D.SAP – an apple-based formulation could treat SARS-CoV-2 infection

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Medical researchers from Khwarizmi Institute of Science and Technology-Iran have found that apple cider vinegar (Iranian apple vinegar called Dezhakam sap (D.SAP)) could be used to treat COVID-19 and also to reduce associated inflammatory responses in COVID-19 especially in the lungs.

The study team said that therapeutic effects could be related to the antimicrobial and antioxidant effects of apple cider vinegar due to its polyphenolic compounds.
 
The study findings were published on a preprint server are currently being peer reviewed. https://www.researchsquare.com/article/rs-1983034/v1

The findings of the present study revealed that different doses of D.SAP is firstly biocompatible and harmless and do not lead to animal mortality as well as able to prevent the continuation of the disease in all doses after one week of smoking and the virus in mice after treatment. Pretreatment of patients also leads to low pathogenicity in mice and makes treatment easier.

SARS-COV-2 is a new respiratory virus that has caused a major pandemic and high mortality in the world due to the way its symptoms appear and the possibility of its clinical symptoms remaining hidden for seven to fourteen days, as well as the ability to transmit quickly from person to person.

Rapid transmission of this virus and its high mutagenicity may cause a constant pandemic with a high mortality rate in this disease. Severe inflammation in the lung tissue, which leads to the destruction of air sacs, was the main cause of death in patients with Covid-19.

Findings showed firstly, inhalation of D.SAP does not lead to any inflammation or adverse effects leading to death or disease as well as reduction of significant inflammation rate in D.SAP recipients. It has been reported that inflammation has a major role in the severity of COVID-19 infection and inflammation overwhelming could cause death (17). An effective therapeutic strategy to suppress or modulate inflammation in COVID-19 which target the immune system as well as strength it in combat with the virus is a great discovery.

Small pro-inflammatory proteins called cytokines are released by immune cells and regulate the immune response to pathogens. Chemokines, interleukins, monokines, tumor necrosis factors (TNF), and interferons (IFN) act on the cells that secret them and neighboring cells or cells that are distant from the site of secretion (18).

Massive and dysregulated cytokine release may cause a cytokine storm (19). Cytokine storms are common in viral infections and had been reported in MERS-CoV, SARS-CoV, influenza, and recently in SARS-Cov-2 (20). The prevalence of cytokine storms in COVID-19 is high and it may relate to delayed viral clearance, the late response of interferon type I, up-regulation of neutrophil extracellular traps, and pyroptosis (21).

It has been determined that a negative coronary test in mice after one week was associated with a reduction in inflammation and thus a reduction in air sac damage. Also, the best results were observed in the pretreatment group G, which showed that smoking 12.5% concentration of D.SAP for seven days before the onset of pneumonia lead to a significant reduction in pneumonia viral load.

Antiviral effects of D.SAP may lead to faster viral clearance that could be one of the mechanisms of cytokine storm inhibition which in turn reduce the severity of symptoms during and after relief from the disease, as well as an increase in resistance to infection.

Other potential protective effects of D.SAP that may explain its potential immune-regulator effects could be associated with probiotics. It has been indicated that probiotics have an immune-boosting quality that effectively fights influenza-like respiratory infections and the common cold (22).

Recent studies provide evidence supporting the antiviral and general immune-strengthening health effects of probiotics. prophylactic and immune-boosting probiotics have potential effects on the prevention of respiratory viral infections such as COVID-19 (23). Several lines of evidence should nutraceuticals such as Zn, vitamin D, vitamin C, curcumin, and cinnamaldehyde, have antioxidant and anti-inflammatory effects.

Grouping these nutrients in the right combination may suppress the lethal inflammation providing both prophylactic and therapeutic support against COVID-19 (24). It may explain the potential immune-boosting and immune regulatory role of D.SAP as apple based formulation.

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