{"id":3391,"date":"2026-04-24T21:06:46","date_gmt":"2026-04-24T21:06:46","guid":{"rendered":"https:\/\/pge2-hypothesis.com\/?page_id=3391"},"modified":"2026-09-02T05:49:19","modified_gmt":"2026-09-02T05:49:19","slug":"lc-trials","status":"publish","type":"page","link":"https:\/\/pge2-hypothesis.com\/?page_id=3391","title":{"rendered":"LC trials"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3391\" class=\"elementor elementor-3391\">\n\t\t\t\t<div class=\"elementor-element elementor-element-25cc27fb e-flex e-con-boxed e-con e-parent\" data-id=\"25cc27fb\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4698ca3 elementor-widget elementor-widget-heading\" data-id=\"4698ca3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Long COVID therapies, tested partially beneficial, linked to EP-receptor profiles <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2be3700 elementor-widget elementor-widget-text-editor\" data-id=\"2be3700\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t\n<p class=\"wp-block-paragraph\"><br \/>Long COVID interventions; PGE2 hypothesis-driven mechanistic explanations<\/p>\n\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<tbody>\n<tr>\n<td><strong>\u00a0<\/strong> <strong>Long COVID therapy trials<\/strong><\/td>\n<td><strong>\u00a0<\/strong> Published data<\/td>\n<td><strong>\u00a0<\/strong> Hypothetical molecular mechanisms underlying symptom alleviation in LC<br \/><br \/><\/td>\n<\/tr>\n<tr>\n<td colspan=\"3\">\u00a0<\/td>\n<\/tr>\n<tr>\n<td><strong><br \/>DNA Aptamer drug BC007<\/strong> <strong>Rovunaptabin<\/strong> <strong>\u00a0<\/strong> Two cohort studies<br \/><sup>1,2<\/sup><br \/>and a case report <sup>3<\/sup> \u00a0 \u201cThe removal of GPCR-AAb might ameliorate the characteristics of the LCD, such as capillary impairment, loss of taste, and CFS.\u201d <sup>3<\/sup><br \/><br \/><\/td>\n<td><br \/>BC007<br \/>decreases IgG-autoantibody-activity <sup>3<\/sup> \u00a0 PGE2 stimulates autoantibodies through EP2 and EP4 <sup>4<\/sup> <sup>5<\/sup> <sup>6,7<\/sup> \u00a0<\/td>\n<td>\n<p><br \/>BC007 could decrease inflammatory PGE2 activity, neutralizing autoantibodies (see <a href=\"https:\/\/pge2-hypothesis.com\/?page_id=3441\">PGE2 in autoimmunity<\/a>)<\/p>\n<p>Potentially beneficial for patients with \u201cEP2 up\u201d and\/or \u201cEP4 up\u201d (\u201cEP3 down\u201d)<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td><strong><br \/>Histamine receptor antagonists (HRA)<br \/><br \/><\/strong> Cohort study <sup>8<\/sup><br \/><br \/>\u201c72% of patients with long COVID who received HRA reported clinical improvement.\u201d <strong>\u00a0<\/strong><\/td>\n<td><br \/>HRA could decrease inflammatory PGE2 activity\u00a0 <sup>8<\/sup><br \/>Histamine reportedly upregulates COX-2\/ PGE2 through H1 <sup>9<\/sup> and through H2 <sup>10<\/sup> \u00a0 HRA therapy antagonizes histamine activity <sup>8<\/sup><br \/><br \/><\/td>\n<td><br \/>HRA could decrease inflammatory PGE2 activity by preventing histamine from upregulating PGE2 through H1 and H2 \u00a0<br \/><br \/>Potentially beneficial for patients with \u201cEP3 down\u201d<br \/><br \/><\/td>\n<\/tr>\n<tr>\n<td><strong><br \/>Hyperbaric oxygen (HBOT)<\/strong> <strong>\u00a0<\/strong> Cohort study <sup>11<\/sup> Review <sup>12<\/sup><br \/><br \/>\u201c56-63% of long term-ill patients had a clinically relevant improvement in MCS\/PCS 3 months after HBOT. <strong>However, 13-19% of the patients had a clinically relevant deterioration in MCS\/PCS.