira platensis and Spirulina platensis microalgae are a rich source of pro-health metabolites (% d.m.): proteins (50.0-71.3/46.0-63.0), carbohydrates (16.0-20.0/12.0-17.0), fats (0.9-14.2/6.4-14.3), polyphenolic compounds and phenols (7.3-33.2/7.8-44.5 and 4.2/0.3 mg GAE/g), and flavonoids (1.9/0.2 QUE/g) used in pharmaceutical and cosmetic formulations. This review summarises the research on the chemical profile, therapeutic effects in dermatological problems, application of Arthrospira and Spirulina microalgae, and contraindications to their use. The pro-health properties of these microalgae were analysed based on the relevant literature from 2019 to 2024. The antiviral mechanism of microalgal activity involves the inhibition of viral replication and enhancement of immunity. The anti-acne activity is attributed to alkaloids, alkanes, phenols, alkenes, phycocyanins, phthalates, tannins, carboxylic and phthalic acids, saponins, and steroids. The antibacterial activity generally depends on the components and structure of the bacterial cell wall. Their healing effect results from the inhibition of inflammatory and apoptotic processes, reduction of pro-inflammatory cytokines, stimulation of angiogenesis, and proliferation of fibroblasts and keratinocytes. The photoprotective action is regulated by amino acids, phlorotannins, carotenoids, mycosporins, and polyphenols inhibiting the production of tyrosinase, pro-inflammatory cytokines, and free oxygen radicals in fibroblasts and the stimulation of collagen production. Microalgae are promising molecular ingredients in innovative formulations of parapharmaceuticals and cosmetics used in the prophylaxis and therapy of dermatological problems. This review shows the application of spirulina-based commercial skin-care products as well as the safety and contraindications of spirulina use. Furthermore, the main directions for future studies of the pro-health suitability of microalgae exerting multidirectional effects on human skin are presented.

Antiviral potential of spirulina in individuals with human immunodeficiency virus or Hepatis C virus infections: A systematic review and meta-analysis

BACKGROUND

Spirulina, a cyanobacterium or blue-green algae that contains phycocyanin, nutritional supplementation has been evaluated in patients living with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) due to its antiviral properties. This supplementation may be beneficial in low resource settings when awaiting antiretroviral therapy (ART) for HIV. This review aimed to evaluate the effectiveness of Spirulina supplement in antiviral-naïve HIV- and HCV-infected patients by assessing its immunological effect (Cluster of Differentiation 4 or CD-4 T-cell count) and disease progression (viral load).

METHODS

We searched PubMed, Cochrane Library, Scopus, and Web of Science from inception through January 23, 2024. Two authors independently performed the study selection, data extraction, and risk of bias assessment. We pooled data by using a random-effects model and evaluated publication bias by a funnel plot.

RESULTS

We identified 5552 articles, 5509 excluded at the title and abstract stage with 44 studies making it to the full text review. Of these 6 studies met the eligibility for inclusion in the final analysis as follows: 4 randomized controlled trials (RCTs) and 2 non-RCTs. The pooled results of the Spirulina intervention found significant improvements in biomarkers of clinical outcomes, viral load (VL) and CD4 T-cell (CD4) counts, in participants of the treatment group compared to controls; the VL had an overall Cohen's d effect size decrease of -2.49 (-4.80, -0.18) and CD4 had an overall effect size increase of 4.09 (0.75, 7.43). [Cohen's d benchmark: 0.2 = small effect; 0.5 = medium effect; 0.8 = large effect].

CONCLUSIONS

Findings from this systematic review showed a potential beneficial effect of Spirulina supplementation in HIV- and HCV-infected patients by increasing CD4 counts and decreasing viral load. However, further research in larger controlled clinical trials is needed to fully investigate the effect of this nutritional supplement on clinically relevant outcomes, opportunities for intervention, optimal dose, and cost-benefit of Spirulina supplementation.

Femoral head and acetabular necrosis combined with hip subluxation in people with HIV: a case report and literature review

INTRODUCTION

HIV is widely prevalent in all regions of the world. The use of antiretroviral drugs has dramatically reduced the mortality rate of HIV-related diseases, but correspondingly increased the incidence of chronic complications in HIV-positive people. Related studies have found that the incidence of osteonecrosis of the femoral head is higher in HIV-positive people, but the co-occurrence of femoral head necrosis, acetabular necrosis and hip joint dislocation in HIV-positive patients is rare.

METHODS

We report a 50-year-old man with a 15-month history of progressively worsening right hip pain with movement restriction. According to the CT findings of the other hospital, the patient was admitted to the hospital with femoral head necrosis. After the admission, the relevant X-ray, CT and MRI examinations showed that the right femoral head collapsed and deformed, with the surrounding bone sclerosis, bone fragments, loose body of the joint, right hip subluxation, acetabular marginal osteogeny, and local microcystic degeneration. The left femoral head was in good shape, and cystic degeneration can be seen under the articular surface. The patient was finally diagnosed with femoral head necrosis and acetabular necrosis combined with hip subluxation.

