Melatonin is a potential adjuvant to improve clinical outcomes in individuals with obesity and diabetes with coexistence of Covid-19

El-Missiry, Mohamed A; El-Missiry, Ziad M.A.; Othman, Azza I.

doi:10.1016/j.ejphar.2020.173329

Cited by 62 publications

(61 citation statements)

References 77 publications

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“…Many studies have highlighted the importance of intracellular redox status as a new target for natural medicines, or synthetic drugs aimed at blocking both viral replication and virus-induced inflammation [38]. It has been suggested that, during COVID-19, the early treatment with antioxidants, such as N-acetylcysteine [49,50], melatonin [51,52], polyphenols [53][54][55], K, C, D, and E vitamins supplementation [56].…”

Section: Antioxidant Activitymentioning

confidence: 99%

Hesperidin and SARS-CoV-2: New Light on the Healthy Function of Citrus Fruits

Bellavite

Donzelli²

2020

Antioxidants

159

140

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Among the many approaches to Coronavirus disease 2019 (COVID-19) prevention, the possible role of nutrition has so far been rather underestimated. Foods are very rich in substances, with a potential beneficial effect on health, and some of these could have an antiviral action or be important in modulating the immune system and in defending cells from the oxidative stress associated with infection. This short review draws the attention on some components of citrus fruits, and especially of the orange (Citrus sinensis), well known for its vitamin and flavonoid content. Among the flavonoids, hesperidin has recently attracted the attention of researchers, because it binds to the key proteins of the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several computational methods, independently applied by different researchers, showed that hesperidin has a low binding energy, both with the coronavirus “spike” protein, and with the main protease that transforms the early proteins of the virus (pp1a and ppa1b) into the complex responsible for viral replication. The binding energy of hesperidin to these important components is lower than that of lopinavir, ritonavir, and indinavir, suggesting that it could perform an effective antiviral action. Furthermore, both hesperidin and ascorbic acid counteract the cell damaging effects of the oxygen free radicals triggered by virus infection and inflammation. There is discussion about the preventive efficacy of vitamin C, at the dose achievable by the diet, but recent reviews suggest that this substance can be useful in the case of strong immune system burden caused by viral disease. Computational methods and laboratory studies support the need to undertake apposite preclinical, epidemiological, and experimental studies on the potential benefits of citrus fruit components for the prevention of infectious diseases, including COVID-19.

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Section: Antioxidant Activitymentioning

confidence: 99%

Hesperidin and SARS-CoV-2: New Light on the Healthy Function of Citrus Fruits

Bellavite

Donzelli²

2020

Antioxidants

159

140

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“…This is also the case with COVID-19, in which many antioxidants such as vitamins A, C, D, melatonin, resveratrol, reduced glutathione, N-acetylcysteine, silymarin, quercetin, artemisinin, curcumin, Boswellia, and hesperidin are currently being evaluated in clinical trials. Likewise, other drugs with antioxidant effects such as statins, colchicine, or amiodarone, have been suggested as part of the arsenal to treat, or at least attenuate, COVID-19 symptoms and sequelae [ 122 , 123 , 124 , 125 ]. Therefore, lessons learned in previous trials using antioxidants in sepsis may serve to hypothesize the therapeutic possibilities of these agents in COVID-19.…”

Section: Antioxidant Therapies In Severe Cases Of Covid-19mentioning

confidence: 99%

Oxidative Stress and Inflammation in COVID-19-Associated Sepsis: The Potential Role of Anti-Oxidant Therapy in Avoiding Disease Progression

et al. 2020

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Since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak emerged, countless efforts are being made worldwide to understand the molecular mechanisms underlying the coronavirus disease 2019 (COVID-19) in an attempt to identify the specific clinical characteristics of critically ill COVID-19 patients involved in its pathogenesis and provide therapeutic alternatives to minimize COVID-19 severity. Recently, COVID-19 has been closely related to sepsis, which suggests that most deceases in intensive care units (ICU) may be a direct consequence of SARS-CoV-2 infection-induced sepsis. Understanding oxidative stress and the molecular inflammation mechanisms contributing to COVID-19 progression to severe phenotypes such as sepsis is a current clinical need in the effort to improve therapies in SARS-CoV-2 infected patients. This article aims to review the molecular pathogenesis of SARS-CoV-2 and its relationship with oxidative stress and inflammation, which can contribute to sepsis progression. We also provide an overview of potential antioxidant therapies and active clinical trials that might prevent disease progression or reduce its severity.