\u201d <\/strong><strong><sup>11<\/sup><\/strong><strong><br \/><br \/><\/strong><\/td>\n<td><br \/>HBOT decreases PGE2 level <sup>13-15<\/sup><br \/>HBOT alleviates predominantly cognitive symptoms <sup>11<\/sup> that we presume to be stimulated by EP1 (see section 10. And 11.1)<br \/>\u201cThe symptoms that showed most improvement were predominantly in the cognitive domain <sup>11<\/sup>.\u201d<\/td>\n<td>\n<p><br \/>HBOT decreases inflammatory PGE2 activity effectively <sup>13-15<\/sup> HBOT elevates BP <sup>16<\/sup><br \/>BP is elevated through EP3<sup>17<\/sup><br \/>\u00a0 <br \/>Potentially beneficial for patients with \u201cEP1 up\u201d<\/p>\n<p>Potentially <strong>harmful for patients with \u201cEP3 up\u201d &amp; \u201cEP1 down\u201d <br \/><br \/><\/strong>Potentially safe for patients with \u201cEP3 down\u201d<br \/><br \/><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td><strong><br \/>Lidocaine<br \/><\/strong>Subcutaneous lidocaine-HP-\u03b2-CD: every other day or daily <strong>\u00a0<\/strong> Cohort study <sup>18<\/sup><br \/><br \/>\u201cTwenty-seven of 30 symptoms improved significantly at week 24 of treatment compared to pre-treatment. No serious adverse events were reported.\u201d <sup>18<\/sup><br \/><br \/><\/td>\n<td><br \/>Prolonged Lidoca\u00efne administration reportedly decreases COX-2 \/ PGE2 activity <sup>19<\/sup><br \/><br \/><\/td>\n<td><br \/>Prolonged Lidoca\u00efne administration could hypothetically alleviate long COVID symptoms, <strong>decreasing PGE2 activity by binding to the Gq subunit of EP1\u00a0\u00a0<\/strong><br \/><br \/>Potentially beneficial for patients with \u201cEP1 up\u201d <strong>potentially unbeneficial for patients with \u201cEP1 down\u201d<\/strong><br \/><br \/><\/td>\n<\/tr>\n<tr>\n<td><strong><br \/>Low Dose Naltrexon<\/strong> <strong>\u00a0<\/strong> Cohort study <sup>20<\/sup> Case series with CFS patients <sup>21<\/sup><br \/><br \/>\u201cWe found a subset of 52\u00a0% of patients to be responders after 12 weeks of treatment.\u201d\u00a0<br \/><br \/>Case series with CFS patients <sup>21<\/sup> \u201csmall-scale clinical trials have shown efficacy and low toxicity.\u201d<br \/><br \/><\/td>\n<td><br \/>LDN decreases PGE2 activity through antagonizing TRL-4 activity <sup>22<\/sup> \u00a0 TRL-4 triggers PGE2 production <sup>23<\/sup><\/td>\n<td><br \/>LDN could decrease inflammatory PGE2 activity through antagonizing TRL-4 activity <sup>22<\/sup><br \/><br \/>Potentially beneficial for patients with \u201cEP3 down\u201d<br \/><br \/><\/td>\n<\/tr>\n<tr>\n<td><strong>Stellate Ganglion Block (SGB)<\/strong> <strong>\u00a0<\/strong> Cohort study <sup>24<\/sup> \u00a0 \u201cResults indicated that a substantial proportion of patients (86%) experienced a reduction of their symptoms following SGB treatment.\u201d <sup>24<\/sup><\/td>\n<td>In general, the SNS and PNS have opposing effects, and they interact <sup>25<\/sup> possibly through PGE2 activity:<br \/>PGE2 binding to EP3 increases inflammatory SNS activity <sup>26<\/sup> <sup>27<\/sup> and suppresses PNS activity <sup>28<\/sup><br \/>(see section 4.) \u00a0<\/td>\n<td>SGB could decrease inflammatory PGE2 activity by inhibiting inflammatory SNS signaling <sup>29<\/sup> and stimulating anti-inflammatory PNS signaling<br \/><br \/>May provide benefits across all four sub-phenotypes, but as it is expected to reduce PGE2 levels very effectively, it <strong>may pose a risk of raising blood pressure in patients with an \u201cEP3-up\u201d profile.