Inosine Pranobex: A Key Player in the Game Against a Wide Range of Viral Infections and Non-Infectious Diseases

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 proinflammatory 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 welldesigned and executed trials are warranted. Funding: Ewopharma International.

Inosine Pranobex Significantly Decreased the Case-Fatality Rate among PCR Positive Elderly with SARS-CoV-2 at Three Nursing Homes in the Czech Republic

“…Inosine pranobex (IP), also known as inosine acedoben dimepranol, inosine pranobex, and methisoprinol, is a synthetic compound with immunomodulatory and antiviral properties. The drug was initially authorized in 1971, and it is currently marketed in more than 70 countries for treating viral diseases, including subacute sclerosing panencephalitis, acute viral respiratory infections, measles, herpes simplex infections, varicella, human papillomavirus, cytomegalovirus, and Epstein–Barr virus [ 14 ].…”

“…Studies on IP have demonstrated that its immunomodulatory activity is characterized by enhancing lymphocyte proliferation, cytokine production, and NK cell cytotoxicity [ 14 , 15 ]. The effects of IP at the cellular level have been investigated in detail [ 15 ], and it was found that NK cells exposed to IP had increased expression of multiple NKG2D ligands, leading to increased NKG2D-dependent target cell immunogenicity.…”

Advances in Antiviral Therapy for Subacute Sclerosing Panencephalitis

“…Inosine pranobex (IP), a combination of inosine, acetamidobenzoic acid and dimethylamino isopropanol, is a drug that exerts both antiviral and immunostimulatory effects [ 49 ]. The exact mechanism of the antiviral effect has not yet clearly defined, but it is hypothesized that inhibition of viral RNA synthesis is due to modification of the structure of infected cell ribosomes by the drug component of IP and rapid metabolism of IP.…”

“…As immunomodulatory effects, T cell proliferation, NK cell activation, and increased production of inflammatory cytokines (e.g., IL-2, IFN-γ) have been observed in vitro and in vivo. Due to its antiviral effect, immunomodulatory effect, and safety, it has been used in SSPE, herpes simplex virus, human papillomavirus, human immunodeficiency virus, influenza virus, and airway virus infections, cytomegalovirus, and Epstein-Barr virus infections [ 49 ]. Generally, 50–100 mg/kg per day is orally administered to SSPE patients in three or four divided doses.…”

Inosine Pranobex (IP) - possibilities of its use in the treatment of COVID19

“…At present, it is used in our country as a non-specifi c immunomodulator in children with recurrent respiratory infections. However, a number of works documenting its immunomodulatory and antiviral effects can be found in the literature [11][12][13].…”