Table 1.
Four-way approach to interventions in sepsis, COVID-19, and the relevance of A. pullulans β-glucans whose effects cover the effects produced by the other interventions.
| Four-way approach to management of Sepsis and COVID-19 | Intervention | Sepsis | Effects | COVID-19 | Effects | Relevance/Effects of A.pullulans beta glucans | ||
|---|---|---|---|---|---|---|---|---|
| Increase | Decrease | Increase | Decrease | |||||
| Anti-microbial | Antibiotics | Infection | Infection | Anti-viral and antibacterial (39, 74) | ||||
| Immune-suppression | Corticosteroids | Ref (75) | NF-κB, IL-1, TNF, IL-8, and MCP-1 | Ref (76) | Cytokines especially IL-6 | NF-κB downregulation; Suppression of NO, IL-1β, IL6, TNF-α (77) | ||
| C5a blockade (78) | Yes | IL-17 | Suppression of inflammatory cytokines (50) | |||||
| Anakinra (IL-1 receptor antagonist) | Ref (79) | Ref (79) | CRP, IL-1 | Decrease in CRP and IL-1 (41, 42) | ||||
| Tocilizumab and sarilumab (IL-6 blockade) | Ref (80) | IL-6 | Ref (81) | IL-6 | Decrease in IL-6 | |||
| Immune-enhancement | IFN-γ, | Ref (82) | HLA-DR expression ; Th1 cytokine | Th1 cytokine increase (83) | ||||
| GM-CSF | Ref (84) | Proinflammatory monocytic cytokine production | Both administration and inhibition of GM-CSF (85) | Administration of GM-CSF: Alveolar macrophages (85) | Inhibition of GM-CSF :IL-1, IL-6, TNF (85) | Cytokine increase, increase in immune cells such as NK cells (38, 86); Increase in GM-CSF expression (39) | ||
| Interleukin-7 | Ref (10) | CD4+ and CD8+ T cells | Increase in CD4+ and CD8 lymphocytes (41, 87) | |||||
| Intravenous Immunoglobulins | Ref (88) | IL-1,IL-6, IL-10,IL2,TNF-α | Ref (89) | IL-13, CD4+ T Cells | IL-6 | Decrease in IL-1β, IL-2, IL-6, IL-12 (p70+40), IFN-γ, TNF-α) (38); Increase in IgA (90) | ||
| Metabolic/Coagulation | Metabolic resuscitators [coenzyme Q10 (CoQ10), cytochrome oxidase (CytOx), L-carnitine, melatonin] | Ref (91) | Mitochondrial function | Improvement in glucose, lipid levels (31, 32) and mitochondrial respiration (92) | ||||
| Ascorbic acid, tocopherol, selenium and zinc | Ref (91) | Mitochondrial function | ||||||
| Ascorbic acid and Zinc | NK cells, T cells | Neutrophils | Increase in NK cells, T cells and decrease in neutrophils (38, 41, 42, 86) | |||||
| Anti-coagulation therapies | Ref (93) | Ferritin, DDimer | Decrease in Ferritin ad D-Dimer (41, 42) | |||||