We spoke to three respected industry professionals, Dilip Ghosh, the director of Nutriconnect in Australia; Sandeep Gupta, chief founder and director of India’s Expert Nutraceutical Advisory Council (ENAC) and Nutraworks; and Dr Anish Desai, director at Intellimed Healthcare Solutions.
CEO of Gencor Pacific, R. V Venkatesh, also recently gave insights on plans to conduct a human clinical trial to validate the effectiveness of palmitoylethanolamide (PEA) in symptomatic relief of the flu symptoms.
A common point brought up by the experts was the need for the government and industry to work together in the areas of new research and regulatory adjustment.
“The initiatives [to conduct research] should come from pharmaceutical-nutraceutical companies, but implementation to be done through government-academic-industry partnership,” Ghosh said, when asked who should take the lead on investigating the potential benefits of nutraceuticals in relation to the COVID-19 pandemic.
He gave the example of how Australia’s CSIRO’s Australia’s Australian Animal Health Laboratory was collaborating with the Peter Doherty Institute for Infection and Immunology in prioritising the assessment of antiviral compounds against COVID-19.
Echoing his views, Gupta and Dr Desai recently formed the Nutraworks Intelligent Scientific Alliance (NISA) in India to work with the institutions, government, and the industry.
“The aim is to engage the industry to invest in nutraceutical research that can build the immune system.
“The government and industry should also create public awareness about how consuming certain supplements can boost the immune system,” Gupta said, pointing out how in the case of India, the traditional diet might not provide enough micronutrients needed to boost immunity.
Venkatesh, on the other hand, stressed the need to investigate immune-boosting ingredients while being cautious and responsible when making product claims at the same time.
“Right now, there are a lot of people making a lot of claims about miracle cures for flu and the coronavirus, and the regulatory authorities also do not like it, because there is no evidence that anything is working against the coronavirus.
“That is why we want to be careful and not to be mistaken,” he said.
On the regulatory front, Gupta highlighted how the recommended dietary allowance (RDA) of certain micronutrients could be increased to maximise their immune-boosting effects.
Citing the example of India, he said that the RDA of vitamin C set was 40mg, which he had described as a “limited dose”.
He said that in order to boost the immunity in light of the pandemic, the RDA of vitamin C should ideally be increased to between 100mg and 200mg.
He added that the Indian Council of Medical Research (ICMR) had submitted a proposal to India’s regulator FSSAI to increase the RDA of vitamin C to 50% of the international tolerable upper limit (TUL).
The experts also singled out traditional herbal medicines and micronutrients as examples of promising nutraceutical ingredients which companies could focus on in light on the outbreak.
Combining evidence-based natural medicines and pharmacological intervention could be a good strategy at this stage, said Ghosh.
“To prevent viral attack, we must stop the viral life cycle, such as viral entry, replication, assembly, and release. These are mediated through many receptors and other binding mechanism; henceforth multi-component approach would be ideal.
“Traditional medicines may possess some advantages in preventing or treating strains resistant to drugs against single viral target,” he said, giving the following examples.
1. Virgin coconut oil
He gave the examples of virgin coconut oil, citing a particular research published by Filipino researchers on how the ingredient and its derivatives – namely lauric acid and monolaurin were showed to be safe and effective antiviral compounds.
Fucoidan has also shown the potential to boost anti-viral responses on coronaviruses, although not on COVID-19 specifically, he said.
He added that extensive research was conducted to find out the immune-modulatory properties of fucoidan, such as reducing allergic responses and the activation of natural killer cells and T cells.
3. Cinnamon bark extract
One more example is cinnamon, where IND02 compounds – which are isolated from the bark have showed antiviral action against viruses such as H1N1 and H3N2.
Currently, researchers at the department of pulmonary medicine at Zhongshan Hospital and Fudan University are investigating the binding kinetics and affinity of IND02 to the receptor binding domain (RBD) of the COVID-19 spike protein by the biolayer interferometry binding assay.
“Based on the many mechanistic and pre-clinical studies, IND02 is expected to exert its action both on the viral entry as well as on the host immune modulation via reducing the oxidative stress and injury to the respiratory milieu in the infected patients,” Ghosh said.
Although nutraceuticals offer multiples possibilities, he said that based on the existing scientific output, he did not support any direct claims on a particular supplement that claim to prevent or treat COVID-19.
4. Micronutrients and phytochemicals
Gupta and Dr Anish, on the other hand, have pointed out how vitamins A, B6, C, D, E, astaxanthin, polyphenols from the pomegranate extract, glutathione, ginger, and garlic could be important nutrients to build up the immunity.
They cited research recently published in Progress in Cardiovascular Diseases on how certain nutraceuticals may help to provide relief for people infected with encapsulated RNA viruses, such as influenza and coronaviruses.
They added that luteolin, apigenin, quercetin, and chlorogenic acid were “among the topmost bioactive photochemical with potential anti-viral activity against coronaviruses and influenza”.
“These have multiple sources and it is important to identify the nutraceuticals with the most potent bioactivity.
“In view of the absence of an approved anti-viral therapy or preventive vaccine for COVID-19 and limited treatment options for influenza, nutraceuticals and phytochemicals must be the focus of anti-viral research,” they said.
5. Palmitoylethanolamide (PEA)
Gencor Pacific will be conducting a human clinical trial to validate the benefits of PEA in Australia during the winter season.
The trial will also study the impact of PEA on the symptomatic relief of flu symptoms.
According to Venkatesh, existing literature has shown that the PEA has anti-inflammatory and painkiller properties. One of the key mechanisms if through mast cell degranulation.