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药物再利用:应对 COVID-19 爆发的新策略。

Drug repurposing: new strategies for addressing COVID-19 outbreak.

机构信息

Department of Pharmaceutics, Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management, Mumbai, India.

出版信息

Expert Rev Anti Infect Ther. 2021 Jun;19(6):689-706. doi: 10.1080/14787210.2021.1851195. Epub 2020 Dec 3.

Abstract

: COVID-19 outbreak has infected 34.20 million people with 1019 thousand deaths in more than 125 countries till 30 September 2020. Due to the unavailability of vaccine or targeted novel drug therapy against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), screening of existential medical treatments facilitates identification of promising drugs for the treatment and management of COVID-19.: The review article highlights repurposing of antiviral, antimalarial, antineoplastic, antidiabetic, analgesic, and immunomodulatory drugs. Furthermore, clinical trials, in-vitro studies, benefits, adverse effects, toxicities, mechanisms of action, and regulatory status of drugs are covered in this article.: Lack of conclusive results from randomized clinical trials indicates absence of specific drugs for treatment of COVID-19. Unavailability of complete data regarding safety, efficacy, and adverse reactions of drugs restricts the recommendation of clinical advice on dose and duration of the drug therapy. Remdesivir and favipiravir show promising outcomes but more clinical evidence is required for use in large populations. Experimental and repurposed drug therapies targeting spike and envelope proteins, Mpro, 3CL and PL enzymes, and RdRp and TMPRSS2 genes show capability to produce effective anti-SARS-CoV-2 action. Development of vaccine against SARS-CoV-2 will offer long-term solution to terminate spread of this global pandemic.

摘要

截至 2020 年 9 月 30 日,COVID-19 疫情已在 125 个以上国家感染了 3420 万人,造成 101.9 万人死亡。由于目前尚无针对严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)的疫苗或靶向新型药物疗法,因此筛选现有医疗方法有助于确定有前途的 COVID-19 治疗和管理药物。本文重点介绍了抗病毒药、抗疟药、抗肿瘤药、抗糖尿病药、镇痛药和免疫调节剂的再利用。此外,本文还涵盖了药物的临床试验、体外研究、益处、不良反应、毒性、作用机制和监管状况。随机临床试验缺乏明确的结果表明,目前尚无治疗 COVID-19 的特效药物。由于缺乏有关药物安全性、疗效和不良反应的完整数据,限制了对药物治疗剂量和持续时间的临床建议。瑞德西韦和法匹拉韦显示出有希望的结果,但需要更多的临床证据才能在大人群中使用。针对刺突蛋白和包膜蛋白、Mpro、3CL 和 PL 酶以及 RdRp 和 TMPRSS2 基因的实验性和再利用药物疗法具有产生有效抗 SARS-CoV-2 作用的能力。开发针对 SARS-CoV-2 的疫苗将为终止这一全球大流行的传播提供长期解决方案。

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