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Many sufferers endure not solely from respiratory signs because of their COVID-19 illness, but additionally from considerably diminished bodily efficiency. A patent-protected pill (CICR-NAM) developed on the College Hospital Schleswig-Holstein (UKSH), Campus Kiel, releases nicotinamide, a type of vitamin B3, particularly within the intestine.
The administration of CICR-NAM has now proven a statistically vital impact in a big research (COVit-2) with 900 COVID-19 sufferers: with CICR-NAM, the sufferers regained their regular bodily efficiency in on a regular basis life extra rapidly inside two weeks than with a placebo.
The staff from the Cluster of Excellence “Precision Medicine in Chronic Inflammation” (PMI) printed the leads to Nature Metabolism. Because of its subtle knowledge administration and integration constructions, the Cluster can perform giant research akin to COVit-2 inside a short while.
Revolutionary pill releases nicotinamide particularly within the intestine
Earlier analysis had already proven that the metabolism of sufferers with COVID-19 and different viral infections has an elevated want for vitality sources through the acute part of the illness. One of many precursors for metabolic elements within the vitality system of cells is vitamin B3.
It is usually recognized that COVID-19 negatively alters the intestine microbiome. That is the place the brand new CICR-NAM pill (controlled-ileocolonic-release nicotinamide) from Kiel is available in: it releases nicotinamide particularly within the final part of the small gut and within the giant gut.
In consequence, nicotinamide can have a constructive impact on the intestinal microbiome, compensate for vitamin deficiency and strengthen sure metabolic processes.
“A breakthrough has been achieved with these results. An intervention based entirely on molecular nutrition can actually influence the course of a severe infectious disease such as COVID-19,” says Professor Stefan Schreiber, Director of the Division of Inside Medication I and the Institute of Scientific Molecular Biology (IKMB) on the UKSH, Campus Kiel, and principal investigator of the research.
“This means that a new anti-inflammatory principle has been established by specifically influencing the microbiome.”
“Nicotinamide from conventional tablets is already absorbed by the body in the stomach and small intestine before it can reach the intestinal microbiome,” explains Dr. Georg Wätzig, Coordinator of Translational Analysis on the IKMB, who led the event of the CICR-NAM tablets and coordinated the COVit-2 research.
“With this study, we have successfully tested a new approach in which vitamin B3 is first protected and released only in the intestine.”
Success in a big placebo-controlled trial
Within the COVit-2 trial, the staff examined 900 freshly identified COVID-19 sufferers all through Germany, half of whom have been randomized to take two nicotinamide tablets (500 mg every of CICR-NAM and traditional nicotinamide) or identical-looking placebo tablets for 4 weeks.
The research was double-blind, i.e. neither the sufferers nor the members of the research staff knew who was through which group. The sufferers underwent repeated phone interviews relating to the course of their illness. Many additionally despatched in stool samples recurrently in order that the composition of their intestine microbiome could possibly be analyzed along with their illness course.
The outcomes of the COVit-2 trial present that sufferers with a danger issue for extreme COVID-19 programs, e.g. people who smoke or individuals with earlier lung illnesses, who obtained nicotinamide have been considerably extra more likely to have regained their regular bodily efficiency after two weeks than sufferers within the placebo group. The flexibility to deal with regular on a regular basis life was additionally considerably higher within the nicotinamide group after two weeks.
Although the research didn’t give attention to extra long-term penalties of the illness, akin to lengthy COVID and submit COVID, the researchers nonetheless noticed a promising pattern on the six-month follow-up: sufferers who had a better danger of submit COVID and responded to nicotinamide confirmed fewer post-COVID signs.
Constructive impact by influencing the microbiome
Within the research, the researchers additionally took a more in-depth have a look at the microbial neighborhood residing within the intestine.
“The microbiome of COVID-19 patients still shows a kind of emergency metabolism around two weeks after the onset of the disease, in which the body obviously tries to compensate for the known deficits in important metabolic factors by upregulating other metabolic processes,” explains Professor Philip Rosenstiel, Director of the IKMB, who led the microbiome research.
“We didn’t observe these modifications within the nicotinamide research group—in all probability as a result of the deficiency could possibly be compensated by administering nicotinamide. On the similar time, we noticed a quicker bodily restoration in these circumstances. The constructive affect on the microbiome is outwardly associated to the quicker restoration.
“This is the first time we have shown that influencing the microbiome, in this case through supplementation of a nutrient, can have a positive effect on a viral infection. This is an important milestone in clinical research.”
The event of the CICR-NAM compound relies on a few years of analysis by members of the Cluster of Excellence PMI.
As early as 2012, a analysis staff led by Professor Rosenstiel and Professor Josef Penninger, at the moment Scientific Director of the Helmholtz Middle for An infection Analysis in Braunschweig, confirmed in Nature {that a} deficiency of nicotinamide and associated substances within the gut will increase the tendency towards irritation in mice. The deficiency additionally adversely impacts the microbiome.
“The effectiveness of the specially encapsulated vitamin B3 in COVID-19 opens up completely new insights and ways of inhibiting inflammation,” says Professor Joachim Thiery, Dean of the School of Medication and Board Member for Analysis and Educating at UKSH, Campus Kiel.
“I would like to congratulate Professor Schreiber on behalf of all those involved in the study program on this great scientific and clinical success. I would also like to thank the patients involved. Without their participation, this milestone in precision medicine for everyone would not have been achieved,” says Professor Thiery.
Extra data:
Stefan Schreiber et al, Nicotinamide modulates intestine microbial metabolic potential and accelerates restoration in mild-to-moderate COVID-19, Nature Metabolism (2025). DOI: 10.1038/s42255-025-01290-1
Supplied by
Exzellenzcluster Präzisionsmedizin für chronische Entzündungserkrankungen
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Scientific trial finds quicker restoration from COVID-19 by way of focused use of high-dose vitamin B3 within the intestine (2025, Might 12)
retrieved 12 Might 2025
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