Psycho-Babble Medication Thread 1110832

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Can someone explain this COVID/MAO-B study?

Posted by PeterMartin on June 19, 2020, at 7:09:19

There was a preprint paper (not yet peer reviewed) suggesting MAOIB may be somehow related to COVID symptoms. Based on this abstract, do you think MAOIs (which reactive MAOb, right?) Would be helpful or perhaps detrimental if someone were to get COVID19? I'm currently on an MAOI so it's relevant to me. Thx!


https://www.medrxiv.org/content/10.1101/2020.06.16.20128660v1

Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a range of extra-respiratory signs and symptoms. One such manifestation is delirium, an acute confusional state occurring in 60-70% of severe SARS-CoV-2 cases. Delirium is also a common clinical syndrome following planned orthopedic surgery. This investigation initially explored the underlying role of metabolism in delirium-susceptibility in this setting. Metabolomics profiles of cerebrospinal fluid (CSF) and blood taken prior to surgery found significant concentration differences of several amino acids, acylcarnitines and polyamines were observed in delirium-prone patients. Phenethylamine (PEA) concentrations in delirium-prone patients was significantly lower in CSF than in blood, whilst in age- and gender-matched controls the opposite was observed (adjusted p values: 1.8x10-6 (control) and 1.788x10-10 (delirium)). PEA is metabolised by monoamine oxidase B (MAOB), a putative enzyme target for the treatment of Alzheimers disease, Parkinsons disease and depression.


Our computational structural comparisons of MAOB and angiotensin converting enzyme (ACE) 2 found high similarity, specifically within the SARS-CoV-2 spike protein. MAOB structural alignment to ACE2 was 51% overall, but this was over 95% in the ACE2-spike protein binding region. Thus, it is possible that the spike protein interacts with MAOB on a molecular level.

A previously published metabolomic dataset of control subjects and patients with either mild or severe COVID-19 was then analysed. Major concentration differences in some metabolites attributed to altered MAO activity were detected.

Therefore, our hypothesis is that the SARS-CoV-2 influences MAOB activity, which is one potential cause for the many observed neurological and platelet based complications of SARS-CoV-2 infection.

 

Re: Can someone explain this COVID/MAO-B study?

Posted by linkadge on June 19, 2020, at 15:01:00

In reply to Can someone explain this COVID/MAO-B study?, posted by PeterMartin on June 19, 2020, at 7:09:19

Great article and question.

I've always been interested in MAO-B. Generally speaking, MAO-B activity is thought to increase with age. It also appears to be increased in depression (especially depression with cognitive disturbance). MAO-B inhibitors are used for Parkinson's disease, but also appear to have pro-cognitive effects (i.e. selegiline is approved for canine cognitive dysfunction). This study doesn't directly say whether MAO-B levels are elevated (or depressed) in patients with COVID associated delirium. My *assumption* would be that there could be an elevation (simply due to the fact that MAO-B elevation is associated with cognitive dysfunction, and the association of worse outcomes in elderly COVID patients).

The study found that "Phenethylamine (PEA) concentrations in delirium-prone patients was significantly lower in CSF than in blood". I'm not sure if this would be the result of MAO-B elevation or depression. MAO-B is responsible for PEA metabolism. Lower PEA in the CFS might be associated with lower PEA metabolism and hence lower MAO-B (?? not sure). I mean, if COVID caused a severe DROP in MAO-B levels, this could theoretically cause delirium too (as a result of higher PEA levels). They said there is an association between ACE2 and MAO-B. I understand that ACE2 is elevated in COVID, perhaps this means that MAO-B levels are elevated as well.

Another consideration is that elevated MAO-B levels are generally associated with brain inflammation. For example, in mice, when agents are given to increase inflammation (or stress induced inflammation) it generally increases MAO-B levels. Given the 'cytokine storm' in COVID, this might be though to induce an increase in MAO-B via inflammation. My thought is that they are suggesting an elevation of MAO-B levels, but I really don't know and, of course, it could be dangerous to self medicate with MAO inhibitors at this stage.

Linkadge


 

Re: Can someone explain this COVID/MAO-B study?

Posted by linkadge on June 19, 2020, at 15:08:05

In reply to Re: Can someone explain this COVID/MAO-B study?, posted by linkadge on June 19, 2020, at 15:01:00

As a side note. I've wondered the effects of omega-3 in COVID. They have anti-inflammatory, blood thinning, immune regulating effects. Also, DHA has some antiviral properties. I wonder if it has been studied. DHA can also lower MAO-B in certain brain regions.

Linkadge

 

Re: Can someone explain this COVID/MAO-B study? linkadge

Posted by Hugh on June 19, 2020, at 15:57:51

In reply to Re: Can someone explain this COVID/MAO-B study?, posted by linkadge on June 19, 2020, at 15:08:05

A derivative of fish oil called specialized pro-resolving mediators (SPMs) contain 17-HDHA, which enhances the immune response against the influenza virus, so perhaps it would have the same effect on COVID. Here's some information about it:

https://www.dr-bob.org/babble/20200303/msgs/1108854.html

 

Re: Can someone explain this COVID/MAO-B study?

Posted by PeterMartin on June 19, 2020, at 17:39:45

In reply to Re: Can someone explain this COVID/MAO-B study? linkadge, posted by Hugh on June 19, 2020, at 15:57:51

Thanks guys!

