2012 Theisen LL Et Al.

15th ICID Abstracts / International Journal of Infectious Diseases 16S (2012) e2–e157 e95
Type: Poster Presentation Type: Poster Presentation
Final Abstract Number: 40.058 Final Abstract Number: 40.059

Session: Virology and Viral Infections (Non-HIV) Session: Virology and Viral Infections (Non-HIV)
Date: Thursday, June 14, 2012 Date: Thursday, June 14, 2012
Time: 12:45-14:15 Time: 12:45-14:15
Room: Poster & Exhibition Area Room: Poster & Exhibition Area
EPs® 7630 (Umckaloabo®), an extract from Pelargonium Acute encephalitis in children caused by influenza virus-AH1N1
sidoides roots, exerts anti-influenza virus activity in vitro and
G. Jugulete 1 , M. Luminos 2,∗ , M.M. Merisescu 3 , A. Draganescu 4 , A.
in vivo
Visan 5 , M. Vasile 1 , A. Bilasco 1
L.L. Theisen, S. Gohrbandt, C.P. Muller, N. Luetteke ∗ 1 Institute of Infectious Diseases “Prof. dr. Matei Bals”, Bucharest,
Centre de Recherche Public de la Santé / National Public Health Labo- Romania
ratory, Luxembourg, Luxembourg 2 Infectious diseases national institute “Prof. dr. Matei Bals”, Bucharest,
Romania
Background: A prodelphinidin-rich extract from Pelargonium 3 National Institute for Infectious Diseases “Prof. Dr. Matei Bals”,
sidoides DC, EPs® 7630 (Umckaloabo®), which is licensed to treat
Bucharest, Romania
respiratory tract infections such as acute bronchitis, was investi- 4 Institute of Infectiouse Diseases “Prof. dr. Matei Bals”, Bucharest,
gated for its antiviral effects.
Romania
Methods: The efficacy of EPs® 7630 on influenza A virus prop- 5 Institute of Infectious Diseases, Bucharest, Romania
agation was investigated in vitro against different strains, after
different infection and treatment timepoints and by neuraminidase Background: Worldwide, seasonal flu epidemics remains a
and hemagglutination inhibition assays. Isolated monomers, major public health problem. Most recent pandemic influenza, with
dimers and oligo-/polymeric fractions were compared for antivi- AH1N1 virus, also included Romania. Acute encephalitis is one of
ral activity. In vivo, EPs® 7630 was investigated after inhalative the most severe complications of influenza in children.
application. Methods: In this article, we present two clinical cases of acute
Results: EPs® 7630 showed dose-dependent anti-influenza encephalitis in children caused by AH1N1 influenza virus, that
activity at non toxic concentrations against pandemic H1N1, were hospitalized in Pediatric Intensive care unit of the National
Oseltamivir sensitive and resistant seasonal H1N1, seasonal H3N2 Institute of Infectious Diseases “Prof. Dr. Matei Bals” in Bucharest.
and the laboratory H1N1 strain A/Puerto Rico/8/34, while it had Positive diagnosis was established on clinical, epidemiological and
no antiviral activity against adenovirus or measles virus. The laboratory data. Diagnosis confirmation was made by RT-PCR from
extract inhibited an early step of influenza infection and impaired nasal-pharyngeal secretions of patients. MRI examination was per-
viral hemagglutination as well as neuraminidase activity. How- formed in both cases and it showed disseminated encephalitis
ever, EPs® 7630 did not exhibit a direct virucidal effect, as virus outbreaks located especially in the brainsteam, in the first case and
preincubation (unlike cell preincubation) with the extract did not for the second patient subarachnoid hemorrhage with the absence
influence infectivity. Analysis of EPs® 7630 constituents revealed of cerebral circulation. The EEG examination confirmed the diag-
that prodelphinidins represent the active principle. Chain length nosis for both patients. They both were treated with Oseltamivir
influenced antiviral activity, as monomers and dimers were less and cortisone in high doses.
effective than oligo- and polymers. Importantly, gallocatechin and Results: The outcome for both patients was grave, the first one
its stereoisomer epigallocatechin exert antiviral activity also in presented severe mental and physical retardation and the second
their monomeric form. In addition, EPs® 7630 administered by one required oral-tracheal intubation and mechanical ventilation
inhalation significantly improved survival, body weight and body for 90 days but still had fatal evolution.
temperature of influenza-infected mice, without obvious toxicity, Conclusion: The flu caused by AH1N1 virus can have severe evo-
demonstrating the benefit of EPs® 7630 in treatment of influenza. lution into encephalitis or other neurological complications or even
Conclusion: In this study, we investigated the anti-influenza death. Establishing early diagnosis and proper treatment may be
mechanism of EPs® 7630 and demonstrate its efficacy in vitro and the key for a good outcome and prognosis improvement.
in vivo. The extract shows a robust effect against multiple different
IAV strains in vitro and protection of mice against a lethal virus http://dx.doi.org/10.1016/j.ijid.2012.05.221
challenge at non-toxic concentrations, underlining the benefit of
EPs® 7630 as a treatment for influenza virus infection.
http://dx.doi.org/10.1016/j.ijid.2012.05.220

2012 Theisen LL Et Al.

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15th ICID Abstracts / International Journal of Infectious Diseases 16S (2012) e2–e157 e95

Type: Poster Presentation Type: Poster Presentation

Final Abstract Number: 40.058 Final Abstract Number: 40.059

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