Abstract
Some coronavirus disease 2019 (COVID-19) patients develop acute pneumonia which can result in a cytokine storm syndrome in response to Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection. The most effective anti-inflammatory drugs employed so far in severe COVID-19 belong to the cytokine-directed biological agents, widely used in the management of many autoimmune diseases. In this paper we analyze the efficacy of epigallocatechin 3-gallate (EGCG), the most abundant ingredient in green tea leaves and a well-known antioxidant, in counteracting autoimmune diseases, which are dominated by a massive cytokines production. Indeed, many studies registered that EGCG inhibits signal transducer and activator of transcription (STAT)1/3 and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) transcription factors, whose activities are crucial in a multiplicity of downstream pro-inflammatory signaling pathways. Importantly, the safety of EGCG/green tea extract supplementation is well documented in many clinical trials, as discussed in this review. Since EGCG can restore the natural immunological homeostasis in many different autoimmune diseases, we propose here a supplementation therapy with EGCG in COVID-19 patients. Besides some antiviral and anti-sepsis actions, the major EGCG benefits lie in its anti-fibrotic effect and in the ability to simultaneously downregulate expression and signaling of many inflammatory mediators. In conclusion, EGCG can be considered a potential safe natural supplement to counteract hyper-inflammation growing in COVID-19.
Highlights
The new emerging coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection, is characterized by a wide spectrum of symptoms and clinical course from asymptomatic form to mild or serious illness
Considering all the properties and the safety profile of epigallocatechin 3-gallate (EGCG) and/or green tea extract (GTE) in human, we can speculate that catechins supplementation will be at least partially effective in controlling the inflammation damages that occur in SARS-CoV-2 infection
It should be reminded that, until now, there is no direct evidence in favor of the hypothesis that EGCG treatment could improve COVID-19 outcome
Summary
The new emerging coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection, is characterized by a wide spectrum of symptoms and clinical course from asymptomatic form to mild or serious illness. Besides the high cytokine release, a relevant worsening of systemic functionality has been registered, with a reduction of total circulating lymphocytes, infiltration of monocytes/macrophages and neutrophils in the lungs, vasculitis with hypercoagulability, increase of C-reactive protein, transaminases, ferritin, and creatinine serum levels All these features point out that multiple organ damages have occurred [3]. SHLH/MAS has been described by the presence of several signs of immune-dysfunction, such as (i) natural killer cells inability to clear antigen after infection or autoimmune stimulation; (ii) persistence of antigen presentation; (iii) repression of regulatory T (Treg) cell functionality; (iv) activation and proliferation of tissue macrophages (histiocytes); and (v) secretion of pro-inflammatory cytokines by activated histiocytes, which induces systemic hyper-inflammatory syndrome [4,5]. Rheumatoid arthritis, Sjogren’s syndrome, multiple sclerosis, and inflammatory bowel diseases present that peculiarity
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