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Beneficial effects of novel aureobasidium pullulans strains produced beta-1,3-1,6 glucans on interleukin-6 and D-dimer levels in COVID-19 patients; results of a randomized multiple-arm pilot clinical study - 12/12/21

Doi : 10.1016/j.biopha.2021.112243 
Kadalraja Raghavan a, b, c, 1 , Vidyasagar Devaprasad Dedeepiya c , Vaddi Suryaprakash d , Kosagi-Sharaf Rao e , Nobunao Ikewaki f, g , Tohru Sonoda g , Gary A. Levy h , Masaru Iwasaki i , Rajappa Senthilkumar j , Senthilkumar Preethy j , Samuel JK Abraham c, i, k,
a Dept of Paediatric Neurology, Kenmax Healthcare Services Pvt Ltd, Madurai, India 
b Research & Development Division, Sarvee Integra Pvt Ltd, Chennai, India 
c Mary-Yoshio Translational Hexagon (MYTH), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India 
d Department of Urology, Yashoda Hospitals, Hyderabad, India 
e Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama 
f Dept. of Medical Life Science, Kyushu University of Health and Welfare, Japan 
g Institute of Immunology, Junsei Educational Institute, Nobeoka, Miyazaki, Japan 
h Professor Emeritus, Medicine and Immunology, University of Toronto, Ontario, Canada 
i Centre for Advancing Clinical Research (CACR), University of Yamanashi - School of Medicine, Chuo, Japan 
j Fujio-Eiji Academic Terrain (FEAT), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India 
k Antony, Xavier Interdisciplinary Scholastics (AXIS), GN Corporation Co. Ltd., Kofu, Japan 

Correspondence to: 3-8, Wakamatsu, Kofu, Yamanashi 400-0866, Japan.3-8, WakamatsuKofuYamanashi400-0866Japan

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Abstract

Objective

In this pilot clinical study, we report the beneficial effects of beta glucans derived from two strains AFO-202 and N-163 of a black yeast Aureobasidium pullulans on the biomarkers for cytokine storm and coagulopathy in COVID-19 patients.

Methods

A total of 24 RT-PCR positive COVID-19 patients were recruited and randomly divided into three groups (Gr): Gr. 1 control (n = 8) – Standard treatment; Gr. 2: Standard treatment + AFO-202 beta glucan (n = 8); and Gr. 3, Standard treatment + combination of AFO-202 and N-163 beta glucans (n = 8) for 30 days.

Results

There was no mortality or requirement of ventilation of the subjects in any of the groups. There was a decrease in D-Dimer values (751 ng/ml to 143.89 ng/ml) and IL-6 values (7.395–3.16 pg/ml) in Gr. 1 in 15 days but the levels increased to abnormal levels on day 30 (D-Dimer: 202.5 ng/ml; IL-6 55.37 pg/ml); which steadily decreased up to day 30 in groups 2 (D-dimer: 560.99 ng/dl to 79.615; IL-6: 26.18–3.41 pg/ml) and 3 (D-dimer: 1614 ng/dl to 164.25 ng/dl; IL-6: 6.25–0.5 pg/ml). The same trend was observed with ESR. LCR and LeCR increased while NLR decreased significantly in Gr. 3. CD4 + and CD8 + T cell count showed relatively higher increase in Gr.3. There was no difference in CRP within the groups.

Conclusion

As these beta glucans are well known food supplements with a track record for safety, larger multi-centric clinical studies are recommended to validate their use as an adjunct in the management of COVID-19 and the ensuing long COVID-19 syndrome.

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Graphical Abstract




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Highlights

Multiple-arm clinical trial of beta 1,3-1,6 glucans in COVID-19 patients.
Control arm could maintain IL-6 and D-DIMER levels only till day-15.
AFO-202 beta glucan consumption yielded IL-6 and D-DIMER control up to day-30.
N-163 +AFO-202 maintained NLR, LCR, LeCR with IL-6 and D-DIMER levels up to day-30.
CD4 + and CD8 + T cell levels were shown advantageous in N-163 +AFO-202 group.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : COVID-19, IL-6, D-dimer, Cytokine storm, Coagulopathy, Immuno-modulation, Beta glucans, Adjunct treatment


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