Correlation of D-xylose with severity and morbidity-related factors of COVID-19 and possible therapeutic use of D-xylose and antibiotics for COVID-19

Abstract

The SARS-Cov-2 pandemic that currently affects the entire world has been shown to be especially dangerous in the elderly (≥65 years) and in smokers, with notably strong comorbidity in patients already suffering from chronic diseases, such as Type 2 diabetes, cancers, chronic respiratory diseases, obesity, and hypertension. Inflammation of the lungs is the main factor leading to respiratory distress in patients with chronic respiratory disease and in patients with severe COVID-19. Several studies have shown that inflammation of the lungs in general and Type 2 diabetes are accompanied by the degradation of glycosaminoglycans (GAGs), especially heparan sulfate (HS). Several studies have also shown the importance of countering the degradation of HS in lung infections and Type 2 diabetes. D-xylose, which is the initiating element for different sulfate GAG chains (especially HS), has shown regeneration properties for GAGs. D-xylose and xylitol have demonstrated anti-inflammatory, antiglycemic, antiviral, and antibacterial properties in lung infections, alone or in combination with antibiotics. Considering the existing research on COVID-19 and related to D-xylose/xylitol, this review offers a perspective on why the association between D-xylose and antibiotics may contribute to significantly reducing the duration of treatment of COVID-19 patients and why some anti-inflammatory drugs may increase the severity of COVID-19. A strong correlation with scurvy, based on gender, age, ethnicity, smoking status, and obesity status, is also reviewed. Related to this, the effects of treatment with plants such as Artemisia are also addressed. Chemical compounds D-xylose; xylitol; l -ascorbic Acid; D-glucuronic acid; N -acetylglucosamine; D- N -acetylglucosamine; N -acetylgalactosamine; galactose.

Antiviral strategies should focus on stimulating the biosynthesis of heparan sulfates, not their inhibition

“…Another molecule that has shown antiviral properties against viruses, including SARS-CoV-2 and hRSV, is xylitol (see Table 3 ). Indeed, as anticipated from a previous article [ 35 ], xylitol completely inhibited SARS-CoV-2 in an in vitro study conducted by Bansal et al [ 72 ], where xylitol was used as a placebo. In addition to a patent filed by a French company demonstrating that D-xylose (a direct metabolite of xylitol) significantly stimulates the biosynthesis of HS [ 103 ], an in vitro study conducted by Johnston and Keller [ 104 ] showed that incubation of SV3T3 cells with β-xylosides resulted in a 10-fold increase in the biosynthesis of HS chains.…”

“…In this study, xylitol was used as a placebo but showed great antiviral properties, both alone and in combination with iota-carageen [ 72 ]. As mentioned in a previous article [ 35 ], these antiviral properties of xylitol against SARS-CoV-2 could be attributed to its ability to stimulate the biosynthesis of HS and the fact that SARS-CoV-2 itself uses syndecans as receptors (see Table 1 ). Since the Ser residues intended to receive D-xylose for initiation of the biosynthesis of HS are the probable viral attachment points, stimulation of HS biosynthesis will block viral attachment to syndecans, thereby inhibiting cellular entry.…”

“…It is important to note here that in a previous article published in this journal, Life Sciences , we showed the importance of stimulating HS biosynthesis to fight inflammation, especially inflammation of the lungs during viral infection. We also formulated the hypothesis mentioned above regarding the attachment site of viruses on core proteins [ 35 ]. In Section 5 of the previous paper, this hypothesis allowed us to give a probable explanation of the appearance of type 2 diabetes during viral infection (without mentioning the notion of insulin resistance) and other observed facts.…”

“…In a previous article, we described the properties of D-xylose/xylitol, explaining their ability to stimulate the biosynthesis of HS [ 35 ]. Therefore, we suggest using the elements listed in Section 2to use them against SARS-CoV-2.…”

Review of the Use of Nasal and Oral Antiseptics During a Global Pandemic

“…In a randomized controlled trial, iota-carrageenan nasal spray was tolerable in patients with the common cold and had a good safety profile [ 27 ]. Xylitol itself has also demonstrated antiviral properties [ 28 ].…”