Abstract
COVID-19 is a lethal disease caused by the pandemic SARS-CoV-2, which continues to be a public health threat. COVID-19 is principally a respiratory disease and is often associated with sputum retention and cytokine storm, for which there are limited therapeutic options. In this regard, we evaluated the use of BromAc®, a combination of Bromelain and Acetylcysteine (NAC). Both drugs present mucolytic effect and have been studied to treat COVID-19. Therefore, we sought to examine the mucolytic and anti-inflammatory effect of BromAc® in tracheal aspirate samples from critically ill COVID-19 patients requiring mechanical ventilation.
Method: Tracheal aspirate samples from COVID-19 patients were collected following next of kin consent and mucolysis, rheometry and cytokine analysis using Luminex kit was performed.
Results: BromAc® displayed a robust mucolytic effect in a dose dependent manner on COVID-19 sputum ex vivo. BromAc® showed anti-inflammatory activity, reducing the action of cytokine storm, chemokines including MIP-1alpha, CXCL8, MIP-1b, MCP-1 and IP-10, and regulatory cytokines IL-5, IL-10, IL-13 IL-1Ra and total reduction for IL-9 compared to NAC alone and control. BromAc® acted on IL-6, demonstrating a reduction in G-CSF and VEGF-D at concentrations of 125 and 250 µg.
Conclusion: These results indicate robust mucolytic and anti-inflammatory effect of BromAc® ex vivo in tracheal aspirates from critically ill COVID-19 patients, indicating its potential to be further assessed as pharmacological treatment for COVID-19.
Keywords: BromAc; COVID-19; Mucolytic therapy; SARS-CoV-2; Tracheal aspirate.
【저자키워드】 COVID-19, SARS-CoV-2, BromAc, Mucolytic therapy, Tracheal aspirate., 【초록키워드】 Cytokine storm, pandemic, mechanical ventilation, IL-6, IP-10, drug, sputum, anti-inflammatory activity, chemokine, Critically ill, Respiratory disease, MCP-1, Acetylcysteine, IL-10, COVID-19 patients, CXCL8, therapeutic options, IL-13, Combination, Concentration, dose, COVID-19 patient, pharmacological treatment, reduction, Ex vivo, G-CSF, treat, IL-5, anti-inflammatory effect, lethal disease, public health threat, Cytokine analysis, MIP-1b, NAC, IL-9, robust, mucolytic, collected, caused, evaluated, was performed, reducing, tracheal, reduction in, mucolysis, regulatory cytokine, tracheal aspirate, 【제목키워드】 anti-inflammatory activity, tracheal aspirate,