Role of pirfenidone in TGF-ß pathways and other inflammatory pathways in acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection: a theoretical perspective.
Pharmacol Rep
; 73(3): 712-727, 2021 Jun.
Article
in English
| MEDLINE | ID: covidwho-1195205
ABSTRACT
BACKGROUND:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes pulmonary injury or multiple-organ injury by various pathological pathways. Transforming growth factor-beta (TGF-ß) is a key factor that is released during SARS-CoV-2 infection. TGF-ß, by internalization of the epithelial sodium channel (ENaC), suppresses the anti-oxidant system, downregulates the cystic fibrosis transmembrane conductance regulator (CFTR), and activates the plasminogen activator inhibitor 1 (PAI-1) and nuclear factor-kappa-light-chain-enhancer of activated B cells (NF-kB). These changes cause inflammation and lung injury along with coagulopathy. Moreover, reactive oxygen species play a significant role in lung injury, which levels up during SARS-CoV-2 infection. DRUG SUGGESTION Pirfenidone is an anti-fibrotic drug with an anti-oxidant activity that can prevent lung injury during SARS-CoV-2 infection by blocking the maturation process of transforming growth factor-beta (TGF-ß) and enhancing the protective role of peroxisome proliferator-activated receptors (PPARs). Pirfenidone is a safe drug for patients with hypertension or diabetes and its side effect tolerated well.CONCLUSION:
The drug as a theoretical perspective may be an effective and safe choice for suppressing the inflammatory response during COVID-19. The recommendation would be a combination of pirfenidone and N-acetylcysteine to achieve maximum benefit during SARS-CoV-2 treatment.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pyridones
/
Signal Transduction
/
Transforming Growth Factor beta
/
Lung Injury
/
COVID-19
/
COVID-19 Drug Treatment
/
Inflammation
Limits:
Humans
Language:
English
Journal:
Pharmacol Rep
Journal subject:
Pharmacology
Year:
2021
Document Type:
Article
Affiliation country:
S43440-021-00255-x
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