Medicinal Potential of the Insoluble Extracted Fibers Isolated from the Fomes fomentarius (Agaricomycetes) Fruiting Bodies: A Review.

The tough, hoof-shaped fruiting bodies of the tinder conk mushroom, Fomes fomentarius (L.) Fr. (Polyporaceae, Agaricomycetes), were traditionally used all over the world as tinder to start fire, for ritual purposes, to make artworks like clothing, frames, ornaments, and also to cure various human diseases (wounds, gastro-intestinal disorders, liver-related problems, inflammations, various cancers, etc.). The first wave of scientific interest in F. fomentarius in Europe dates back to the early 1970s with the discovery of the red-brown pigments of the F. fomentarius external layer. Since then, a number of research papers and reviews have mentioned the history of use, taxonomy, composition and medicinal properties of some F. fomentarius preparations, e.g., soluble extracts and their fractions, isolated cell walls, mycelia and compounds purified from the culture broth. The present review is focused on the composition and benefits of the water-insoluble cell walls obtained from the F. fomentarius fruiting bodies. Isolated cell walls of the tinder mushroom reveal a fibrous hollow structure with an average diameter of 3-5 µm and a wall thickness of 0.2-1.5 µm. Naturally, the fibers are composed of 25-38% glucans, with a majority of ß-glucans, around 30% polyphenols, 6% chitin and less than 2% hemicellulose. The percentage of the main structural compounds can vary either slightly or considerably, depending on the extraction conditions. According to in vitro, in vivo, ex vivo as well as clinical studies, F. fomentarius fibers can modulate the immune system, contribute to intestinal health, accelerate wound healing, absorb heavy metals, organic dyes and radionuclides, normalize kidney and liver function, and provide antibacterial, antiviral, antifungal, anxiolytic, anti-inflammatory and analgesic effects. Multiple action of the insoluble cell walls purified from the F. fomentarius fruiting bodies is particularly effective in the treatment of chronic, recurring, complicated multifactorial diseases. It is certainly worth exploring the medicinal potential and the practical application of these preparations further.

Open-label use of an aliphatic polyamine immunomodulator in patients hospitalized with COVID-19.

Background: Evidence-based therapies used to treat coronavirus disease (COVID-19) remain limited. Azoximer bromide (AZB; Polyoxidonium®) is an immunomodulating molecule frequently used in the Russian Federation. It offers demonstrable therapeutic benefit in upper respiratory tract infections. This study evaluated the safety and efficacy of AZB when used in combination with standard of care treatment in patients hospitalized with COVID-19. Methods: Hospitalized patients with COVID-19 (n=81; nine sites) received AZB 12 mg intravenously once daily for 3 days then intramuscularly every other day until day 17. The primary endpoint included clinical status at day 15 versus baseline. Historical control data of 100 patients from a randomized, controlled, open-label trial conducted in China were included to serve as a direct control group. Results: Notable clinical improvement, assessed by seven-point ordinal scale (OS) score and National Early Warning Score, was observed. Mean duration of hospitalization was 19.3 days. Indicators of pneumonia and lung function showed gradual recovery to normalization. No patients died but, by day 28, one patient still required respiratory support; this patient died on day 34. A higher proportion of patients receiving AZB required invasive or non-invasive ventilation (OS 5 or 6) at baseline compared with the historical control group. Improvement in mean OS score by day 14/15 was not notable in the control group (OS 3.99-3.87) but was clear in the AZB group (OS 4.36-2.90). Mean duration of hospitalization was similar in the control group (16.0 days); however, day 28 mortality was higher, at 25.0% (n=25). Conclusion: AZB combined with standard of care was safe and well tolerated. An apparent clinical improvement could not be fully evaluated due to the lack of a direct control group; further assessment of AZB for the treatment of COVID-19 in a randomized, placebo-controlled study is warranted.

The effect of azoximer bromide (Polyoxidonium®) in patients hospitalized with coronavirus disease (COVID-19): an open-label, multicentre, interventional clinical study.

A clinical need for aetiotropic coronavirus disease (COVID-19) treatments is required. The immune modulator azoximer bromide (AZB; Polyoxidonium®) is indicated in Russia for use against acute viral infections and during remission. In this study, adults hospitalized with COVID-19 (n=32) received AZB and standard of care in an open-label, multicentre, interventional study. All patients were symptomatic; 22 had severe disease (National Early Warning Score ≥5) and required mechanical ventilation or oxygen saturation (SpO2) and 19 patients had co-morbidities. Patients received AZB 12 mg intravenously once daily for 3 days, then intramuscularly every other day (approximately ten injections) until discharge. The primary endpoint was the patient's clinical status (7-point Ordinal Scale; OS) on day 15 versus that at baseline. The mean duration of hospitalization was 20 days. All patients were alive and discharged with normal SpO2 with no secondary infections or delayed mortality reported by the end-of-study visit (on day 28-72). A decrease in the mean OS and National Early Warning Score values was observed following treatment with AZB. A decrease in OS score was marked in patients identified as severe. Both sets of patients achieved similar scores, which can be classified as an improvement by day 9-10; SpO2 levels trended to normalization over time. By day 11-12, all patients had a normal body temperature. Serum C-reactive protein levels decreased in patients with severe and mild disease. Most patients had signs of pneumonia at baseline (n=27), with the majority recovering by days 10-12. No major toxicities were observed. AZB was safe and well tolerated when administered in addition to standard of care treatment for COVID-19. Further randomized, placebo-controlled studies are needed to elucidate any potential therapeutic effect in COVID-19.

Hawthorn.

A review with 54 references covers all aspects of hawthorn, the genus Crataegus, including its traditional uses, chemical constituents, pharmacological activities, and clinical effects. Although the effectiveness of hawthorn on the treatment of cardiovascular diseases has received extensive attention worldwide, further scientific research on various areas such as pharmacokinetics, mechanism of actions will be necessary to ensure its safe and effective usage.

Saterinone: A New Dual-Action Drug in the Acute Management of Chronic Heart Failure.

A new dual-action drug called saterinone combines both alpha-1 blocking vasodilatory property and phosphodiesterase III inhibition--mediated inotropism. A placebo-controlled, randomized, double-blind study was performed in 12 patients with severe congestive heart failure. Either 2 &mgr;g center dot kg center dot min(minus sign1) saterinone (n = 8) or placebo (n = 4) was injected intravenously over 3 h at rest. On-line hemodynamic measurement utilizing intra-arterial blood pressure monitoring and two-dimensional (2D) echocardiography were performed at basal time; then 30, 60, 120 and 180 min after infusion. The parameters measured were blood pressure (mmHg), systemic vascular resistance (SVR dynes center dot cm(5) center dot min(minus sign1)), pulmonary artery pressure (PAP mmHg), mean pulmonary capillary wedge pressure (PCWP mmHg) and cardiac index (CI 1 min/m(2)) using right heart catheterization and end-systolic volume (ESV ml) and end-diastolic volumes (EDV ml), ejection fraction (EF%) using 2D echocardiography. Placebo had no significant effects on any of the parameters (p = NS). Saterinone decreased SVR by 37% (p < 0.001), PAPm by 24% (p < 0.05), PCWP by 35% (p < 0.05), ESV by 27% (p < 0.01) and increased CI by 32% (p < 0.05) and EF by 45% (p < 0.05). Saterinone appears to be a potent drug that produces improvements in both cardiac hemodynamics and LV functional parameters. Further study with this interesting agent is indicated.