13 cis retinoic acid improved the outcomes of COVID-19 patients. A randomized clinical trial
RCT with 20 13-cis-retinoic acid patients and 20 control patients, showing faster recovery and viral clearance with treatment. Aerosolized 13-cis-retinoic acid with increasing dose from 0.2 mg/kg/day to 4 mg/kg/day for 14 days, plus oral 13-cis-retinoic acid 20 mg/day. 13-cis retinoic acid is a synthetic vitamin A derivative, and is teratogenic. NCT04353180 (history)
risk of death, 85.7% lower, RR 0.14, p = 0.23, treatment 0 of 20 (0.0%), control 3 of 20 (15.0%), NNT 6.7, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of ICU admission, 66.7% lower, RR 0.33, p = 0.24, treatment 2 of 20 (10.0%), control 6 of 20 (30.0%), NNT 5.0.
recovery time, 35.4% lower, relative time 0.65, p < 0.001, treatment mean 16.3 (±4.5) n=20, control mean 25.23 (±4.72) n=20.
time to viral-, 44.0% lower, relative time 0.56, p < 0.001, treatment mean 13.36 (±1.49) n=20, control mean 23.85 (±4.0) n=20.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Elkazzaz et al., 8 Mar 2022, Randomized Controlled Trial, Egypt, preprint, 4 authors, study period June 2020 - August 2020, trial NCT04353180 (history)
Abstract: STRA6 (vitamin A receptor), as a Novel binding receptor of
COVID-19 (A breakthrough)
Mahmoud Elkazzaz ( Mahmoudramadan2051@yahoo.com )
Faculty of Science Damietta University https://orcid.org/0000-0003-3703-520X
Faculty of Medicine, Kafrelsheikh University, Egypt
Yousry Esam-Eldin Abo-Amer
Hepatology,Gastroenterology and Infectious Diseases Department, Mahala Hepatology Teaching Hospital, Egypt
Israa M Shamkh
Chemo and Bioinformatics Lab, Bio Search Research Institution, BSRI. Giza , Egypt, Federal University of Alfenas, Brazil.
Mohammed .F. Abo El Magd
Zoology and Nematode department, Faculty of Agriculture , Al Azhar University, Cairo, Egypt
Director of tuberculosis program Ghubera, public health department ,First health cluster ,Ministry of health , Riyadh, Saudia
Keywords: COVID-19, Retinoic Acid, STRA6, Spike protein
Posted Date: September 13th, 2021
License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License
A global pandemic of pneumonia caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Wuhan,
China, at the end of 2019. Although, the ACE2 receptor has been demonstrated to be the main entry receptor of COVID-19, but our
docking analysis , predicted and discovered a novel receptor termed STRA6 that may play a critical role in the pathogenicity of
COVID-19 and explain the common pre and post COVID-19 symptoms with unknown etiology. STRA6 receptor expressed in many
organs and immune cells, upregulated by retinoic acid jm6 (STRA6) was the first protein to be identified in a novel category of
proteins, cytokine signaling transporters, due to its ability to function as both a cell surface receptor and a membrane protein that
binds to retinol binding protein facilitating cellular uptake of retinol. The primary ligand of STRA6 (vitamin/retinol) was shown to
be drastically reduced during COVID-19 infection, which agrees with our findings.
The STRA6 receptor protein were submitted to the server for functional interaction associated network between partners for the
STRING (Research Online of Interacting Genes/Proteins Data Basis version 10.0)13 .Docking study of each Spike -ACE 2 and
STRA6 receptor protein were carried out using HDOCK server (http://hdock.phys.hust.edu.cn/). The binding mode of Spike -ACE 2
and STRA6 receptor protein is retrieved form the PDB https://www.rcsb.org/ with accession number (7DMU , 5sy1)
Surprisingly, our molecular docking based analysis showed that spike protein Receptor Binding Domain(RDB) of COVID19 strongly and efficiently binds to STRA6 receptor, definitely to the RDB vital residues of RBP-binding motif located in STRA6
receptor. STRA6 receptor is a membrane receptor responsible for signaling and transporting of Vitamin A(Retinol) from plasma
retinol binding protein (RBP) to our cells. In an outstanding manner, COVID-19 Spike protein exhibited high docking score with
human STRA6 with low binding energy . The docking score of COVID-19 spike protein was stronger than the docking score of
spike protein with ACE2.The surface view of complex reveals that the binding pocket of STRA6- Spike protein and Spike ACE 2
complexes with RMSD (189.44 Å , 1.00 Å )..
is less effective
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