Adeleh Sahebnasagh1, Fatemeh Saghafi2, Mohammadreza Safdari3, Masoud Khataminia4, Afsaneh Sadremomtaz5, Zeinab Talaei6, Hassan Rezai Ghaleno7, Mahdi Bagheri8, Solomon Habtemariam9, Razieh Avan10. 1. Department of Internal Medicine, Clinical Research Center, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran. 2. Department of Clinical Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 3. Department of Orthopedic Surgery, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran. 4. Student Research Committee, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 5. XB20 Drug Design, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands. 6. Department of Chemistry, Faculty of Science, Shahid Rajaee Teacher Training University, Tehran, Iran. 7. Department of Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran. 8. Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran. 9. Pharmacognosy Research Laboratories and Herbal Analysis Services, School of Science, University of Greenwich, Kent, UK. 10. Department of Clinical Pharmacy, Medical Toxicology and Drug Abuse Research Center (MTDRC), Faculty of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran.
Abstract
WHAT IS KNOWN AND OBJECTIVE: This article summarizes the effects of sivelestat on acute lung injury/acute respiratory distress syndrome (ALI/ARDS) or ARDS with coagulopathy, both of which are frequently seen in patients with COVID-19. COMMENT: COVID-19 patients are more susceptible to thromboembolic events, including disseminated intravascular coagulation (DIC). Various studies have emphasized the role of neutrophil elastase (NE) in the development of DIC in patients with ARDS and sepsis. It has been shown that NE inhibition by sivelestat mitigates ALI through amelioration of injuries in alveolar epithelium and vascular endothelium, as well as reversing the neutrophil-mediated increased vascular permeability. WHAT IS NEW AND CONCLUSIONS: Sivelestat, a selective NE inhibitor, has not been evaluated for its possible therapeutic effects against SARS-CoV-2 infection. Based on its promising beneficial effects in underlying complications of COVID-19, sivelestat could be considered as a promising modality for better management of COVID-19-induced ALI/ARDS or coagulopathy.
WHAT IS KNOWN AND OBJECTIVE: This article summarizes the effects of sivelestat on acute lung injury/acute respiratory distress syndrome (ALI/ARDS) or ARDS with coagulopathy, both of which are frequently seen in patients with COVID-19. COMMENT: COVID-19patients are more susceptible to thromboembolic events, including disseminated intravascular coagulation (DIC). Various studies have emphasized the role of neutrophil elastase (NE) in the development of DIC in patients with ARDS and sepsis. It has been shown that NE inhibition by sivelestat mitigates ALI through amelioration of injuries in alveolar epithelium and vascular endothelium, as well as reversing the neutrophil-mediated increased vascular permeability. WHAT IS NEW AND CONCLUSIONS:Sivelestat, a selective NE inhibitor, has not been evaluated for its possible therapeutic effects against SARS-CoV-2 infection. Based on its promising beneficial effects in underlying complications of COVID-19, sivelestat could be considered as a promising modality for better management of COVID-19-induced ALI/ARDS or coagulopathy.
Authors: Luiz Henrique Agra Cavalcante-Silva; Deyse Cristina Madruga Carvalho; Éssia de Almeida Lima; José G F M Galvão; Juliane S de França da Silva; José Marreiro de Sales-Neto; Sandra Rodrigues-Mascarenhas Journal: Int Immunopharmacol Date: 2020-11-30 Impact factor: 4.932
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