The Enygma of Asthenia: A Study of Angiotensin 1-7 and Melatonin in the Treatment of Asthenia Induced by Different Pathological Conditions

Asthenia, which is defined as a subjective privation of force, may occur in all chronic inflammation-related diseases, and it would be due to alterations in neurotransmitter pathways induced by an abnormal production of inflammatory cytokines.Chronic disease-related enhanced production of inflammatory cytokines may be controlled by the pineal hormone melatonin (MLT) and angiotensin 1-7 (Ang 1-7), the active molecule produced by the action of ACE2, which is widely expressed by most tissue, including brain.Therefore, both MLT and Ang 1-7 could be effective in the treatment of asthenia.On these bases, a study was planned to evaluate the effects of a concomitant administration of high-dose MLT plus low-dose Ang 1-7 in patients suffering from asthenia due to different causes.The study included 72 consecutive patients with asthenia, which was due to advanced cancer in 23 patients, Covid19 infection in 17, post-Covid19 syndrome in 15, cardiopathy in 7, neurodegenerative pathologies in 4, multiple sclerosis in 3, and diabetes in the remaining 3 cases.MLT was given orally at 100 mg/day in the evening.Ang 1-7 was also given orally at 0.5 mg twice/day.Irrespectively of the pathology, a rapid relief of asthenia was achieved in 51/72 (71%) patients.Moreover, the relief of asthenia was associated with an improvement of the inflammatory status.In conclusion, this preliminary study shown that the neuroendocrine regimen of high-dose MLT in association with low-dose Ang 1-7 is an effective and well tolerated therapy of asthenia.