In the race to find an effective, low-cost treatment for COVID-19, a powerful molecule that has long captured the attention of medical researchers is gaining popularity.
Nitric oxide, a two-part nanomolecule made in the cells that line the blood vessels, is being examined as an experimental treatment for the disease caused by the novel coronavirus. Studies show it plays a role in helping to relax blood vessels and open the airways in the lung -- critical in treating those with advanced cases.
Among the companies vying to harness this naturally produced gas is a Canadian firm that is experimenting with using nitric oxide nasal spray or mouth gargles that may help those at a high risk of becoming infected from contracting COVID-19 in the first place.
SaNOtize Research has been given a $400,000 grant from the National Research Council and is now conducting phase two of a clinical trial on people at high risk for contracting COVID-19, including front-line workers, and those with mild symptoms of the disease.
The trial, which started in British Columbia, is being expanded to participants in Quebec come June 1, with talk of an Ontario-based study in the near future.
“It’s really important we get this trial done as soon as possible and then we can work with regulatory authority, then we can turn it around in three to four months,” Chris Miller, SaNOtize Chief Scientific Officer, told CTV News.
Nitric Oxide has many properties -- it’s produced by cells that line our blood vessels to helps control blood pressure and open the airways in the lung, allowing more oxygen to be absorbed.
But researchers have also found nitric oxide has an antibacterial and antiviral effect.
SaNOtize's nasal spray is designed to “disinfect” your upper airway using nitric oxide. Initial tests of the company's product suggest that the spray inactivated more than 99.9 per cent of SARs-CoV-2, the virus that causes COVID-19, within two minutes during laboratory tests.
“You’re using a hand sanitizer to disinfect your hands. It’s a similar idea, but instead of a hand sanitizer, it’s a nasal spray to disinfect your upper airway,” SaNOtize CEO Gilly Regev told CTV Vancouver.
With no confirmed therapeutic treatment for COVID-19, researchers around the world have turned their attention to the molecule once dubbed “molecule of the year.”
With its role in the human body discovered in the 1980s, nitric oxide is already approved for use in helping improve oxygen levels in premature babies and is used in some cardiac procedures and drugs for erectile dysfunction.
One of the studies suggesting it may have potential as a tool against COVID-19 is a report by Dr. Roham Zamanian, a pulmonologist at Stanford Health Care in California. His team gave nitric oxide to a woman suffering from pulmonary arterial hypertension who had also developed COVID-19.
Doctors treated her at home, adding the gas to her oxygen supply.
Over the course of 11 days, the patient improved and didn’t need hospital care.
“We saw an improvement in her symptoms, we saw an improvement in her ability to walk distances over six minutes, which is our usual test of cardiopulmonary reserve,” Zamanian told CTV News.
“We were able to document that she was feeling better and better as we provided her with the nitric oxide, until day 15, 16 where we want to begin to wean the medication off.”
Her recovery encouraged Zamanian so much that his centre is now launching a study of inhaled nitric oxide in hospitalized patients and those recovering at home
Another study is underway at the University Health Network in Toronto to see whether high dose inhaled nitric oxide given in hospital can reduce levels of the virus and improve breathing in COVID-19 patients on ventilators.
Scientists in Boston and Louisiana are also giving several hundred severely ill patients nitric oxide, with preliminary results expected in the coming weeks. Several devices that produce nitric oxide have also been given the green light for testing in the U.S.
Researchers say side effects from the gas are minimal and they hope to have more data on the various approaches later this year, before the expected second wave of the disease.
Meanwhile, watching from the sidelines, is one of the three Nobel Prize winning scientists responsible for discovering the molecule some two decades ago.
“There's every reason to believe that the nitric oxide will work in the present coronavirus situation,” American pharmacologist Lou Ignarro told CTV News.
“That's going to be worth much more than the Nobel Prize I will be so happy. You know I'm 79-years-old and this would just be the, the most fantastic thing I could hear.”