The anti-inflammatory and antioxidant effects of astaxanthin as an adjunctive therapy in community-acquired pneumonia: a randomized controlled trial

BackgroundCommunity-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide, particularly in low- and middle-income countries. Oxidative stress and excessive inflammation contribute significantly to disease progression and severity. Astaxanthin (ASX), a potent antioxidant an...

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Main Authors: Fatma Makram Youssef, Hayam Ateyya, Amir Eskander Hanna Samy, Eman Mohamed Elmokadem
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1621308/full
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author Fatma Makram Youssef
Hayam Ateyya
Amir Eskander Hanna Samy
Eman Mohamed Elmokadem
author_facet Fatma Makram Youssef
Hayam Ateyya
Amir Eskander Hanna Samy
Eman Mohamed Elmokadem
author_sort Fatma Makram Youssef
collection DOAJ
description BackgroundCommunity-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide, particularly in low- and middle-income countries. Oxidative stress and excessive inflammation contribute significantly to disease progression and severity. Astaxanthin (ASX), a potent antioxidant and anti-inflammatory carotenoid, has demonstrated protective effects against oxidative damage and immune dysregulation in various conditions. However, its potential role as an adjunctive therapy in CAP remains underexplored. This study aims to evaluate the effects of ASX supplementation on inflammatory cytokines, and clinical outcomes in patients with CAP.Patients and methodsA prospective, randomized, double-blind, placebo-controlled study was conducted, in which adult patients diagnosed with CAP were enrolled and assigned to receive either 12 mg/day ASX or a placebo in addition to standard antibiotic therapy for 7 days. Inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interleukin-10 (IL-10), were measured at baseline and post-treatment. Secondary outcomes included Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, as well as length of hospital stay.ResultsA total of 80 patients (40 per group) completed the study. Patients receiving ASX exhibited significant reductions in pro-inflammatory cytokines compared to the placebo group. Notably, IL-6 and TNF-α levels were significantly lower in the ASX group at the end of the study (P < 0.05). Additionally, SOFA and APACHE II scores showed greater improvements in ASX-treated patients, suggesting a potential role in mitigating disease severity. Although the ASX group had a shorter hospital stay than the placebo group, the difference was not statistically significant (P > 0.05).ConclusionASX supplementation as an adjunct to standard CAP treatment significantly reduced inflammation while improving disease severity scores. ASX was found to be safe and well-tolerated. These findings highlight its potential therapeutic role in CAP management, warranting further investigation in larger, long-term clinical trials to confirm its benefits and establish optimal dosing strategies.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT06334874, identifier NCT06334874.
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spelling doaj-art-eaf70bb8e9374c4e8511f093f24b094f2025-08-20T03:41:00ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-08-011610.3389/fphar.2025.16213081621308The anti-inflammatory and antioxidant effects of astaxanthin as an adjunctive therapy in community-acquired pneumonia: a randomized controlled trialFatma Makram Youssef0Hayam Ateyya1Amir Eskander Hanna Samy2Eman Mohamed Elmokadem3Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, Future University in Egypt, Cairo, EgyptDepartment of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, Future University in Egypt, Cairo, EgyptDepartment of Critical Care, El Matarya Teaching Hospital, Cairo, EgyptDepartment of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, Future University in Egypt, Cairo, EgyptBackgroundCommunity-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide, particularly in low- and middle-income countries. Oxidative stress and excessive inflammation contribute significantly to disease progression and severity. Astaxanthin (ASX), a potent antioxidant and anti-inflammatory carotenoid, has demonstrated protective effects against oxidative damage and immune dysregulation in various conditions. However, its potential role as an adjunctive therapy in CAP remains underexplored. This study aims to evaluate the effects of ASX supplementation on inflammatory cytokines, and clinical outcomes in patients with CAP.Patients and methodsA prospective, randomized, double-blind, placebo-controlled study was conducted, in which adult patients diagnosed with CAP were enrolled and assigned to receive either 12 mg/day ASX or a placebo in addition to standard antibiotic therapy for 7 days. Inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interleukin-10 (IL-10), were measured at baseline and post-treatment. Secondary outcomes included Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, as well as length of hospital stay.ResultsA total of 80 patients (40 per group) completed the study. Patients receiving ASX exhibited significant reductions in pro-inflammatory cytokines compared to the placebo group. Notably, IL-6 and TNF-α levels were significantly lower in the ASX group at the end of the study (P < 0.05). Additionally, SOFA and APACHE II scores showed greater improvements in ASX-treated patients, suggesting a potential role in mitigating disease severity. Although the ASX group had a shorter hospital stay than the placebo group, the difference was not statistically significant (P > 0.05).ConclusionASX supplementation as an adjunct to standard CAP treatment significantly reduced inflammation while improving disease severity scores. ASX was found to be safe and well-tolerated. These findings highlight its potential therapeutic role in CAP management, warranting further investigation in larger, long-term clinical trials to confirm its benefits and establish optimal dosing strategies.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT06334874, identifier NCT06334874.https://www.frontiersin.org/articles/10.3389/fphar.2025.1621308/fullcommunity-acquired pneumoniaantioxidantastaxanthinoxidative stressadjuvant therapyinflammatory markers
spellingShingle Fatma Makram Youssef
Hayam Ateyya
Amir Eskander Hanna Samy
Eman Mohamed Elmokadem
The anti-inflammatory and antioxidant effects of astaxanthin as an adjunctive therapy in community-acquired pneumonia: a randomized controlled trial
Frontiers in Pharmacology
community-acquired pneumonia
antioxidant
astaxanthin
oxidative stress
adjuvant therapy
inflammatory markers
title The anti-inflammatory and antioxidant effects of astaxanthin as an adjunctive therapy in community-acquired pneumonia: a randomized controlled trial
title_full The anti-inflammatory and antioxidant effects of astaxanthin as an adjunctive therapy in community-acquired pneumonia: a randomized controlled trial
title_fullStr The anti-inflammatory and antioxidant effects of astaxanthin as an adjunctive therapy in community-acquired pneumonia: a randomized controlled trial
title_full_unstemmed The anti-inflammatory and antioxidant effects of astaxanthin as an adjunctive therapy in community-acquired pneumonia: a randomized controlled trial
title_short The anti-inflammatory and antioxidant effects of astaxanthin as an adjunctive therapy in community-acquired pneumonia: a randomized controlled trial
title_sort anti inflammatory and antioxidant effects of astaxanthin as an adjunctive therapy in community acquired pneumonia a randomized controlled trial
topic community-acquired pneumonia
antioxidant
astaxanthin
oxidative stress
adjuvant therapy
inflammatory markers
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1621308/full
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