RESULTS

The pain of the patient was significantly relieved after the operation, and the patient was discharged from the hospital one week after the start of treatment to continue rehabilitation training. During the follow-up one month after the operation, the self-reported pain disappeared completely, and the limitation of activity was significantly improved.

Effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19: a randomized controlled trial

Objective

Spirulina (arthrospira platensis) is a cyanobacterium proven to have anti-inflammatory, antiviral, and antioxidant effects. However, the effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19 is currently unclear. This study aimed to evaluate the efficacy and safety of high-dose Spirulina platensis for SARS-CoV-2 infection.

Study Design

We conducted a randomized, controlled, open-label trial involving 189 patients with COVID-19 who were randomly assigned in a 1:1 ratio to an experimental group that received 15.2g of Spirulina supplement plus standard treatment (44 non-intensive care unit (non-ICU) and 47 ICU), or to a control group that received standard treatment alone (46 non-ICU and 52 ICU). The study was conducted over six days. Immune mediators were monitored on days 1, 3, 5, and 7. The primary outcome of this study was mortality or hospital discharge within seven days, while the overall discharge or mortality was considered the secondary outcome.

Results

Within seven days, there were no deaths in the Spirulina group, while 15 deaths (15.3%) occurred in the control group. Moreover, within seven days, there was a greater number of patients discharged in the Spirulina group (97.7%) in non-ICU compared to the control group (39.1%) (HR, 6.52; 95% CI, 3.50 to 12.17). Overall mortality was higher in the control group (8.7% non-ICU, 28.8% ICU) compared to the Spirulina group (non-ICU HR, 0.13; 95% CI, 0.02 to 0.97; ICU, HR, 0.16; 95% CI, 0.05 to 0.48). In non-ICU, patients who received Spirulina showed a significant reduction in the levels of IL-6, TNF-α, IL-10, and IP-10 as intervention time increased. Furthermore, in ICU, patients who received Spirulina showed a significant decrease in the levels of MIP-1α and IL-6. IFN-γ levels were significantly higher in the intervention group in both ICU and non-ICU subgroups as intervention time increased. No side effects related to Spirulina supplements were observed during the trial.

Conclusion

High-dose Spirulina supplements coupled with the standard treatment of COVID-19 may improve recovery and remarkably reduce mortality in hospitalized patients with COVID-19.

Clinical Trial Registration

https://irct.ir/trial/54375, Iranian Registry of Clinical Trials number (IRCT20210216050373N1).

Nutritional Supplements for Skin Health-A Review of What Should Be Chosen and Why

Supplementation of micronutrients is considered to be crucial in the reinforcement of the skin's barrier. In this paper, 14 nutritional compounds commonly used in food or pharmaceutic industries were analyzed in terms of influencing skin conditions. The major objective of this paper was to provide a narrative review of the available literature regarding several chosen compounds that are currently widely recommended as supplements that aim to maintain proper and healthy skin conditions. We conducted a review of the literature from PubMed, Scopus, and Web of Science until September 2023 without any other restrictions regarding the year of the publication. Ultimately, we reviewed 238 articles, including them in this review. Each of the reviewed compounds, including vitamin A, vitamin C, vitamin D, vitamin E, curcumin, chlorella, Omega-3, biotin,Ppolypodium leucotomos, Simmondsia chinesis, gamma oryzanol, olive leaf extract, spirulina, and astaxanthin, was observed to present some possible effects with promising benefits for a skin condition, i.e., photoprotective radiation. Adding them to the diet or daily routine might have a positive influence on some skin inflammatory diseases such as atopic dermatitis or psoriasis. Further, UV radiation protection facilitated by some supplements and their impact on human cells might be helpful during chemotherapy or in preventing melanoma development. Further research is needed because of the lack of clear consensus regarding the doses of the described compounds that could provide desirable effects on the skin.

Polysaccharides from Spirulina platensis: Extraction methods, structural features and bioactivities diversity

Spirulina platensis, a well-known blue-green microalga cultivated and consumed in China and United States, is traditionally used as a food supplement and medical ingredient. Increasing evidence has confirmed that the Spirulina platensis polysaccharides (SPPs) are vital and representative pharmacologically active biomacromolecules and exhibit multiple health-promoting activities both in vivo and in vitro, such as those of anti-cancer, anti-oxidant, immunomodulatory, hypolipidemic and hypoglycemic, anti-thrombotic, anti-viral, regulation of the gut microbiota properties and other biological activity. The purpose of this review aims to comprehensively and systematically outline the extraction and purification methods, structural features, biological activities, underlying mechanisms, and toxicities of SPPs to support their potential utilization value in pharmaceuticals fields and functional foods. The structural and activities relationship of SPPs is also discussed. Besides, new valuable insights for future research with SPPs have also been proposed in the important areas of structural characterization and pharmacological activities.