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“…Under the additional stress of the virus infection, especially, when melatonin synthesis is targeted by virus, the extremely low melatonin may contribute to a collapse of mitochondrial function and decreased tolerance of obese persons to the virus infection. Therefore, the use of melatonin has been suggested to improve the clinical outcome in COVID-19 patients with obesity and diabetes [ 192 ]. In cardiovascular disease and hypertension, patients usually suffer from melatonin deficiency and are prone to heart infarction or sudden death [ 116 , 193 , 194 ].…”

Section: The Outcomes Of Covid-19 Are Potentially Linked To Melatomentioning

confidence: 99%

Targeting Host Defense System and Rescuing Compromised Mitochondria to Increase Tolerance against Pathogens by Melatonin May Impact Outcome of Deadly Virus Infection Pertinent to COVID-19

Tan¹,

Hardeland

2020

Molecules

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Fighting infectious diseases, particularly viral infections, is a demanding task for human health. Targeting the pathogens or targeting the host are different strategies, but with an identical purpose, i.e., to curb the pathogen’s spreading and cure the illness. It appears that targeting a host to increase tolerance against pathogens can be of substantial advantage and is a strategy used in evolution. Practically, it has a broader protective spectrum than that of only targeting the specific pathogens, which differ in terms of susceptibility. Methods for host targeting applied in one pandemic can even be effective for upcoming pandemics with different pathogens. This is even more urgent if we consider the possible concomitance of two respiratory diseases with potential multi-organ afflictions such as Coronavirus disease 2019 (COVID-19) and seasonal flu. Melatonin is a molecule that can enhance the host’s tolerance against pathogen invasions. Due to its antioxidant, anti-inflammatory, and immunoregulatory activities, melatonin has the capacity to reduce the severity and mortality of deadly virus infections including COVID-19. Melatonin is synthesized and functions in mitochondria, which play a critical role in viral infections. Not surprisingly, melatonin synthesis can become a target of viral strategies that manipulate the mitochondrial status. For example, a viral infection can switch energy metabolism from respiration to widely anaerobic glycolysis even if plenty of oxygen is available (the Warburg effect) when the host cell cannot generate acetyl-coenzyme A, a metabolite required for melatonin biosynthesis. Under some conditions, including aging, gender, predisposed health conditions, already compromised mitochondria, when exposed to further viral challenges, lose their capacity for producing sufficient amounts of melatonin. This leads to a reduced support of mitochondrial functions and makes these individuals more vulnerable to infectious diseases. Thus, the maintenance of mitochondrial function by melatonin supplementation can be expected to generate beneficial effects on the outcome of viral infectious diseases, particularly COVID-19.

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Melatonin is a potential adjuvant to improve clinical outcomes in individuals with obesity and diabetes with coexistence of Covid-19

Cited by 62 publications

References 77 publications

Hesperidin and SARS-CoV-2: New Light on the Healthy Function of Citrus Fruits

Hesperidin and SARS-CoV-2: New Light on the Healthy Function of Citrus Fruits

Oxidative Stress and Inflammation in COVID-19-Associated Sepsis: The Potential Role of Anti-Oxidant Therapy in Avoiding Disease Progression

Targeting Host Defense System and Rescuing Compromised Mitochondria to Increase Tolerance against Pathogens by Melatonin May Impact Outcome of Deadly Virus Infection Pertinent to COVID-19

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