Author:
Coelho dos Reis Jordana Grazziela A.,Ferreira Geovane Marques,Lourenço Alice Aparecida,Ribeiro Ágata Lopes,Martins da Mata Camila Pacheco da Silveira,de Melo Oliveira Patrícia,de Almeida Marques Daisymara Priscila,Ferreira Linziane Lopes,Clarindo Felipe Alves,da Silva Murillo Ferreira,Póvoas Filho Heitor Portella,Oliveira Junior Nilson Roberto Ribeiro,D’Carmo Sodré Maisah Meyhr,Gadelha Sandra Rocha,Albuquerque George Rego,Maciel Bianca Mendes,Melo Mariano Ana Paula,de Melo Silva Mylene,Fontana Renato,Marin Lauro Juliano,Alberto Carlos Renata Santiago,Sampaio Lopes Amanda Teixeira,Ferreira Fabrício Barbosa,dos Santos Uener Ribeiro,de Santana Íris Terezinha Santos,Fehlberg Hllytchaikra Ferraz,Rezende Rachel Passos,Dias João Carlos T,Gross Eduardo,Castro Goulart Gisele Assis,Santiago Marie Gabriele,de Lemos Ana Paula Motta Lavigne,da Conceição Aline O,Romano Carla Cristina,de Carvalho Luciana Debortoli,Martins Filho Olindo Assis,Quadros Claudio Almeida,Valle Sarah J,Morris David L
Abstract
AbstractCOVID-19 is a lethal disease caused by the pandemic SARS-CoV-2, which continues to be a public health threat. COVID-19 is principally a respiratory disease and is often associated with sputum retention, for which there are limited therapeutic options. In this regard, we evaluated the use of BromAc®, a combination of Bromelain and Acetylcysteine (NAC). Both drugs present mucolytic effect and have been studied to treat COVID-19. Therefore, we sought to examine the mucolytic, antiviral, and anti-inflammatory effect of BromAc® in tracheal aspirate samples from critically ill COVID-19 patients requiring mechanical ventilation.MethodTracheal aspirate samples from COVID-19 patients were collected following next of kin consent and mucolysis, rheometry and cytokine storm analysis was performed.ResultsBromAc® displayed a robust mucolytic effect in a dose dependent manner. BromAc® showed anti-inflammatory activity, reducing the action of cytokine storm, chemokines including MIP-1alpha, CXCL8, MIP-1b, MCP-1 and IP-10, and regulatory cytokines IL-5, IL-10, IL-13 IL-1RA and total reduction for IL-9 compared to NAC alone and control. BromAc® acted on IL-6, demonstrating a reduction in G-CSF and VEGF-D at concentrations of 125 and 250µg.ConclusionThese results indicate robust mucolytic and anti-inflammatory effect of BromAc® in tracheal aspirates from critically ill COVID-19 patients, indicating its potential as a therapeutic strategy to COVID-19.
Publisher
Cold Spring Harbor Laboratory