Seifirad Soroush
Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Medicine, Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, USA.
Med Hypotheses. 2020 Nov;144:110005. doi: 10.1016/j.mehy.2020.110005. Epub 2020 Jun 17.
Cytokine storm, multiorgan failure, and particularly acute respiratory distress syndrome (ARDS) is the leading cause of mortality and morbidity in patients with COVID-19. A fulminant ARDS kills the majority of COVID-19 victims. Pirfenidone (5-methyl-1-phenyl-2-[1H]-pyridone), is a novel anti-fibrotic agent with trivial adverse effects. Pirfenidone is approved for the treatment of Idiopathic Pulmonary Fibrosis (IPF) for patients with mild to moderate disease. Pirfenidone could inhibit apoptosis, downregulate ACE receptors expression, decrease inflammation by several mechanisms and ameliorate oxidative stress and hence protect pneumocytes and other cells from COVID-19 invasion and cytokine storm simultaneously. Based on the pirfenidone mechanism of action and the known pathophysiology of COVID-19, I believe that pirfenidone has the potential for the treatment of COVID-19 patients.
细胞因子风暴、多器官功能衰竭，尤其是急性呼吸窘迫综合征（ARDS）是新冠肺炎患者死亡和发病的主要原因。暴发性ARDS导致大多数新冠肺炎患者死亡。吡非尼酮（5-甲基-1-苯基-2-[1H]-吡啶酮）是一种新型抗纤维化药物，副作用轻微。吡非尼酮被批准用于治疗轻至中度特发性肺纤维化（IPF）患者。吡非尼酮可以抑制细胞凋亡，下调ACE受体表达，通过多种机制减轻炎症，改善氧化应激，从而同时保护肺细胞和其他细胞免受新冠病毒侵袭和细胞因子风暴的影响。基于吡非尼酮的作用机制和已知的新冠肺炎病理生理学，我认为吡非尼酮有治疗新冠肺炎患者的潜力。
