Inosine Pranobex Enhances Human NK Cell Cytotoxicity in the Treatment of Acute Respiratory Viral Infections Including Covid-19

Enhances Human NK Cell Cytotoxicity in the Treatment of in the infections and hopefully measles was significantly better in the prevention of lethal course of measles infection. In a recent clinical study, we compared the efficacy in subjects with laboratory-confirmed acute respiratory viral infections. Time to resolution (in subgroups) of all influenza-like symptoms between treatment groups was statistically significant with faster clinical improvement in the IP group. The knowledge of IP antiviral activity can be used for the treatment of Covid-19 as an acute viral disease. In the elderly, who are immunosenescenced and for people with a significant chronic disease the standard dose can be 1g (2 tablets)/4 times per day for 7-14 days or 2 days after symptoms resolution.


Introduction
states [1]. IP affects via NK almost all the viruses that replicate in the human body. As authors pointed out in their publication, studies with IP demonstrate that the immunomodulatory activity of IP is characterized by enhanced lymphocyte proliferation, cytokine production, and NK cell cytotoxicity [2]. In detail, all the immunomodulatory activity are described in the publication of Slíva [1].
In one of the recent studies [3], the authors proved that after IP administration was an early and durable rise in NK cells. For half the cohort, NK cells increased as a percentage of total peripheral blood lymphocytes within 1.5 h of receiving the IP. By Day 5, all but one of the volunteers displayed higher NK cell percentages, such elevation-effectively a doubling or greater -was maintained at the termination of the study. The IP induced populations were as replete in Granzyme A and Perforin as basal NK cells. [3]. The authors of the study [2] show a more detailed influence of the IP on cellular level. They show that exposure of target cells to IP leads to increased expression of multiple NKG2D ligands. They found that IP causes an increase in intracellular concentration of purine nucleotides and Tricarboxylic Acid (TCA) cycle intermediates and NKG2D ligand induction. The degree of NKG2D ligand induction was functionally significant, leading to increased NKG2Ddependent target cell immunogenicity. These findings demonstrate that the immunomodulatory properties of IP are due to metabolic activation with NKG2D ligand induction [2]. Approximately 40 years ago when the measles vaccine was not available, IP was used to treat measles, resp. primary measles pneumonia. One of the very old studies was shown that IP treatment of measles was significantly better in the prevention of lethal course of measles infection (Table 1) [4]. Today, such a study cannot be repeated rhinovirus, enterovirus, reovirus, bocavirus, and adenovirus [6,7].
In view of the current Covid-19 pandemic is very important to mention also the results of the study we compared the efficacy and safety of IP with placebo in subjects with laboratory-confirmed acute respiratory viral infections in order to evaluate the clinical use of IP for the treatment of acute respiratory viral infections.
The primary efficacy endpoint was a comparison between IP and placebo groups in terms of the time to resolution of all influenzalike symptoms present at baseline to none [8]. IP 500-mg tablets or placebo were self-administered by the subjects for 7 days (2 tablets orally 3 times daily). The first dose was taken immediately after randomization at the study site, and the remaining doses were to be self-administered at home. Doses were taken approximately 8 h apart but consistent with the subject's lifestyle, i.e., scheduling of dosing did not disturb the subject's usual sleep patterns.
The subjects were provided with kits containing (randomized) medication sufficient for 1 subject for 7 days of treatment [8]. IP treatment 100 mg/kg/weight is statistically significant (0.05 < p < 0.025) in prevention of lethal course of measles. Note: Time to resolution was the total number of days from randomisation to the first instance at which all influenza-like symptoms had a score of 0.
In the subgroup analysis, for subjects, less than 50 years of age without related ongoing disease, the difference in time to resolution of all influenza-like symptoms between treatment groups was statistically significant (p = 0.050) and showed faster improvement in subjects in the IP group compared with subjects in the placebo group ( Figure 1) [8]. where immune performance may be compromised [3,8].