Title : Probiotic and anti-inflammatory potential of D.SAP, a new apple-based formulation, against COVID-19: Preclinical and clinical evidence
Abstract:
Introduction: SARS-CoV-2, the causative agent of COVID-19, is associated with severe respiratory complications and unpredictable mortality. A key pathogenic mechanism involves hyperinflammation and cytokine storms, often leading to acute respiratory distress and fatal outcomes. Natural products with anti-inflammatory or immunomodulatory effects may provide complementary therapeutic strategies. Dezhakam sap (D.SAP), a specially formulated apple-derived product, has been proposed as a potential natural intervention due to its probiotic, polyphenolic, and antioxidant properties. This study aimed to evaluate the effects of D.SAP on COVID-19–associated inflammation in both a rodent model and human patients.
Methods: Rodent models of SARS-CoV-2 infection were treated with D.SAP smoke at varying concentrations for seven days. Viral RNA (RDRP, N, and E genes) and inflammatory markers (IL6, IL1β, and TNF) in lung tissue were assessed using real-time PCR. In a human cohort, 210 COVID-19 patients with ≥12 months of prior D.SAP use and 350 patients without prior use were compared, alongside 1080 healthy controls. Peripheral blood samples were analyzed for inflammatory gene expression by real-time PCR.
Results: In rodents, D.SAP treatment significantly reduced viral RNA levels (RDRP, N, and E) and decreased IL6, IL1β, and TNF expression compared with untreated infected controls. In humans, prior D.SAP use was associated with markedly reduced expression of inflammatory markers relative to non-users with COVID-19 infection.
Conclusion: Clinical and preclinical findings consistently support the anti-inflammatory and antiviral potential of D.SAP in COVID-19. These effects may be attributed to its probiotic, polyphenolic, and antioxidant components preserved during production. D.SAP may represent a promising natural adjunctive therapy to mitigate hyperinflammation and improve outcomes in COVID-19 and related respiratory infections.
Keywords: COVID-19, probiotic, D.SAP, inflammation, gene expression, SARS-CoV-2.
