Ferrer Gustavo, Valerio-Pascua Fernando, Alas-Pineda César, Gaitán-Zambrano Kristhel, Pavón-Varela Dennis J
Department of Pulmonary and Critical Care Medicine, Aventura Hospital and Medical Center, Aventura, USA.
Department of Critical Care Medicine, Hospital CEMESA, San Pedro Sula, HND.
Cureus. 2025 Apr 21;17(4):e82736. doi: 10.7759/cureus.82736. eCollection 2025 Apr.
This review explores the therapeutic potential of intranasal chlorpheniramine maleate (iCPM) in managing both acute COVID-19 and Long COVID by integrating histamine H1 receptor antagonism and bitter taste receptor (T2R) activation. Current literature on histamine-mediated inflammation, T2R activation, and the dual-action mechanisms of iCPM were analyzed. Emphasis was placed on its antiviral, anti-inflammatory, and mucosal immunity-enhancing properties. iCPM demonstrates significant efficacy in addressing acute COVID-19 symptoms by inhibiting histamine-mediated inflammatory pathways and reducing cytokine storms. As a T2R agonist, it enhances mucosal immunity through nitric oxide production, mucociliary clearance, and antimicrobial peptide synthesis, reducing viral replication and supporting respiratory health. Additionally, iCPM shows promise in mitigating persistent symptoms of long COVID, including fatigue, brain fog, and respiratory dysfunction, by addressing chronic inflammation and residual viral activity. The integration of H1 receptor antagonism and T2R activation positions iCPM as a novel dual-target therapy for respiratory infections. Its localized delivery and broad mechanism of action make it a promising candidate for managing both the acute and chronic phases of COVID-19. Future research should focus on large-scale clinical trials and personalized approaches based on genetic variations in T2R pathways.
本综述通过整合组胺H1受体拮抗作用和苦味受体（T2R）激活作用，探讨了鼻内用马来酸氯苯那敏（iCPM）在治疗急性新冠肺炎和新冠后遗症方面的治疗潜力。分析了目前关于组胺介导的炎症、T2R激活以及iCPM双重作用机制的文献。重点关注了其抗病毒、抗炎和增强黏膜免疫的特性。iCPM通过抑制组胺介导的炎症途径和减少细胞因子风暴，在缓解急性新冠肺炎症状方面显示出显著疗效。作为一种T2R激动剂，它通过一氧化氮生成、黏液纤毛清除和抗菌肽合成增强黏膜免疫，减少病毒复制并维持呼吸道健康。此外，通过解决慢性炎症和残留病毒活性，iCPM在减轻新冠后遗症的持续症状（包括疲劳、脑雾和呼吸功能障碍）方面也显示出前景。H1受体拮抗作用和T2R激活作用的整合使iCPM成为一种用于呼吸道感染的新型双靶点疗法。其局部给药方式和广泛的作用机制使其成为治疗新冠肺炎急性和慢性阶段的有潜力候选药物。未来的研究应聚焦于基于T2R途径基因变异的大规模临床试验和个性化方法。
