title: Coenzyme Q(10), vitamin E, selenium, and methionine in the treatment of chronic recurrent viral mucocutaneous infections.
abstract: OBJECTIVE
  Host defense and latency determinants in viral recurrent dermatologic infections are not entirely understood, as conventional protocols are inadequate to achieve fast healing and relapse prevention. Endogenously produced oxygen/nitrogen reactive species (ROS/RNS) are essential for antiviral immune defense, while their excess may aggravate skin inflammation. Here, we sought a nutritional approach capable of controlling ROS/RNS balance to accelerate recovery and inhibit recurrences of two mucocutaneous chronic DNA-virus infections.
  
  
  METHODS
  Two controlled clinical trials evaluated the feasibility of ROS/RNS-modulating nutriceutical dosages of coenzyme Q(10), RRR-α-tocopherol, selenium aspartate, and L-methionine associated with established therapies. Clinical trial 1 evaluated 68 patients with relapsing human papillomavirus skin warts treated with cryotherapy followed by 180 d of nutriceutical/placebo administration. Clinical trial 2 compared the combination of acyclovir followed by 90 d of nutriceutical administration versus acyclovir alone in patients with recurrences of herpes simplex genitalis (n = 60) or herpes zoster (n = 29). Viral DNA levels were assessed by polymer chain reaction, biomarkers of antiviral defense (peroxynitrite and IFNα/γ) and antioxidant capacity (lipophilic antioxidants and glutathione) were assayed by biochemical/enzyme-linked immunosorbent assay techniques in blood fractions.
  
  
  RESULTS
  In both trials, the nutriceutical induced significantly faster healing (P < 0.01-0.05) with reduced incidence of relapses (P < 0.05) as compared to control groups, which was confirmed by decreased viral load and increased antiviral cytokine and peroxynitrite plasma levels. Plasma antioxidant capacity was higher (P < 0.01) in the experimental versus control groups.
  
  
  CONCLUSIONS
  Results document positive clinical outcomes of the selected nutriceutical associated with conventional protocols in the management of relapsing mucocutaneous human papillomavirus and herpes infections.
authors.affiliation: Dermatology Research Institute (IDI IRCCS), Rome, Italy. c.deluca@idi.it
authors.forename: Chiara
authors.initials: C
authors.lastname: De Luca
authors.forename: Zaira
authors.initials: Z
authors.lastname: Kharaeva
authors.forename: Desanka
authors.initials: D
authors.lastname: Raskovic
authors.forename: Palmira
authors.initials: P
authors.lastname: Pastore
authors.forename: Antonio
authors.initials: A
authors.lastname: Luci
authors.forename: Liudmila
authors.initials: L
authors.lastname: Korkina
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000284:Administration, Oral; D000328:Adult; D052685:Alphapapillomavirus / Q000187:drug effects / Q000472:pathogenicity; D000975:Antioxidants / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D017679:Cryotherapy / Q000379:methods; D004266:DNA Virus Infections / Q000188:drug therapy*; D004279:DNA, Viral / Q000302:isolation & purification; D019587:Dietary Supplements; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006558:Herpes Genitalis / Q000188:drug therapy; D006562:Herpes Zoster / Q000188:drug therapy; D054884:Host-Pathogen Interactions / Q000187:drug effects; D006801:Humans; D008297:Male; D008715:Methionine / Q000627:therapeutic use*; D008875:Middle Aged; D026361:Reactive Nitrogen Species; D017382:Reactive Oxygen Species; D012008:Recurrence; D012643:Selenium / Q000627:therapeutic use*; D012874:Skin Diseases, Infectious / Q000188:drug therapy*; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019562:Viral Load; D014810:Vitamin E / Q000627:therapeutic use*; D055815:Young Adult; D024502:alpha-Tocopherol / Q000627:therapeutic use
chemical_list: D000975:Antioxidants; D000998:Antiviral Agents; D004279:DNA, Viral; D026361:Reactive Nitrogen Species; D017382:Reactive Oxygen Species; D014451:Ubiquinone; D014810:Vitamin E; D008715:Methionine; C024989:coenzyme Q10; D024502:alpha-Tocopherol; D012643:Selenium; D000212:Acyclovir