IRVINE3 Labs, OOLEX Project for COVID, Department of Medical, Oral and Biotechnological Sciences, Chieti-Pescara University, Chieti, Italy.
IRVINE3 Labs, OOLEX Project for COVID, Department of Medical, Oral and Biotechnological Sciences, Chieti-Pescara University, Chieti, Italy -
Minerva Med. 2022 Feb;113(1):135-140. doi: 10.23736/S0026-4806.20.07225-0. Epub 2021 Jun 28.
The aim of this study was to evaluate the combination of Pycnogenol (150 mg/day) (Horphag Research, London, UK) and Centella asiatica (Centellicum 3×225 mg/day; Horphag Research) (PY-CE) for 8 months in subjects with sequelae of idiopathic interstitial pneumonia (IIP). Recently, post-COVID-19 lung disease is emerging with large numbers of patients left with chronic lung conditions. Considering the antifibrotic activity of the combination PY-CE, we also tested this supplementary management in post-COVID-19 lung patients.
Nineteen subjects with idiopathic interstitial pneumonia (IIP) were included in the study. High Resolution CT scans at inclusion confirmed the presence of lung fibrosis: 10 patients were treated with the Pycnogenol Centellicum combination and 9 subjects with standard management (SM) served as controls. Oxidative stress that was very high in all subjects at inclusion, decreased significantly in the supplement group (P<0.05). The Karnofsky Performance Scale Index significantly improved in the supplement group in comparison with controls (P<0.05). The symptoms (fatigue, muscular pain, dyspnea) were significantly lower after 8 months in supplemented patients (P<0.05) as compared with controls.
At the end of the study, the small cystic lesions (honeycombing) and traction bronchiectasis were stable or in partial regression in 4 subjects in the supplemented group (vs. none in the control group) with a significant improvement in tissue edema in the supplemented subjects. On ultrasound lung scans the white (more echogenic) fibrotic component at inclusion was 18.5±2.2% in the images in controls vs. 19.4±2.7% in the supplement group. At the end of the study, there was no improvement in controls (18.9±2.5%) vs. a significant improvement in supplemented subjects (16.2±2.1%; P<0.05). In addition, 18 subjects with post-COVID-19 lung disease were included in the study; 10 patients were treated with the Pycnogenol Centellicum combination and evaluated after 4 weeks; 8 patients served as controls. Preliminary results show that symptoms associated with post-COVID-19 lung disease after 4 weeks were significantly improved with the supplement combination (P<0.05). Oxidative stress and the Karnofsky Performance Scale Index were significantly improved in the supplements group as compared with controls (P<0.05).
According to these observations, Pycnogenol controls and decreases edema and Centellicum by modulating the apposition of collagen, slows down the development of irregular cicatrization, the keloidal scarring and fibrosis. More time is needed to evaluate this effect in a larger number of post-COVID-19 patients with lung disease. This disease has affected millions of subjects worldwide, leaving severe consequences. Pycnogenol and Centellicum may improve the residual clinical picture in post-COVID-19 lung disease (PCL) patients and may reduce the number of subjects evolving into lung fibrosis. The evolution from edema to fibrosis seems to be slower or attenuated with this supplement combination both in Idiopathic pulmonary fibrosis (IPF) and in PCL patients.
本研究旨在评估碧萝芷(150 毫克/天)(Horphag Research,伦敦,英国)和积雪草(Centellicum 3×225 毫克/天;Horphag Research)(PY-CE)联合治疗特发性间质性肺炎(IIP)后遗症患者 8 个月。最近,新冠病毒后肺病正在出现,大量患者遗留慢性肺部疾病。鉴于组合 PY-CE 的抗纤维化活性,我们还在新冠病毒后肺病患者中测试了这种补充治疗。
19 名特发性间质性肺炎(IIP)患者纳入本研究。高分辨率 CT 扫描在纳入时证实存在肺部纤维化:10 名患者接受碧萝芷积雪草联合治疗,9 名患者接受标准治疗(SM)作为对照。所有患者在纳入时的氧化应激水平均非常高,补充组的氧化应激水平显著下降(P<0.05)。补充组的卡诺夫斯基表现量表指数与对照组相比显著改善(P<0.05)。补充组患者在 8 个月后疲劳、肌肉疼痛、呼吸困难等症状明显低于对照组(P<0.05)。
研究结束时,补充组 4 名患者的小囊性病变(蜂窝肺)和牵引性支气管扩张稳定或部分消退(对照组无),补充组的组织水肿明显改善。在超声肺部扫描中,对照组的图像中包含的白色(回声更强)纤维化成分在纳入时为 18.5±2.2%,而补充组为 19.4±2.7%。研究结束时,对照组无改善(18.9±2.5%),而补充组有显著改善(16.2±2.1%;P<0.05)。此外,18 名新冠病毒后肺病患者纳入本研究;10 名患者接受碧萝芷积雪草联合治疗,并在 4 周后进行评估;8 名患者作为对照组。初步结果显示,新冠病毒后肺病患者在接受补充治疗 4 周后,与疾病相关的症状明显改善(P<0.05)。补充组的氧化应激和卡诺夫斯基表现量表指数与对照组相比显著改善(P<0.05)。
根据这些观察结果,碧萝芷可控制和减少水肿,积雪草通过调节胶原的附着,减缓不规则瘢痕形成、瘢痕疙瘩形成和纤维化的发展。需要更多时间来评估这种在更多新冠病毒后肺病患者中的效果。这种疾病已影响到全球数百万人,留下了严重的后果。碧萝芷和积雪草可能改善新冠病毒后肺病(PCL)患者的残留临床症状,并可能减少发展为肺纤维化的患者数量。在特发性肺纤维化(IPF)和 PCL 患者中,这种补充组合似乎使从水肿到纤维化的演变更慢或减弱。