Mechanism of baricitinib supports artificial intelligence-predicted testing in COVID-19 patients.
EMBO Mol Med
; 12(8): e12697, 2020 08 07.
Article
in English
| MEDLINE | ID: covidwho-434202
ABSTRACT
Baricitinib is an oral Janus kinase (JAK)1/JAK2 inhibitor approved for the treatment of rheumatoid arthritis (RA) that was independently predicted, using artificial intelligence (AI) algorithms, to be useful for COVID-19 infection via proposed anti-cytokine effects and as an inhibitor of host cell viral propagation. We evaluated the in vitro pharmacology of baricitinib across relevant leukocyte subpopulations coupled to its in vivo pharmacokinetics and showed it inhibited signaling of cytokines implicated in COVID-19 infection. We validated the AI-predicted biochemical inhibitory effects of baricitinib on human numb-associated kinase (hNAK) members measuring nanomolar affinities for AAK1, BIKE, and GAK. Inhibition of NAKs led to reduced viral infectivity with baricitinib using human primary liver spheroids. These effects occurred at exposure levels seen clinically. In a case series of patients with bilateral COVID-19 pneumonia, baricitinib treatment was associated with clinical and radiologic recovery, a rapid decline in SARS-CoV-2 viral load, inflammatory markers, and IL-6 levels. Collectively, these data support further evaluation of the anti-cytokine and anti-viral activity of baricitinib and support its assessment in randomized trials in hospitalized COVID-19 patients.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Antiviral Agents
/
Pneumonia, Viral
/
Sulfonamides
/
Azetidines
/
Artificial Intelligence
/
Coronavirus Infections
/
Protein Kinase Inhibitors
/
Pandemics
/
Betacoronavirus
Type of study:
Experimental Studies
/
Prognostic study
/
Randomized controlled trials
Topics:
Traditional medicine
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
EMBO Mol Med
Journal subject:
Molecular Biology
Year:
2020
Document Type:
Article
Affiliation country:
Emmm.202012697
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