Facts and myths about inosine Review article
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Published:
Nov 30, 2023
Keywords:
inosine pranobex, antiviral, safety, effectiveness
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Abstract
Pranobex inosine is an immunostimulating and antiviral drug, using for over 50 years in the treatment of viral infections of the upper respiratory tract and herpes. During this time, a lot of experiences has been gained about its use and safety. This effected in the many facts and myths about the drug safety and effectiveness. In this paper we analyze the most important of them.
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How to Cite
Sapilak , B. J. (2023). Facts and myths about inosine. Medycyna Faktow (J EBM), 16(3(60), 353-356. https://doi.org/10.24292/01.MF.0323.13
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References
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3. McCarthy MT, Lin D, Soga T et al. Inosine pranobex enhances human NK cell cytotoxicity by inducing metabolic activation and NKG2D ligand expression. Eur J Immunol. 2020; 50(1): 130-7. http://doi.org/10.1002/eji.201847948.
4. Krastev Z, Jelev D, Ivanova R. Isoprinosine induces a rapid lympho-mononuclear response in adult participants. Med Inf. 2015; 2(1): 80-5.
5. Corey L, Chiang W, Reeves W et al. Effect of isoprinosine on the cellular immune response in initial genital herpes virus infection. Clin Res. 1979; 27: 41A.
6. Galbraith GM, Thiers BH, Fudenberg HH. An open-label trial of immunomodulation therapy with inosiplex (Isoprinosine) in patients with alopecia totalis and cell-mediated immunodeficiency. J Am Acad Dermatol. 1984; 11(2): 224-30.
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8. Wybran J, Schandene L. Isoprinosine in aphthous stomatitis: clinical improvement associated with enhancement of IL2 production. Int J Immunopharmacol. 1985; 7(3): 318.
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10. Cianciara J, Laskus T, Gabinska E et al. Isoprinosine in the treatment of chronic active hepatitis type B. Scand J Infect Dis. 1990; 22(6): 645-8.
11. Schinazi RF, Cannon DL, Arnold BH et al. Combinations of isoprinosine and 3’-azido-3’-deoxythymidine in lymphocytes infected with human immunodeficiency virus type 1. Antimicrob Agents Chemother. 1988; 32(12): 1784-7.
12. Majewska A, Lasek W, Janyst M et al. Inhibition of adenovirus multiplication by inosine pranobex and interferon α in vitro. Cent Eur J Immunol. 2015; 40(4): 395-9. http://doi.org/10. 5114/ceji.2015.56960.
13. Piret J, Boivin G. Resistance of herpes simplex viruses to nucleoside analogues: mechanisms, prevalence, and management. Antimicrob Agents Chemother. 2011; 55(2): 459-72. http://doi.org/10.1128/ AAC.00615-10.
14. Gupta R, Warren T, Wald A. Genital herpes. Lancet. 2007; 370(9605): 2127-37. http://doi.org/10.1016/ s0140-6736(07)61908-4.
15. Looker KJ, Magaret AS, May MT et al. Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. PLoS ONE. 2015; 10(10): e0140765. http://doi.org/10.1371/ journal.pone.0140765.
16. Looker KJ, Magaret AS, Turner KME et al. Global estimates of prevalent and incident herpes simplex virus type 2 infections in 2012. PLoS ONE. 2015; 10(1): e114989. http://doi.org/10.1371/journal. pone.0114989.
17. Majewska A, Lasek W, Młynarczyk G. Pranobeks inozyny – działanie cytotoksyczne oraz wpływ na replikację ludzkich wirusów paragrypy (HPIV-2, HPIV-4), enterowirusów (CA16, EV71) i adenowirusów (HAdV-2, HAdV-5) w badaniu in vitro [Inosine pranobex – cytotoxic activities and effect of on replication of human parainfluenza viruses (HPIV-2, HPIV-4), entroviruses (CA16, EV71) and adenoviruses (HAdV-2, HAdV-5) in vitro]. Med Dosw Mikrobiol. 2015; 67(2): 107-13.
18. Malgouyat J. A new approach to the treatment of genital condyloma in women. Gynecologie. 1983; 34(5): 415-517.
19. Sadoul G, Beuret T. Treatment of cervical and vulvar condylomata by CO2 laser also with a immunostimulant. Rev Fr Gynecol Obstet. 1984; 79(11): 681-4.
