2. Academic Validation
  3. Neutrophil elastase inhibitor (sivelestat) may be a promising therapeutic option for management of acute lung injury/acute respiratory distress syndrome or disseminated intravascular coagulation in COVID-19

Neutrophil elastase inhibitor (sivelestat) may be a promising therapeutic option for management of acute lung injury/acute respiratory distress syndrome or disseminated intravascular coagulation in COVID-19

  • J Clin Pharm Ther. 2020 Dec;45(6):1515-1519. doi: 10.1111/jcpt.13251.
Adeleh Sahebnasagh 1,  Fatemeh Saghafi 2,  Mohammadreza Safdari 3,  Masoud Khataminia 4,  Afsaneh Sadremomtaz 5,  Zeinab Talaei 6,  Hassan Rezai Ghaleno 7,  Mahdi Bagheri 8,  Solomon Habtemariam 9,  Razieh Avan 10
Affiliations

Affiliations

  • 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.
PMID: 32860252 DOI: 10.1111/jcpt.13251
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.

Keywords

COVID-19; acute lung injury/acute respiratory distress syndrome; coagulopathy; neutrophil elastase inhibitor; sivelestat.

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