Bousquet, JeanTorre Fornell, Rafael de laPizarro Lozano, Mª NievesAntó i Boqué, Josep Maria2021-02-172021-02-172020Bousquet J, Le Moing V, Blain H, Czarlewski W, Zuberbier T, de la Torre R et al. Efficacy of broccoli and glucoraphanin in COVID-19: From hypothesis to proof-of-concept with three experimental clinical cases. World Allergy Organ J. 2020; 14(1):100498. DOI: 10.1016/j.waojou.2020.1004981939-4551http://hdl.handle.net/10230/46507COVID-19 is described in a clinical case involving a patient who proposed the hypothesis that Nuclear factor (erythroid-derived 2)-like 2 (Nrf2)-interacting nutrients may help to prevent severe COVID-19 symptoms. Capsules of broccoli seeds containing glucoraphanin were being taken before the onset of SARS-CoV-2 infection and were continued daily for over a month after the first COVID-19 symptoms. They were found to reduce many of the symptoms rapidly and for a duration of 6-12 h by repeated dosing. When the patient was stable but still suffering from cough and nasal obstruction when not taking the broccoli capsules, a double-blind induced cough challenge confirmed the speed of onset of the capsules (less than 10 min). A second clinical case with lower broccoli doses carried out during the cytokine storm confirmed the clinical benefits already observed. A third clinical case showed similar effects at the onset of symptoms. In the first clinical trial, we used a dose of under 600 μmol per day of glucoraphanin. However, such a high dose may induce pharmacologic effects that require careful examination before the performance of any study. It is likely that the fast onset of action is mediated through the TRPA1 channel. These experimental clinical cases represent a proof-of-concept confirming the hypothesis that Nrf2-interacting nutrients are effective in COVID-19. However, this cannot be used in practice before the availability of further safety data, and confirmation is necessary through proper trials on efficacy and safety.application/pdfeng© 2020 The Author(s). Published by Elsevier Inc. on behalf ofWorld Allergy Organization. This is an open access article under the CC BYlicense (http://creativecommons.org/licenses/by/4.0/)info:eu-repo/semantics/articlehttp://dx.doi.org/10.1016/j.waojou.2020.100498ACE, Angiotensin converting enzymeAT1R, Angiotensin II receptor type 1BMI, Body mass indexBroccoliBroccoli, Broccoli seed capsulesCOVID-19COVID-19, Coronavirus 19 diseaseCough challengeNAPQI, N-acetyl-p-benzoquinone imineNrf2Nrf2, Nuclear factor (erythroid-derived 2)-like 2SARS, Severe acute respiratory syndromeSARS-Cov-2, Severe acute respiratory syndrome coronavirus 2TRP, Transient receptor potentialTRPA1TRPA1, Transient receptor potential ankyrin 1TRPV1TRPV1, Transient receptor potential vanillin 1VAS, Visual analogue scaleinfo:eu-repo/semantics/openAccess