Top

Published in:

Open Access 01-12-2020 | SARS-CoV-2 | Editorial

Neutrophil Elastase Inhibitors: A potential prophylactic treatment option for SARS-CoV-2-induced respiratory complications?

Authors: Mahmoud M. A. Mohamed, Ismail Amr El-Shimy, Muhammad Abdul Hadi

Published in: Critical Care | Issue 1/2020

Excerpt

As the death toll from the COVID-19 pandemic caused by SARS-CoV-2 continues to mount globally, scientists, healthcare agencies, and pharmaceutical companies are trying hard to find a “cure” and devise treatment strategies to reduce mortality. “Repurposing” existing drugs to fight COVID-19 remains an important strategy. Since respiratory failure remains one of the leading causes of death in COVID-19 patients, in this commentary, we have critically discussed the potential benefit of neutrophil elastase inhibitors (NEIs) in patients hospitalised with severe COVID-19. …

Zhang C, Wu Z, Li J-W, Zhao H, Wang GQ. The cytokine release syndrome (CRS) of severe COVID-19 and interleukin-6 receptor (IL-6R) antagonist tocilizumab may be the key to reduce the mortality. Int J Antimicrob Agents. 2020. https://doi.org/10.1016/j.ijantimicag.2020.105954.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.CrossRef

Shi Y, Wang Y, Shao C, Huang J, Gan J, Huang X, et al. COVID-19 infection: the perspectives on immune responses. Cell Death Differ. 2020. https://doi.org/10.1038/s41418-020-0530-3.

Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis. 2020. https://doi.org/10.1093/cid/ciaa248.

Zhang B, Zhou X, Zhu C, Feng F, Qiu Y, Feng J, et al. Immune phenotyping based on neutrophil-to-lymphocyte ratio and IgG predicts disease severity and outcome for patients with COVID-19. medRxiv. 2020. https://doi.org/10.1101/2020.03.12.20035048.

Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8:420–2.CrossRef

Donnelly SC, MacGregor I, Zamani A, Gordon MW, Robertson CE, Steedman DJ, et al. Plasma elastase levels and the development of the adult respiratory distress syndrome. Am J Respir Crit Care Med. 1995;151:1428–33.CrossRef

Zimmermann M, Arruda-Silva F, Bianchetto-Aguilera F, Finotti G, Calzetti F, Scapini P, et al. IFNα enhances the production of IL-6 by human neutrophils activated via TLR8. Sci Rep. 2016;6:19674. https://doi.org/10.1038/srep19674.CrossRefPubMedPubMedCentral

Farahi N, Paige E, Balla J, Prudence E, Ferreira RC, Southwood M, et al. Neutrophil-mediated IL-6 receptor trans-signaling and the risk of chronic obstructive pulmonary disease and asthma. Hum Mol Genet. 2017;26:1584–96.CrossRef

10.

Li C, Zhang C, Chen X, Zhang Y, Chen J, Kang L, et al. Relative depletion of soluble interleukin 6 receptors abolished the development of cytokine release syndrome after CART19/22 and lenalidomide treatment for lymphoma. Blood. 2019;134(Supplement 1):5313.CrossRef

11.

Belouzard S, Madu I, Whittaker GR. Elastase-mediated activation of the severe acute respiratory syndrome coronavirus spike protein at discrete sites within the S2 domain. J Biol Chem. 2010;285:22758–63.CrossRef

12.

Zeiher BG, Artigas A, Vincent JL, Dmitrienko A, Jackson K, Thompson BT, et al. Neutrophil elastase inhibition in acute lung injury: results of the STRIVE study. Crit Care Med. 2004;32:1695–702.CrossRef

13.

Aikawa N, Kawasaki Y. Clinical utility of the neutrophil elastase inhibitor sivelestat for the treatment of acute respiratory distress syndrome. Ther Clin Risk Manag. 2014;10:621–9.PubMedPubMedCentral

Title: Neutrophil Elastase Inhibitors: A potential prophylactic treatment option for SARS-CoV-2-induced respiratory complications?
Authors: Mahmoud M. A. Mohamed
Ismail Amr El-Shimy
Muhammad Abdul Hadi
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: SARS-CoV-2
Lymphopenia
Acute Respiratory Distress-Syndrome
COVID-19
Published in: Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-020-03023-0

At a glance: The STEP trials

Springer Medicine

Neutrophil Elastase Inhibitors: A potential prophylactic treatment option for SARS-CoV-2-induced respiratory complications?

Excerpt

At a glance: The STEP trials

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 1/2020

Prevention of thrombotic risk in hospitalized patients with COVID-19 and hemostasis monitoring

Prone ventilation of critically ill adults with COVID-19: how to perform CPR in cardiac arrest?

COVID-19-associated acute cerebral venous thrombosis: clinical, CT, MRI and EEG features

Recommendations for core critical care ultrasound competencies as a part of specialist training in multidisciplinary intensive care: a framework proposed by the European Society of Intensive Care Medicine (ESICM)

Correction to: The association between premorbid beta blocker exposure and mortality in sepsis—a systematic review

Crucial role of temporary airborne infection isolation rooms in an intensive care unit: containing the COVID-19 outbreak in South Korea