20. Beran J, Špajdel M, Slíva J. Inosine Pranobex Deserves Attention as a Potential Immunomodulator to Achieve Early Alteration of the COVID-19 Disease Course. Viruses. 2021; 13(11): 2246. http://doi. org/10.3390/v13112246.
21. Beran J, Špajdel M, Katzerová V et al. Inosine Pranobex Significantly Decreased the Case-Fatality Rate among PCR Positive Elderly with SARS-CoV-2 at Three Nursing Homes in the Czech Republic. Pathogens. 2020; 9(12): 1055. http://doi.org/10.3390/pathogens9121055. Erratum in: Pathogens. 2021; 10(9): 1121.
22. Jayanthi CR, Swain AK, Ganga RT et al. Efficacy and Safety of Inosine Pranobex in COVID-19 Patients: A Multicenter Phase 3 Randomized Double-Blind, Placebo-Controlled Trial. Adv Ther (Weinh). 2022: 2200159. http://doi.org/10.1002/adtp.202200159.
23. You Y, Wang L, Li Y et al. Multicenter randomized study of inosine pranobex versus acyclovir in the treatment of recurrent herpes labialis and recurrent herpes genitalis in Chinese patients. J Dermatol. 2015; 42(6): 596-601. http://doi.org/10.1111/1346-8138.12845.
24. De Simone C, Famularo G, Tzantzoglou S et al. Inosine pranobex in the treatment of HIV infection: a review. Int J Immunopharmacol. 1991; 13(suppl 1): 19-27. http://doi.org/10.1016/0192-0561(91)90120-v.
25. Beran J, Šalapová E, Špajdel M; Isoprinosine Study (EWO ISO-2014/1) Team. Inosine pranobex is safe and effective for the treatment of subjects with confirmed acute respiratory viral infections: analysis and subgroup analysis from a Phase 4, randomised, placebo-controlled, double-blind study. BMC Infect Dis. 2016; 16(1): 648. http://doi.org/10.1186/s12879-016-1965-5.
26. Wybran J, Appelboom T. Isoprinosine (inosiplex): immunological and clinical effects. Immunomodulation. Boston, MA: Springer; 1984: 363-74.
27. Masihi KN. C7 Anti-infective activity of immunomodulators. Principles of immunopharmacology. Basel: Birkha¨user; 2011: 411-35.
2. Baza Leków. Groprinosin. (access: 20.07.2023).
3. McCarthy MT, Lin D, Soga T et al. Inosine pranobex enhances human NK cell cytotoxicity by inducing metabolic activation and NKG2D ligand expression. Eur J Immunol. 2020; 50(1): 130-7. http://doi.org/10.1002/eji.201847948.
4. Krastev Z, Jelev D, Ivanova R. Isoprinosine induces a rapid lympho-mononuclear response in adult participants. Med Inf. 2015; 2(1): 80-5.
5. Corey L, Chiang W, Reeves W et al. Effect of isoprinosine on the cellular immune response in initial genital herpes virus infection. Clin Res. 1979; 27: 41A.
6. Galbraith GM, Thiers BH, Fudenberg HH. An open-label trial of immunomodulation therapy with inosiplex (Isoprinosine) in patients with alopecia totalis and cell-mediated immunodeficiency. J Am Acad Dermatol. 1984; 11(2): 224-30.
7. Lowy M, Ledoux-Corbusier M, Achten G et al. Clinical and immunologic response to Isoprinosine in alopecia areata and alopecia universalis: association with autoantibodies. J Am Acad Dermatol. 1985; 12(1): 78-84.
8. Wybran J, Schandene L. Isoprinosine in aphthous stomatitis: clinical improvement associated with enhancement of IL2 production. Int J Immunopharmacol. 1985; 7(3): 318.
9. Dabrowska-Bernstein B, Stasiak A, Dabrowski M et al. Evaluation of the treatment of chronic active hepatitis (HBsAg?) with Isoprinosine. II. Immunological studies. Pol Tyg Lek. 1990; 45(16-18): 347-51.
10. Cianciara J, Laskus T, Gabinska E et al. Isoprinosine in the treatment of chronic active hepatitis type B. Scand J Infect Dis. 1990; 22(6): 645-8.
11. Schinazi RF, Cannon DL, Arnold BH et al. Combinations of isoprinosine and 3’-azido-3’-deoxythymidine in lymphocytes infected with human immunodeficiency virus type 1. Antimicrob Agents Chemother. 1988; 32(12): 1784-7.
