Coronavirus Pandemic Update 70: Glutathione Deficiency, Oxidative Stress, and COVID 19

Welcome to another MedCram COVID-19

update

. I want to focus a little bit on the United States for the particular reason that there are several states and counties that are opening up, it seems like some of the rural areas are just starting to pick up, so I want to look at some states in terms of deaths per million population. New York is still at the top followed by New Jersey Connecticut Massachusetts New York is also near the top here in terms of testing per million population in terms of states that have the fewest deaths per million population, we're looking at Hawaii Wyoming Alaska Montana, they are generally rural areas, but even when you start looking at them per capita, they have the lowest death rates, going back to deaths per million population. when you look at the west coast as a state like California, they're actually below average in terms of the United States average, which is 252 deaths per million.

In California, 73 is the state that has conducted the most tests per capita. Rhode Island and the state that has done the least testing per capita is the state of Maine in California, where things are supposed to open up soon, at least slowly through phases, we're not really seeing a reduction here in the new daily cases nor are we really seeing a reduction in daily deaths. Well, let's look at Russia. We previously reported that there had been a dramatic increase in cases that appears to have stabilized at least based on these numbers. Fortunately, in Spain we are seeing a reduction in daily deaths.

We are starting to see in the media how many cases people are getting the idea that Kovat 19 is not just a respiratory disease but in fact it is affecting many other parts of the body and many of you. We know we've discussed this topic regarding the triple impact on

oxidative

stress

of this virus and that opened up a whole discussion about the body's defense mechanisms regarding antioxidants. One we highlighted last time was the enzyme

glutathione

peroxidase that takes up

glutathione

. and oxidizes it in the process of reducing hydrogen peroxide to water and this sparked all the discussion regarding an acidic cysteine ​​in its way of recharging glutathione and improving

oxidative

stress

in some of these respiratory diseases and for a complete review e integral of I recommend that you look at

update

69, one of the important things that we talked about was glutathione and if you don't know, glutathione is actually three amino acids put together, the one in the middle is cysteine ​​and it's here, it's the part that hold this.

The SH group that we talked about last time, which is a reducing agent, on this side we have glycine and on this side we have glutamate, but the glutamate is not attached to the normal one that it would normally be attached to in a polypeptide chain. It's actually attached to the gamma carboxylic group down here, but there are three amino acids that make up glutathione. The other part I want you to know is that this part here, which is the glycine and cysteine ​​residue on the right, is an active like cysteine ​​so you can clearly see how an active like cysteine ​​is one of the precursors to glutathione and that It is important because we talked about administering an active like cysteine ​​as a way to recharge this SH group in patients with oxidized glutathione, but what would happen?

If you actually just administered glutathione and I received a number of comments about it, here is a published report of two cases with kovat 19 that were treated with glutathione. Now you should know in the business that when you look at the evidence, case reports are the lowest form of evidence we have this is not a randomized controlled trial, we have no idea whether or not the two patients' improvement was the result of the medications they took, however, is a case report and we can see here that there were two patients living in New York City with a history of Lyme and tick-borne co-infections who experienced cough and dyspnea and demonstrated radiographic findings consistent with kovat 19 these people were given two grams of glutathione orally or intravenously now it doesn't say which one was administered orally or intravenously and, from my point of view, that is important because when polypeptides are administered orally, the expectation is that The protease cuts them, they are in the stomach and the job of the stomach is to cut them. some reports show it may not be as bioavailable, but I guess the question is if you're cutting glutathione, you're going to be cutting into glutamates and glycine cysteines, which eventually are the building blocks of glutathione, patients also received this intravenously , what happened with oral and intravenous glutathione, glutathione precursors as a cysteine ​​acetal, as we just talked about, an alpha lipoic acid can represent a novel. treatment approach to block NF kappa-b and address cytokine storm syndrome and respiratory distress in patients with Kovan 19 and the reason they say this is because in both patients their dissonance improves within an hour of use, although This is far from proven.

Whatever it does makes it very interesting to think about whether or not patients would improve if they were given acid-sealed cysteine ​​and intravenous glutathione; After all, we discussed the potent thrombolytic effect of a cysteine ​​acetal on the hypoxemia of arterial thrombosis, and that is the pulmonary artery. thrombosis and again the reason we say this is because the von Willebrand factor uses these disulfide bridges to convert these monomers into multimers essentially polymerizing and causing the clot with a lot of platelets, of course what I'm waiting for is the actual clinical evaluation. trial and we have talked about this before is the study of n-acetylcysteine ​​in patients with kovat 19:00 it is the only one that I can find for the treatment of severe Cova 19 infections and in fact here they say that this study is the first to test and acetate in people with severe Cova 19 infections apparently it looks like it is going to be a non-randomized trial with 86 participants with a parallel assignment and an open label in this particular trial they are administering an active eel cysteine ​​at six grams intravenously per day according to the case reports we just saw.

