Biological Effects of Quercetin in COPD

Temple University

Status and phase: Enrolling; Phase 2; Phase 1

Conditions: Chronic Obstructive Pulmonary Disease

Treatments: Drug: Quercetin

Study type: Interventional

Funder types: Other; Industry; NIH

Identifiers

NCT03989271

R33AT009991 (U.S. NIH Grant/Contract)

25738

Details and patient eligibility

About

This study determines whether quercetin supplementation reduces the inflammation and oxidative stress markers in patients with chronic obstructive pulmonary disease. It is small study with 8 subjects receive quercetin 2000 mg/day and 4 subjects receive placebo.

Full description

Chronic obstructive pulmonary disease (COPD) is a progressive lung disorder and affects millions of people globally. Although the exact mechanisms of pathogenesis of this disease are not well-understood, the general consensus is that oxidative stress and inflammation induced by exposure to cigarette smoke or other environmental or occupational hazards are responsible for development of COPD. Therefore, therapies aimed at decreasing oxidative stress and inflammation constitutes an important component of treating COPD.

The current pharmacological therapies may provide temporary symptom relief, reduce acute exacerbations and hospitalizations, but are associated with side effects. Therefore complementary method of treatment with potentially fewer side effects and relatively well-tolerated provide promising alternative. One such compound is quercetin, which is plant polyphenol and is present in variety of foods that we consume. Quercetin has potent antioxidant and anti-inflammatory properties and reduces oxidative stress and inflammation in a preclinical model of COPD. Quercetin exerts it antioxidant properties not only by neutralizing free radical species, but also by enhancing the expression of antioxidant enzymes. Similarly, quercetin inhibits various protein and lipid kinases by competing for adenosine triphosphate (ATP) binding sites thus reducing the inflammatory pathways.

Enrollment: 29 estimated patients

Sex: All

Ages: 40 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Subjects with COPD, 40 - 80 yrs of age
• Post-bronchodilator forced expiratory volume (FEV)1/forced vital capacity (FVC) ratio 0.7, FEV1% predicted between 40 to 70
• Both active and ex-smokers with at least 10 pack-years history of smoking
• COPD patients taking H2 antagonists, loperamide or loratadine and willing to stop during the study period

Exclusion criteria

• Known allergy/sensitivity to quercetin

• Subjects with primary current diagnosis of asthma

• Upper respiratory tract infection within two weeks of the screening visit

• Acute bacterial infection requiring antibiotics within two weeks of screening

• Emergency treatment or hospitalization within one month of screening for any reasons

• Unwillingness to stop flavonoid supplementation

• Dietary intake exceeding or averaging 150 mg quercetin daily as assessed by Bioflavonoid Food and Supplement Screener

• Daily warfarin or cyclosporine (Neoral, Sandimmune)

• Subjects taking H2 antagonists (cimetidine, ranitidine), loperamide (Imodium) or loratadine and not willing to stop during study period

• Lung cancer history or undergoing chemo- or radiation therapy

• Inflammatory bowel disease

• Subjects with no detectable levels of inflammatory CRP or SP-D in blood and/or IL-

  1β or 8-isoprostane in the exhaled breath condensate

• Women of child-bearing age and unwilling to take pregnancy test

• Child-bearing age, who are unwilling to use adequate contraception or abstain during the course of the study.

• Pregnant or lactating mothers

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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29 participants in 2 patient groups, including a placebo group

Quercetin

Active Comparator group

Description:

Quercetin 2000 mg/day Quercetin is provided as orange flavored soft chews and each chew will have 250 mg of quercetin Quercetin will be administered orally twice daily, one half dose (4 chews) in the morning after breakfast and one half dose (4 chews) in the evening after dinner for six months.

Treatment:

Drug: Quercetin

Placebo

Placebo Comparator group

Description:

Placebo is also provided as soft chews that is similar to quercetin in color, taste and texture and will contain all the stabilizers and the inactive ingredients that is present in the quercetin chews. Placebo will be administered orally twice daily, one half dose (4 chews) in the morning after breakfast and one half dose (4 chews) in the evening after dinner for six months.

Treatment:

Drug: Quercetin