<\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong><br \/>Vagal Nerve Stimulation (VNS)<\/strong> <strong>\u00a0<\/strong> Cohort study <sup>30<\/sup><br \/><br \/>\u201cThis pilot study provides preliminary evidence supporting the potential of t-VNS as a therapeutic intervention for female Long COVID patients.\u201d<br \/><br \/><\/td>\n<td><br \/>PGE2 binding to EP3 suppresses PNS activity <sup>28<\/sup>\u00a0 and increases inflammatory SNS activity <sup>26<\/sup> <sup>27<br \/><\/sup><br \/><strong>\u00a0 VNS decreases brain COX-2\/PGE2 <sup>31<\/sup><\/strong><\/td>\n<td><br \/>VNS could decrease inflammatory PGE2 activity by stimulating anti-inflammatory PNS signaling decreasing inflammatory SNS activity<br \/><br \/>May provide benefits across the four sub-phenotypes<strong> for patients with an &#8220;EP1-up&#8221; profile<\/strong> as expression of EP1 is expected to decrease with decerasing COX2\/PGE2 levels in the brain and nervoussystem.\u00a0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/figure>\n\n<p class=\"wp-block-paragraph\">1\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hohberger, B.<em> et al.<\/em> Safety, tolerability and clinical effects of rovunaptabin, also known as BC007 on fatigue and quality of life in patients with Post-COVID syndrome (reCOVer): a prospective, exploratory, placebo-controlled, double-blind, randomised phase IIa clinical trial (RCT). <em>EClinicalMedicine<\/em> <strong>86<\/strong>, 103358 (2025). <a href=\"https:\/\/doi.org\/10.1016\/j.eclinm.2025.103358\">https:\/\/doi.org\/10.1016\/j.eclinm.2025.103358<\/a><\/p>\n\n<p class=\"wp-block-paragraph\">2\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Mardin, C. 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Rapamycin suppresses TLR4-triggered IL-6 and PGE(2) production of colon cancer cells by inhibiting TLR4 expression and NF-kappaB activation. <em>Mol Immunol<\/em> <strong>45<\/strong>, 2929-2936 (2008). <a href=\"https:\/\/doi.org\/10.1016\/j.molimm.2008.01.025\">https:\/\/doi.org\/10.1016\/j.molimm.2008.01.025<\/a><\/p>\n\n<p class=\"wp-block-paragraph\">24\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Pearson, L.<em> et al.<\/em> Stellate Ganglion Block Relieves Long COVID-19 Symptoms in 86% of Patients: A Retrospective Cohort Study. <em>Cureus<\/em> <strong>15<\/strong>, e45161 (2023). <a href=\"https:\/\/doi.org\/10.7759\/cureus.45161\">https:\/\/doi.org\/10.7759\/cureus.45161<\/a><\/p>\n\n<p class=\"wp-block-paragraph\">25\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Luo, D., Pan, W., Li, Y., Feng, K. &amp; Liu, G. The Interaction Analysis between the Sympathetic and Parasympathetic Systems in CHF by Using Transfer Entropy Method. <em>Entropy (Basel)<\/em> <strong>20<\/strong> (2018). <a href=\"https:\/\/doi.org\/10.3390\/e20100795\">https:\/\/doi.org\/10.3390\/e20100795<\/a><\/p>\n\n<p class=\"wp-block-paragraph\">26\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Zhang, Z. H.<em> et al.<\/em> EP\u2083 receptors mediate PGE\u2082-induced hypothalamic paraventricular nucleus excitation and sympathetic activation. <em>Am J Physiol Heart Circ Physiol<\/em> <strong>301<\/strong>, H1559-1569 (2011). <a href=\"https:\/\/doi.org\/10.1152\/ajpheart.00262.2011\">https:\/\/doi.org\/10.1152\/ajpheart.00262.2011<\/a><\/p>\n\n<p class=\"wp-block-paragraph\">27\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yokotani, K.