New challenges can bring out new uses for old drugs. In the fight against the world’s most famous virus, we know of many old drugs and old supplements that have been tested to prevent and/or treat COVID-19. The newer therapies with big price tags often get more media attention, but many old drugs have offered signficant benefits in the ongoing ground war against SARS CoV2 causing COVID 19. Researchers at Cambridge believe the ursodeoxycholic acid (UDCA) offers another off-patent, and thus inexpensive, option in both treatment and prevention.
UDCA has been used for years to treat primary biliary cirrhosis, an autoimmune disease of the liver. In studying the effects of various drugs on liver organoids, they found that a molecule called FXR, regulates the ACE2 doorway through which SARS CoV2 enters cells. These organoids are groups of actual liver cells combined to create a min version of liver cells and bile ducts. This is as close to testing on actual human livers as you can get.
The drug UDCA turns down this FXR protein and pathway, thus closing ACE2 and the entry of the SARS CoV2 virus into the cells. This potential prompted the researchers to test out the UDCA in mini-lung organoids which also showed the ability to prevent the infection of the mini-lungs by SARS CoV2 and in hamsters exposed to SARS CoV2. With that promising finding, they tested the UDCA out on a pair of donated lungs that were not suitable for transplantation into a human. They treated one set of lungs that were keep viable by artificial means with the UDCA and the other set received no UDCA. When both were exposed to SARS CoV2, the UDCA treated lung did not become infected. At the very least, this could be used to sterilize transplanted lungs from COVID before transplantation surgery.
Next they tested the UDCA on a small group of test subjects and monitored them for infection with COVID19 over a period of time. Those subjects who receive UDCA were less likely to become infected and be hospitalized.
More study is needed, but we thank the researchers who work behind the scenes to discover new uses for old drugs. Then we can work out how to apply this to our patients in our office. I will have to consider if this drug is suitable for my patients based on risk – benefits. Helping patients live healthier more abundant lives requires all of us working together.
Teresa Brevini, Mailis Maes, Gwilym J. Webb, Binu V. John, Claudia D. Fuchs, Gustav Buescher, Lu Wang, Chelsea Griffiths, Marnie L. Brown, William E. Scott, Pehuén Pereyra-Gerber, William T. H. Gelson, Stephanie Brown, Scott Dillon, Daniele Muraro, Jo Sharp, Megan Neary, Helen Box, Lee Tatham, James Stewart, Paul Curley, Henry Pertinez, Sally Forrest, Petra Mlcochova, Sagar S. Varankar, Mahnaz Darvish-Damavandi, Victoria L. Mulcahy, Rhoda E. Kuc, Thomas L. Williams, James A. Heslop, Davide Rossetti, Olivia C. Tysoe, Vasileios Galanakis, Marta Vila-Gonzalez, Thomas W. M. Crozier, Johannes Bargehr, Sanjay Sinha, Sara S. Upponi, Corrina Fear, Lisa Swift, Kourosh Saeb-Parsy, Susan E. Davies, Axel Wester, Hannes Hagström, Espen Melum, Darran Clements, Peter Humphreys, Jo Herriott, Edyta Kijak, Helen Cox, Chloe Bramwell, Anthony Valentijn, Christopher J. R. Illingworth, Bassam Dahman, Dustin R. Bastaich, Raphaella D. Ferreira, Thomas Marjot, Eleanor Barnes, Andrew M. Moon, Alfred S. Barritt, Ravindra K. Gupta, Stephen Baker, Anthony P. Davenport, Gareth Corbett, Vassilis G. Gorgoulis, Simon J. A. Buczacki, Joo-Hyeon Lee, Nicholas J. Matheson, Michael Trauner, Andrew J. Fisher, Paul Gibbs, Andrew J. Butler, Christopher J. E. Watson, George F. Mells, Gordon Dougan, Andrew Owen, Ansgar W. Lohse, Ludovic Vallier, Fotios Sampaziotis. FXR inhibition may protect from SARS-CoV-2 infection by reducing ACE2. Nature, 2022; DOI: 10.1038/s41586-022-05594-0
Thanks to Science Daily:
University of Cambridge. (2022, December 5). Off-patent liver disease drug could prevent COVID-19 infection and protect against future variants, researchers find: Unique experiments involved ‘mini-organs’, animal research, donated human organs, volunteers and patients. ScienceDaily. Retrieved December 6, 2022 from www.sciencedaily.com/releases/2022/12/221205121604.htm
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.