Effects of pentoxifylline on inflammatory markers and blood pressure

Brie, Daniel; Sahebkar, Amirhossein; Penson, Peter E.; Dinca, Madalina; Ursoniu, Sorin; Şerban, Corina; Zanchetti, Alberto; Howard, George; Ahmed, Ali Mahmoud; Aronow, Wilbert S.; Muntner, Paul; Lip, Gregory Y.H.; Wong, Nathan D.; Rysz, Jacek; Banach, Maciej

doi:10.1097/hjh.0000000000001086

Cited by 36 publications

(17 citation statements)

References 47 publications

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“…Complementary therapies such as antioxidants supplementation are recommended in patients with metabolic abnormalities to improve their nutritional status and boost their immune system [ 12 ]. Existing evidence has proved the beneficial effects of several antioxidants supplements including pentoxifylline [ 13 ] and lycopene [ 14 ] on reducing inflammation. Available data regarding the effects of alpha-lipoic acid (ALA) supplementation on inflammatory markers are controversial.…”

Section: Introductionmentioning

confidence: 99%

The effects of alpha-lipoic acid supplementation on inflammatory markers among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials

et al. 2018

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ObjectiveThis systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to determine the effect of alpha-lipoic acid (ALA) supplementation on the inflammatory markers among patients with metabolic syndrome (MetS) and related disorders.MethodsWe searched the following databases until November 2017: PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. Three reviewers independently assessed study eligibility, extracted data, and evaluated risk of bias of included primary studies. Statistical heterogeneity was assessed using Cochran’s Q test and I-square (I2) statistic. Data were pooled by using the random-effect model and standardized mean difference (SMD) was considered as the summary effect size.ResultsEighteen trials out of 912 potential citations were found to be eligible for our meta-analysis. The findings indicated that ALA supplementation significantly decreased C-reactive protein (CRP) (SMD = − 1.52; 95% CI, − 2.25, − 0.80; P < 0.001), interlokin-6 (IL-6) (SMD = − 1.96; 95% CI, − 2.60, − 1.32; P < 0.001), and tumor necrosis factor alpha levels (TNF-α) (SMD = − 2.62; 95% CI, − 3.70, − 1.55; P < 0.001) in patients diagnosed with metabolic diseases.ConclusionIn summary, the current meta-analysis demonstrated the promising impact of ALA administration on decreasing inflammatory markers such as CRP, IL-6 and TNF-α among patients with MetS and related disorders.Electronic supplementary materialThe online version of this article (10.1186/s12986-018-0274-y) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

The effects of alpha-lipoic acid supplementation on inflammatory markers among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials

et al. 2018

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“…A meta-analysis showed that PTX had an anti-inflammatory effect in adults with a variety of disorders, including coronary artery disease, type 2 diabetes mellitus, idiopathic or ischemic cardiomyopathy, and chronic kidney disease. The statistically significant differences were corroborated by a reduction in plasma concentrations of TNF-α and CRP and no deleterious effects on blood pressure [34].…”

Section: Inflammation and The Immune Response In Covid-19mentioning

confidence: 74%

“…In this regard, PTX, as the drug we are considering repositioning for COVID-19 treatment, has shown ATR blocking effects in experimental studies, along with clinical evidence in humans showing no secondary effect on blood pressure [32][33][34].…”

Section: Sars-cov-2 and The Rasmentioning

confidence: 99%

Repositioning of pentoxifylline as an immunomodulator and regulator of the renin-angiotensin system in the treatment of COVID-19

Maldonado

Loza-Mejía

Chávez³

2020

Medical Hypotheses

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Pentoxifylline (PTX) is a phosphodiesterase inhibitor that increases cyclic adenosine monophosphate levels, which in turn activate protein kinase, leading to a reduction in the synthesis of proinflammatory cytokines to ultimately influence the renin-angiotensin system (RAS) in vitro by inhibiting angiotensin 1 receptor (AT1R) expression. The rheological, anti-inflammatory, and renin-angiotensin axis properties of PTX highlight this drug as a therapeutic treatment alternative for patients with COVID-19 by helping reduce the production of the inflammatory cytokines without deleterious effects on the immune system to delay viral clearance. Moreover, PTX can restore the balance of the immune response, reduce damage to the endothelium and alveolar epithelial cells, improve circulation, and prevent microvascular thrombosis. There is further evidence that PTX can improve ventilatory parameters. Therefore, we propose repositioning PTX in the treatment of COVID-19. The main advantage of repositioning PTX is that it is an affordable drug that is already available worldwide with an established safety profile, further offering the possibility of immediately analysing the result of its use and associated success rates. Another advantage is that PTX selectively reduces the concentration of TNF-α mRNA in cells, which, in the case of an acute infectious state such as COVID-19, would seem to offer a more strategic approach.

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“…This action is correlated with the proteolytic activity of MMPs. In addition to the in vitro and in vivo data, a randomized controlled clinical trial showed that pentoxifylline treatment significantly reduced the circulating levels of pro-inflammatory TNF- α ( Brie et al, 2016 ) indicating its clinical anti-inflammatory role.…”

Section: Pentoxifyllinementioning

confidence: 99%

Can pentoxifylline and similar xanthine derivatives find a niche in COVID-19 therapeutic strategies? A ray of hope in the midst of the pandemic

Monji

Siddiquee

Hashemian

2020

European Journal of Pharmacology

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COVID-19 pandemic presents an unprecedented challenge to identify effective drugs for treatment. Despite multiple clinical trials using different agents, there is still a lack of specific treatment for COVID-19. Having the potential role in suppressing inflammation, immune modulation, antiviral and improving respiratory symptoms, this review discusses the potential role of methylxanthine drugs like pentoxifylline and caffeine in the management of COVID-19 patients. COVID-19 pathogenesis for clinical features like severe pneumonia, acute lung injury (ALI) / acute respiratory distress syndrome (ARDS), and multi-organ failures are excessive inflammation, oxidation, and cytokine storm by the exaggerated immune response. Drugs like pentoxifylline have already shown improvement of the symptoms of ARDS and caffeine has been in clinical use for decades to treat apnea of prematurity (AOP) in preterm infants and improve respiratory function. Pentoxifylline is well-known anti-inflammatory and anti-oxidative molecules that have already shown to suppress Tumor Necrosis Factor (TNF-α) as well as other inflammatory cytokines in pulmonary diseases, and this may be beneficial for better clinical outcomes in COVID-19 patients. Pentoxifylline enhances blood flow, improves microcirculation and tissue oxygenation, and caffeine also efficiently improves tissue oxygenation, asthma, decreases pulmonary hypertension and an effective analgesic. There are significant shreds of evidence that proved the properties of pentoxifylline and caffeine against virus-related diseases as well. Along with the aforementioned evidences and high safety profiles, both pentoxifylline and caffeine offer a glimpse of considerations for future use as a potential adjuvant to COVID-19 treatment. However, additional clinical studies are required to confirm this speculation.

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Effects of pentoxifylline on inflammatory markers and blood pressure

Cited by 36 publications

References 47 publications

The effects of alpha-lipoic acid supplementation on inflammatory markers among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials

The effects of alpha-lipoic acid supplementation on inflammatory markers among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials

Repositioning of pentoxifylline as an immunomodulator and regulator of the renin-angiotensin system in the treatment of COVID-19

Can pentoxifylline and similar xanthine derivatives find a niche in COVID-19 therapeutic strategies? A ray of hope in the midst of the pandemic

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