Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran.
Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mol Cell Biochem. 2022 Mar;477(3):711-726. doi: 10.1007/s11010-021-04325-9. Epub 2022 Jan 11.
The novel coronavirus pandemic has emerged as one of the significant medical-health challenges of the current century. The World Health Organization has named this new virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the first detection of SARS-CoV-2 in November 2019 in Wuhan, China, physicians, researchers, and others have made it their top priority to find drugs and cures that can effectively treat patients and reduce mortality rates. The symptoms of Coronavirus Disease 2019 (COVID-19) include fever, dry cough, body aches, and anosmia. Various therapeutic compounds have been investigated and applied to mitigate the symptoms in COVID-19 patients and cure the disease. Degenerative virus analyses of the infection incidence and COVID-19 have demonstrated that SARS-CoV-2 penetrates the pulmonary alveoli's endothelial cells through Angiotensin-Converting Enzyme 2 (ACE2) receptors on the membrane, stimulates various signaling pathways and causes excessive secretion of cytokines. The continuous triggering of the innate and acquired immune system, as well as the overproduction of pro-inflammatory factors, cause a severe condition in the COVID-19 patients, which is called "cytokine storm". It can lead to acute respiratory distress syndrome (ARDS) in critical patients. Severe and critical COVID-19 cases demand oxygen therapy and mechanical ventilator support. Various drugs, including immunomodulatory and immunosuppressive agents (e.g., monoclonal antibodies (mAbs) and interleukin antagonists) have been utilized in clinical trials. However, the studies and clinical trials have documented diverging findings, which seem to be due to the differences in these drugs' possible mechanisms of action. These drugs' mechanism of action generally includes suppressing or modulating the immune system, preventing the development of cytokine storm via various signaling pathways, and enhancing the blood vessels' diameter in the lungs. In this review article, multiple medications from different drug families are discussed, and their possible mechanisms of action are also described.
新型冠状病毒疫情是本世纪重大医学健康挑战之一。世界卫生组织将这种新型病毒命名为严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）。自 2019 年 11 月在中国武汉首次检测到 SARS-CoV-2 以来，医生、研究人员和其他人员一直将寻找能够有效治疗患者并降低死亡率的药物和疗法作为首要任务。2019 年冠状病毒病（COVID-19）的症状包括发热、干咳、身体疼痛和嗅觉丧失。已经研究和应用了各种治疗化合物来减轻 COVID-19 患者的症状并治愈该疾病。对感染发生率和 COVID-19 的退行性病毒分析表明，SARS-CoV-2 通过膜上的血管紧张素转换酶 2（ACE2）受体穿透肺肺泡的内皮细胞，刺激各种信号通路并导致细胞因子过度分泌。固有和获得性免疫系统的持续触发以及促炎因子的过度产生，导致 COVID-19 患者出现严重情况，称为“细胞因子风暴”。它可导致危重症患者发生急性呼吸窘迫综合征（ARDS）。严重和危重症 COVID-19 病例需要氧疗和机械通气支持。在临床试验中已经使用了包括免疫调节剂和免疫抑制剂（例如，单克隆抗体（mAbs）和白细胞介素拮抗剂）在内的各种药物。然而，这些研究和临床试验记录了不同的发现，这似乎是由于这些药物的可能作用机制存在差异。这些药物的作用机制通常包括抑制或调节免疫系统，通过各种信号通路预防细胞因子风暴的发展，以及增强肺部血管的直径。在这篇综述文章中，讨论了来自不同药物家族的多种药物，并且还描述了它们可能的作用机制。