I'm wondering if it would be wise to add glutathione to the regimen. Also published recently, it seems that a Russian researcher associated with a medical university also has a similar hypothesis and we may have even thought of this before we thought about it and the proposal is titled endogenous glutathione

deficiency

as the most likely cause of severe manifestations and death in patients with kovat 19:00 and the summary goes like this based on a thorough analysis of the literature and my own observations I proposed the hypothesis that glutathione

deficiency

is exactly the most plausible explanation for the severe manifestation of death in patients infected with kovat 19 the main risk factors established for severe Koba 19 infection and the relative glutathione deficiency found in patients affected with covent 19 The moderate to severe disease has led me to two very important conclusions: first, the Oxidative stress contributes to lung hyperinflammation, leading to adverse disease outcomes such as acute respiratory distress syndrome, multiple organ failure and death, and second, poor antioxidant defense due to endogenous glutathione.

Deficiency as a result of decreased biosynthesis and/or increased GSH depletion is the most likely cause of increased oxidative damage to the lung, regardless of which of the factors, aging, chronic diseases, central morbidities, smoking or something else were responsible for this deficit, the hypothesis provides novel insights. on the etiology and mechanisms responsible for the severe manifestations of Cova 19 infection and justifies promising opportunities for effective treatment and prevention of the disease through glutathione recovery with n-acetylcysteine ​​and glutathione depletion and in his article Professor paul anakov lists a series of observations he saw with some kovat 19 patients here he has patient M, 34 years old, with symptoms of fever, mild myalgia appeared on the eighth day after contact with a positive kovat 19 patient and disappeared on the sixth day of the disease without treatment and you can see here that the gsh was about 0.7 1/2 micromoles per liter and the reactive oxygen species, which is bad, were at two point zero seven five, which gives us a ro s the gsh ratio of two point nine.

Here is another patient of forty-seven years old with symptoms of fever of thirty. fatigue seven point three miles here the patient's gsh was zero point nine three three reactive oxygen species was one point one four three with a ratio of one point these patients both improved without treatment okay, let's go to the patient three first symptoms like fever and Hundred air appeared on the fourth day after contact with a kovat of nineteen positive patients and the patient persisted for thirteen days. Notice how low this GSHS is, it's zero point zero seven nine and the reactive oxygen species or up to two point seven three, which gives a ro s two gsh ratio of thirty four point six patients had a fever of 39 degrees Celsius dry cough severe dyspnea Navigator fatigue and tachycardia appeared on the 7th day after contact with a kovat and 19 positive patients were hospitalized with radiographic alignment characteristic of kovat 19 and clinical symptoms persist to date for 11 days, so this must have been at the time of writing this article, the gsh is 0.5, our operating system is 3.6 7 7 and again the ratio is as high as 6.9, so the good professor comes up with We come to very conclusions similar, which is that a cysteine ​​acid in the heel as a preventive measure can be very effective.

The professor says here that the oral administration of n-acetylcysteine ​​as a preventive measure against viral infections, as well as the intravenous injection of nak or reduced glutathione, may be effective options against the new

coronavirus

, however, clinical trials are needed to objectively evaluate the effectiveness of an acetalcysteine ​​and reducing glutathione for both the treatment and prevention of this new viral infection, but don't forget that I think there's actually more than just oxidative stress because the clots that they're getting out of people with kovat 19 who are finding they are very rich in platelets and that means that there is also the problem of the von Willebrand factor, these von Willebrand factors are connected to each other by these disulfides. bonds and as we've already talked about acetal cysteine ​​and reduced glutathione will break these disulfide bonds and cause them to lyse and potentially relieve the blockage in hypoxemia with kovat 19 again, this is all a hypothesis, but it seems to fit and I wanted to remind everyone that If you go to med cram comm and sign up there, you'll see all of our kovat 19 resources, including all of the videos we've recorded on ANCOVA 19.

I also encourage you to check out some of our other offerings. like our very popular ECG interpretation, CBC results are clearly explained and vasopressors are clearly explained thank you for joining us