Department of Biogerontology, Saint Petersburg Institute of Bioregulation and Gerontology, 197110 Saint Petersburg, Russia.
The Group of Peptide Regulation of Aging, Pavlov Institute of Physiology of RAS, 199034 St. Petersburg, Russia.
Molecules. 2020 Sep 24;25(19):4389. doi: 10.3390/molecules25194389.
There is a vast practice of using antimalarial drugs, RAS inhibitors, serine protease inhibitors, inhibitors of the RNA-dependent RNA polymerase of the virus and immunosuppressants for the treatment of the severe form of COVID-19, which often occurs in patients with chronic diseases and older persons. Currently, the clinical efficacy of these drugs for COVID-19 has not been proven yet. Side effects of antimalarial drugs can worsen the condition of patients and increase the likelihood of death. Peptides, given their physiological mechanism of action, have virtually no side effects. Many of them are geroprotectors and can be used in patients with chronic diseases. Peptides may be able to prevent the development of the pathological process during COVID-19 by inhibiting SARS-CoV-2 virus proteins, thereby having immuno- and bronchoprotective effects on lung cells, and normalizing the state of the hemostasis system. Immunomodulators (RKDVY, EW, KE, AEDG), possessing a physiological mechanism of action at low concentrations, appear to be the most promising group among the peptides. They normalize the cytokines' synthesis and have an anti-inflammatory effect, thereby preventing the development of disseminated intravascular coagulation, acute respiratory distress syndrome and multiple organ failure.
针对 COVID-19 重症，常发生于慢性病患者和老年人身上，目前存在使用抗疟药物、RAS 抑制剂、丝氨酸蛋白酶抑制剂、病毒 RNA 依赖性 RNA 聚合酶抑制剂和免疫抑制剂进行治疗的广泛实践，但这些药物治疗 COVID-19 的临床疗效尚未得到证实。抗疟药物的副作用可能会使患者病情恶化，增加死亡的可能性。肽类药物由于其生理作用机制，几乎没有副作用。其中许多是衰老抑制剂，可用于慢性病患者。肽类药物可能通过抑制 SARS-CoV-2 病毒蛋白来预防 COVID-19 发病过程，从而对肺细胞具有免疫和支气管保护作用，并使止血系统状态正常化。免疫调节剂（RKDVY、EW、KE、AEDG），在低浓度时具有生理作用机制，似乎是肽类药物中最有前途的一类。它们可使细胞因子的合成正常化，并具有抗炎作用，从而防止弥散性血管内凝血、急性呼吸窘迫综合征和多器官衰竭的发展。