<em> et al.<\/em> Elevation of plasma noradrenaline levels in urethane-anaesthetized rats by activation of central prostanoid EP3 receptors. <em>Br J Pharmacol<\/em> <strong>115<\/strong>, 672-676 (1995). <a href=\"https:\/\/doi.org\/10.1111\/j.1476-5381.1995.tb14985.x\">https:\/\/doi.org\/10.1111\/j.1476-5381.1995.tb14985.x<\/a><\/p>\n\n<p class=\"wp-block-paragraph\">28\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Reinheimer, T., Harnack, E., Racke, K. &amp; Wessler, I. Prostanoid receptors of the EP3 subtype mediate inhibition of evoked [3H]acetylcholine release from isolated human bronchi. <em>Br J Pharmacol<\/em> <strong>125<\/strong>, 271-276 (1998). <a href=\"https:\/\/doi.org\/10.1038\/sj.bjp.0702057\">https:\/\/doi.org\/10.1038\/sj.bjp.0702057<\/a><\/p>\n\n<p class=\"wp-block-paragraph\">29\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Deng, J. J.<em> et al.<\/em> Treatment of stellate ganglion block in diseases: Its role and application prospect. <em>World J Clin Cases<\/em> <strong>11<\/strong>, 2160-2167 (2023). <a href=\"https:\/\/doi.org\/10.12998\/wjcc.v11.i10.2160\">https:\/\/doi.org\/10.12998\/wjcc.v11.i10.2160<\/a><\/p>\n\n<p class=\"wp-block-paragraph\">30\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Zheng, Z. S., Simonian, N., Wang, J. &amp; Rosario, E. R. Transcutaneous vagus nerve stimulation improves Long COVID symptoms in a female cohort: a pilot study. <em>Frontiers in Neurology<\/em> <strong>15<\/strong> (2024). <a href=\"https:\/\/doi.org\/10.3389\/fneur.2024.1393371\">https:\/\/doi.org\/10.3389\/fneur.2024.1393371<\/a><\/p>\n\n<p class=\"wp-block-paragraph\">31\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Revathikumar, P., Ma\u00eetre, E. L., Jakobsson, P.-J., Korotkova, M. &amp; Lampa, J. A2.7\u2005Effects of Vagus Nerve Stimulation on the Central Prostaglandin System and Substance P Following Peripheral Inflammation. <em>Annals of the Rheumatic Diseases<\/em> <strong>72<\/strong>, A6-A7 (2013). <a href=\"https:\/\/doi.org\/https:\/doi.org\/10.1136\/annrheumdis-2013-203215.7\">https:\/\/doi.org\/https:\/\/doi.org\/10.1136\/annrheumdis-2013-203215.7<\/a><\/p>\n<p>\u00a0<\/p>\n<p>\u00a0<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Long COVID therapies, tested partially beneficial, linked to EP-receptor profiles Long COVID interventions; PGE2 hypothesis-driven mechanistic explanations \u00a0 Long COVID [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-3391","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/pge2-hypothesis.com\/index.php?rest_route=\/wp\/v2\/pages\/3391","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pge2-hypothesis.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/pge2-hypothesis.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/pge2-hypothesis.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pge2-hypothesis.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3391"}],"version-history":[{"count":43,"href":"https:\/\/pge2-hypothesis.com\/index.php?rest_route=\/wp\/v2\/pages\/3391\/revisions"}],"predecessor-version":[{"id":6583,"href":"https:\/\/pge2-hypothesis.com\/index.php?rest_route=\/wp\/v2\/pages\/3391\/revisions\/6583"}],"wp:attachment":[{"href":"https:\/\/pge2-hypothesis.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3391"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}