Linkadge, I really appreciate your in depth breakdown. Hopefully Marplan would help (if anything) if I should end up catching this thing.

 

Re: Can someone explain this COVID/MAO-B study?

Posted by undopaminergic on June 20, 2020, at 5:53:55

In reply to Re: Can someone explain this COVID/MAO-B study?, posted by linkadge on June 19, 2020, at 15:01:00

> Great article and question.
>
> I've always been interested in MAO-B. Generally speaking, MAO-B activity is thought to increase with age. It also appears to be increased in depression (especially depression with cognitive disturbance). MAO-B inhibitors are used for Parkinson's disease, but also appear to have pro-cognitive effects (i.e. selegiline is approved for canine cognitive dysfunction).
>

What about rasagiline? It could be the (l-) amphetamine metabolites of selegiline.

PEA can most definitely have pro-cognitive effects, especially in ADHD, but I'm not sure this is true at physiological (natural) PEA levels, because my experience is with exogenous PEA and, on top of it, under MAO-B inhibition with selegiline.

> This study doesn't directly say whether MAO-B levels are elevated (or depressed) in patients with COVID associated delirium.
>

If that were so, I think the abstract would have stated that much. From what I read, it is about the differential concentrations in blood vs. CSF.

-undopaminergic

 

Re: Can someone explain this COVID/MAO-B study? undopaminergic

Posted by linkadge on June 21, 2020, at 17:22:45

In reply to Re: Can someone explain this COVID/MAO-B study?, posted by undopaminergic on June 20, 2020, at 5:53:55

>What about rasagiline? It could be the (l-) >amphetamine metabolites of selegiline.

This could play a role. However, there is more to MAO-B inhibition than simply elevation of PEA / dopamine. I don't pretend to understand it all myself, but there is a (perhaps bidirectional) interaction between MAO-B and inflammation / neuroprotective factors. MAO-B inhibitors likely don't prevent one from contracting COVID (again, not sure), but *may* reduce some of the deleterious neurological effects (again, just speculation at this point).

Linkadge

 

Re: Can someone explain this COVID/MAO-B study?

Posted by rjlockhart37 on June 21, 2020, at 22:52:27

In reply to Re: Can someone explain this COVID/MAO-B study?, posted by undopaminergic on June 20, 2020, at 5:53:55

looks like Parnate anti-depressant would be a choice for covid, but not sure how.

 

Re: Can someone explain this COVID/MAO-B study?

Posted by rjlockhart37 on June 21, 2020, at 22:53:38

In reply to Re: Can someone explain this COVID/MAO-B study?, posted by rjlockhart37 on June 21, 2020, at 22:52:27

I don't think so, its too advanced, parnate is mainly for dopamine MAO-B, there is no way it could treat covid

 

Re: Can someone explain this COVID/MAO-B study?

Posted by undopaminergic on June 22, 2020, at 1:01:24

In reply to Re: Can someone explain this COVID/MAO-B study?, posted by rjlockhart37 on June 21, 2020, at 22:53:38

> I don't think so, its too advanced, parnate is mainly for dopamine MAO-B, there is no way it could treat covid
>

Tranylcypromine (Parnate) has only a modest preference for MAO-B. At usual doses, it is unselective.

 

Re: Can someone explain this COVID/MAO-B study? undopaminergic

Posted by linkadge on June 22, 2020, at 7:56:40

In reply to Re: Can someone explain this COVID/MAO-B study?, posted by undopaminergic on June 22, 2020, at 1:01:24

Again, we need to back up here.

There is no evidence that MAO-B inhibitors prevent or treat COVID. This NOT what the study is talking about.

The study is simply suggesting an association between MAO-B levels and COVID induced delirium. However the study does not indicate whether it is high MAO-B or low MAO-B in this relationship.

The other 'risk' of MAOis in COVID is that they can preclude the use of other drugs (which may interact).

Again, at this stage there is not enough evidence to suggest that MAOIs treat, prevent or cure COVID in any form.

Linkadge

 

Re: Can someone explain this COVID/MAO-B study?

Posted by pontormo on June 25, 2020, at 1:27:40

In reply to Re: Can someone explain this COVID/MAO-B study? undopaminergic, posted by linkadge on June 22, 2020, at 7:56:40

Also, the study hasn't been peer-reviewed, which means that the relevant scientists haven't subjected the investigative method and reasoning to scrutiny, and affirmed its conforming to the standards of research that would make it worth serious consideration.

So it's premature to deduce anything from it.

 

Re: Can someone explain this COVID/MAO-B study?

Posted by rjlockhart37 on June 30, 2020, at 1:32:45

In reply to Re: Can someone explain this COVID/MAO-B study?, posted by pontormo on June 25, 2020, at 1:27:40

yeah,, parnate would do nothing for COVID-19 treatment, it may help their depression while there having it, parnate is blockbustered as one the most potent anti-depressants, but some people don't like it. Nardil, Parnate, Marplan, but one that i've researched, that has been effective in psych hospitals, Elavil. There are high response rates to it, patients got better, there were more percentage increase than the others.

I don't know, the research on COVID-19 and parnate, there's some things they said, but truely it would not treat it.


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