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棕榈酰乙醇酰胺可降低新近确诊 COVID-19 的未接种疫苗成年人的促炎标志物:一项随机对照试验。

Palmitoylethanolamide Reduces Proinflammatory Markers in Unvaccinated Adults Recently Diagnosed with COVID-19: A Randomized Controlled Trial.

机构信息

College of Health Solutions, Arizona State University, Phoenix, AZ, USA.

Biodesign Institute, Arizona State University, Tempe, AZ, USA.

出版信息

J Nutr. 2022 Oct 6;152(10):2218-2226. doi: 10.1093/jn/nxac154.

Abstract

BACKGROUND

Inflammation is at the core of many chronic conditions and exacerbates infectious conditions, including the severity of coronavirus disease 2019 (COVID-19) infections.

OBJECTIVES

This study aimed to examine the effects of a novel food supplement, palmitoylethanolamide (PEA), specifically Levagen+, as compared with a placebo on proinflammatory biomarkers in adults recently diagnosed with COVID-19 who were unvaccinated and nonhospitalized.

METHODS

This study was a double-blind randomized placebo-controlled trial conducted October 2020-March 2021 (clinicaltrials.gov: NCT04912921). Participants aged 19-53 y were unvaccinated and recently infected with COVID-19 as indicated by a positive test result per RT-PCR or antigen test, and they reported to the test site following diagnosis as allowed by the CDC's return-to-work policy. Participants were stratified by age, sex, and BMI and randomly assigned by coin toss to receive 600 mg Levagen+ twice daily (LEV) or placebo tablets twice daily (CON) for 4 wk. At baseline and week 4, participants completed health histories, 24-h dietary recalls, anthropometrics, and nonfasting blood sampling. The primary outcomes were the 4-wk change between groups for IL-6, C-reactive protein, ferritin, intercellular adhesion molecule 1, soluble P-selectin (sP-selectin), and neutrophil/lymphocyte ratio. Multiple linear regression models were utilized to assess treatment effects on outcomes, adjusting for covariates.

RESULTS

A total of 60 participants completed the study (LEV: n = 30; CON: n = 30). After 4 wk of supplementation, sP-selectin (β = -11.5; 95% CI: -19.8, -3.15; P = 0.0078), IL-1β (β = -22.9; 95% CI: -42.4, -3.40; P = 0.0222), and IL-2 (β = -1.73; 95% CI: -3.45, -0.065; P = 0.0492) concentrations were significantly reduced in the LEV group compared with the CON group.

CONCLUSIONS

Inflammatory mechanisms are crucial to optimal resolution of infectious conditions, yet unchecked secretion of inflammatory mediators can promote the dysregulated immune response implicated in COVID-19 complications. Overall, PEA supplementation produced anti-inflammatory effects in individuals recently diagnosed with COVID-19 who were nonhospitalized.

摘要

背景

炎症是许多慢性疾病的核心,会加剧感染性疾病,包括 2019 年冠状病毒病(COVID-19)感染的严重程度。

目的

本研究旨在研究新型食品补充剂棕榈酸乙醇酰胺(PEA)(即 Levagen+)与安慰剂相比,对未接种疫苗和未住院的最近诊断为 COVID-19 的成年人的促炎生物标志物的影响。

方法

这是一项 2020 年 10 月至 2021 年 3 月进行的双盲随机安慰剂对照试验(clinicaltrials.gov:NCT04912921)。参与者年龄在 19-53 岁之间,未接种疫苗,最近感染了 COVID-19,如 RT-PCR 或抗原检测呈阳性结果所示,并且根据疾病预防控制中心的返工政策,在诊断后到检测点报到。参与者按年龄、性别和 BMI 分层,并通过掷硬币随机分配,每天两次接受 600mg Levagen+(LEV)或安慰剂片剂(CON)治疗 4 周。在基线和第 4 周,参与者完成健康史、24 小时膳食回忆、人体测量和非禁食血液采样。主要结局是两组间 IL-6、C 反应蛋白、铁蛋白、细胞间黏附分子 1、可溶性 P 选择素(sP-选择素)和中性粒细胞/淋巴细胞比值的 4 周变化。利用多元线性回归模型评估治疗对结局的影响,调整协变量。

结果

共有 60 名参与者完成了研究(LEV:n=30;CON:n=30)。补充 4 周后,sP-选择素(β=-11.5;95%CI:-19.8,-3.15;P=0.0078)、IL-1β(β=-22.9;95%CI:-42.4,-3.40;P=0.0222)和 IL-2(β=-1.73;95%CI:-3.45,-0.065;P=0.0492)浓度在 LEV 组明显低于 CON 组。

结论

炎症机制对感染性疾病的最佳缓解至关重要,然而,炎症介质的不受控制的分泌会促进 COVID-19 并发症中涉及的失调免疫反应。总体而言,PEA 补充剂对未住院的最近诊断为 COVID-19 的个体产生了抗炎作用。

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