Mij
Senior Member (Voting Rights)
Abstract
Inosine pranobex (IP), commonly known as inosine acedoben dimepranol, isoprinosine and methisoprinol, has been proven to positively impact the host’s immune system, by enhancing T-cell lymphocyte proliferation and activity of natural killer cells, increasing levels of pro-inflammatory cytokines, and thereby restoring deficient responses in immunosuppressed patients. At the same time, it has been shown that it can affect viral RNA levels and hence inhibit growth of several viruses. Due to its immunomodulatory and antiviral properties, and its safety profile, it has been widely used since 1971 against viral infections and diseases, among which subacute sclerosis panencephalitis, herpes simplex virus, human papilloma virus, human immunodeficiency virus, influenza and acute respiratory infections, cytomegalovirus and Epstein–Barr virus infections. Following an analysis of almost five decades of scientific literature since its original approval, we here summarize in vivo and in vitro studies manifesting the means in which IP impacts the host’s immune system. We also provide a synopsis of therapeutic trials in the majority of which IP was found to have a beneficial effect. Lastly, positive results from limited studies, suggesting the putative future use of IP in new therapeutic indications are briefly described. In order to support use of IP against viral infections apart from those already approved, and to establish its use in clinical practice, further well-designed and executed trials are warranted.
Chronic Fatigue Syndrome
Chronic fatigue syndrome (CFS) is characterised by symptoms such as severe fatigue, exercise intolerance, myalgia, cognitive deficit, dizziness and problems in sleep, thinking and concentration. It is most common in people between 40 and 60 years old, but it can also affect children, adolescents, and adults of all ages, with women being more susceptible. Its pathogenicity has not been yet defined and remains undiagnosed in 90% of affected people. It is speculated that changes in the immune system, such as chronic production of cytokines, decreased NK activity and differences in markers of T-cell activation, may contribute to the onset of CFS. There is no cure or established treatment for CFS, and healthcare professionals are mainly trying to cure the symptoms rather the disease itself [94].
The safety and efficacy of IP in CFS were investigated in a single-blind, placebo-controlled study of 16 CFS patients, with a mean age of 45.6 years [17]. Ten patients were randomly assigned to a regimen of IP for 12 weeks, consisting of 3 g/day on the odd weeks and 1 g/day on the even weeks, and six patients received methylcellulose placebo tablets. Following the 12 weeks of treatment, patients from both the treatment and the placebo groups received IP for 16 more weeks. Immune measures as well as responses of the patients to three tests, i.e., the Activities of Daily Living Questionnaire, the Cognitive Deficit Subset of the Symptom Checklist Questionnaire and the Karnofsky Performance Score, were evaluated.
Of the ten patients treated initially with IP, six reported improvement in their symptoms (improved group) and the median percentage reduction in cognitive symptoms for this group was 16%. The results from this study suggest that patients with CFS could benefit from treatment with IP. Nevertheless, further studies are warranted, with an adequate sample size and a longer follow-up period, in order to extract firm conclusions as to the efficacy of IP.
https://link.springer.com/article/10.1007/s12325-019-00995-6#Abs1
Inosine pranobex (IP), commonly known as inosine acedoben dimepranol, isoprinosine and methisoprinol, has been proven to positively impact the host’s immune system, by enhancing T-cell lymphocyte proliferation and activity of natural killer cells, increasing levels of pro-inflammatory cytokines, and thereby restoring deficient responses in immunosuppressed patients. At the same time, it has been shown that it can affect viral RNA levels and hence inhibit growth of several viruses. Due to its immunomodulatory and antiviral properties, and its safety profile, it has been widely used since 1971 against viral infections and diseases, among which subacute sclerosis panencephalitis, herpes simplex virus, human papilloma virus, human immunodeficiency virus, influenza and acute respiratory infections, cytomegalovirus and Epstein–Barr virus infections. Following an analysis of almost five decades of scientific literature since its original approval, we here summarize in vivo and in vitro studies manifesting the means in which IP impacts the host’s immune system. We also provide a synopsis of therapeutic trials in the majority of which IP was found to have a beneficial effect. Lastly, positive results from limited studies, suggesting the putative future use of IP in new therapeutic indications are briefly described. In order to support use of IP against viral infections apart from those already approved, and to establish its use in clinical practice, further well-designed and executed trials are warranted.
Chronic Fatigue Syndrome
Chronic fatigue syndrome (CFS) is characterised by symptoms such as severe fatigue, exercise intolerance, myalgia, cognitive deficit, dizziness and problems in sleep, thinking and concentration. It is most common in people between 40 and 60 years old, but it can also affect children, adolescents, and adults of all ages, with women being more susceptible. Its pathogenicity has not been yet defined and remains undiagnosed in 90% of affected people. It is speculated that changes in the immune system, such as chronic production of cytokines, decreased NK activity and differences in markers of T-cell activation, may contribute to the onset of CFS. There is no cure or established treatment for CFS, and healthcare professionals are mainly trying to cure the symptoms rather the disease itself [94].
The safety and efficacy of IP in CFS were investigated in a single-blind, placebo-controlled study of 16 CFS patients, with a mean age of 45.6 years [17]. Ten patients were randomly assigned to a regimen of IP for 12 weeks, consisting of 3 g/day on the odd weeks and 1 g/day on the even weeks, and six patients received methylcellulose placebo tablets. Following the 12 weeks of treatment, patients from both the treatment and the placebo groups received IP for 16 more weeks. Immune measures as well as responses of the patients to three tests, i.e., the Activities of Daily Living Questionnaire, the Cognitive Deficit Subset of the Symptom Checklist Questionnaire and the Karnofsky Performance Score, were evaluated.
Of the ten patients treated initially with IP, six reported improvement in their symptoms (improved group) and the median percentage reduction in cognitive symptoms for this group was 16%. The results from this study suggest that patients with CFS could benefit from treatment with IP. Nevertheless, further studies are warranted, with an adequate sample size and a longer follow-up period, in order to extract firm conclusions as to the efficacy of IP.
https://link.springer.com/article/10.1007/s12325-019-00995-6#Abs1
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