12. Majewska A, Lasek W, Janyst M et al. Inhibition of adenovirus multiplication by inosine pranobex and interferon α in vitro. Cent Eur J Immunol. 2015; 40(4): 395-9. http://doi.org/10. 5114/ceji.2015.56960.
13. Piret J, Boivin G. Resistance of herpes simplex viruses to nucleoside analogues: mechanisms, prevalence, and management. Antimicrob Agents Chemother. 2011; 55(2): 459-72. http://doi.org/10.1128/ AAC.00615-10.
14. Gupta R, Warren T, Wald A. Genital herpes. Lancet. 2007; 370(9605): 2127-37. http://doi.org/10.1016/ s0140-6736(07)61908-4.
15. Looker KJ, Magaret AS, May MT et al. Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. PLoS ONE. 2015; 10(10): e0140765. http://doi.org/10.1371/ journal.pone.0140765.
16. Looker KJ, Magaret AS, Turner KME et al. Global estimates of prevalent and incident herpes simplex virus type 2 infections in 2012. PLoS ONE. 2015; 10(1): e114989. http://doi.org/10.1371/journal. pone.0114989.
17. Majewska A, Lasek W, Młynarczyk G. Pranobeks inozyny – działanie cytotoksyczne oraz wpływ na replikację ludzkich wirusów paragrypy (HPIV-2, HPIV-4), enterowirusów (CA16, EV71) i adenowirusów (HAdV-2, HAdV-5) w badaniu in vitro [Inosine pranobex – cytotoxic activities and effect of on replication of human parainfluenza viruses (HPIV-2, HPIV-4), entroviruses (CA16, EV71) and adenoviruses (HAdV-2, HAdV-5) in vitro]. Med Dosw Mikrobiol. 2015; 67(2): 107-13.
18. Malgouyat J. A new approach to the treatment of genital condyloma in women. Gynecologie. 1983; 34(5): 415-517.
19. Sadoul G, Beuret T. Treatment of cervical and vulvar condylomata by CO2 laser also with a immunostimulant. Rev Fr Gynecol Obstet. 1984; 79(11): 681-4.
20. Beran J, Špajdel M, Slíva J. Inosine Pranobex Deserves Attention as a Potential Immunomodulator to Achieve Early Alteration of the COVID-19 Disease Course. Viruses. 2021; 13(11): 2246. http://doi. org/10.3390/v13112246.
21. Beran J, Špajdel M, Katzerová V et al. Inosine Pranobex Significantly Decreased the Case-Fatality Rate among PCR Positive Elderly with SARS-CoV-2 at Three Nursing Homes in the Czech Republic. Pathogens. 2020; 9(12): 1055. http://doi.org/10.3390/pathogens9121055. Erratum in: Pathogens. 2021; 10(9): 1121.
22. Jayanthi CR, Swain AK, Ganga RT et al. Efficacy and Safety of Inosine Pranobex in COVID-19 Patients: A Multicenter Phase 3 Randomized Double-Blind, Placebo-Controlled Trial. Adv Ther (Weinh). 2022: 2200159. http://doi.org/10.1002/adtp.202200159.
23. You Y, Wang L, Li Y et al. Multicenter randomized study of inosine pranobex versus acyclovir in the treatment of recurrent herpes labialis and recurrent herpes genitalis in Chinese patients. J Dermatol. 2015; 42(6): 596-601. http://doi.org/10.1111/1346-8138.12845.
24. De Simone C, Famularo G, Tzantzoglou S et al. Inosine pranobex in the treatment of HIV infection: a review. Int J Immunopharmacol. 1991; 13(suppl 1): 19-27. http://doi.org/10.1016/0192-0561(91)90120-v.
25. Beran J, Šalapová E, Špajdel M; Isoprinosine Study (EWO ISO-2014/1) Team. Inosine pranobex is safe and effective for the treatment of subjects with confirmed acute respiratory viral infections: analysis and subgroup analysis from a Phase 4, randomised, placebo-controlled, double-blind study. BMC Infect Dis. 2016; 16(1): 648. http://doi.org/10.1186/s12879-016-1965-5.
26. Wybran J, Appelboom T. Isoprinosine (inosiplex): immunological and clinical effects. Immunomodulation. Boston, MA: Springer; 1984: 363-74.
27. Masihi KN. C7 Anti-infective activity of immunomodulators. Principles of immunopharmacology. Basel: Birkha¨user; 2011: 411-35.