Mehta Jyoti, Rolta Rajan, Mehta Brij Bhushan, Kaushik Neha, Choi Eun Ha, Kaushik Nagendra Kumar
Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, India.
Department of Immunology, University Institute of Oslo, Oslo, Norway.
Front Microbiol. 2022 Feb 15;13:813358. doi: 10.3389/fmicb.2022.813358. eCollection 2022.
The WHO announced coronavirus disease 2019 (COVID-19) as a pandemic disease globally on March 11, 2020, after it emerged in China. The emergence of COVID-19 has lasted over a year, and despite promising vaccine reports that have been produced, we still have a long way to go until such remedies are accessible to everyone. The immunomodulatory strategy has been kept at the top priority for the research agenda for COVID-19. Corticosteroids have been used to modulate the immune response in a wide range of diseases for the last 70 years. These drugs have been shown to avoid and reduce inflammation in tissues and the bloodstream through non-genomic and genomic effects. Now, the use of corticosteroids increased the chance of survival and relief by combating the viral strong inflammatory impacts and has moved to the forefront in the management of patients seeking supplemental oxygen. The goal of this review is to illuminate dexamethasone and methylprednisolone, i.e., in terms of their chemical and physical properties, role in COVID-19 patients suffering from pneumonia, the proposed mode of action in COVID-19, pharmacokinetics, pharmacodynamics, clinical outcomes in immunocompromised populations with COVID-19, interaction with other drugs, and contradiction to explore the trends and perspectives for future research. Literature was searched from scientific databases such as Science Direct, Wiley, Springer, PubMed, and books for the preparation of this review. The RECOVERY trial, a massive, multidisciplinary, randomized, and open-label trial, is mainly accountable for recommendations over the usage of corticosteroids in COVID-19 patients. The corticosteroids such as dexamethasone and methylprednisolone in the form of medication have anti-inflammatory, analgesic, and anti-allergic characteristics, including the ability to inhibit the immune system. These drugs are also recommended for treating symptoms of multiple ailments such as rheumatic and autoimmune diseases, leukemia, multiple myeloma, and Hodgkin's and non-Hodgkin's lymphoma along with other drugs. Toxicology studies proved them safe usually at low dosage oral or other routes.
2020年3月11日,在新型冠状病毒肺炎(COVID-19)在中国出现后,世界卫生组织宣布其为全球大流行病。COVID-19的出现已持续了一年多,尽管有令人鼓舞的疫苗报告,但在这些疗法可供所有人使用之前,我们仍有很长的路要走。免疫调节策略一直是COVID-19研究议程的首要任务。在过去70年里,皮质类固醇已被用于调节多种疾病中的免疫反应。这些药物已被证明可通过非基因组和基因组效应避免和减轻组织及血液中的炎症。现在,使用皮质类固醇通过对抗病毒的强烈炎症影响增加了生存和缓解的机会,并已在寻求补充氧气的患者管理中占据前沿位置。本综述的目的是阐明地塞米松和甲泼尼龙,即就其化学和物理性质、在患有肺炎的COVID-19患者中的作用、在COVID-19中提议的作用方式、药代动力学、药效学、免疫功能低下的COVID-19人群的临床结果、与其他药物的相互作用以及禁忌证进行探讨,以探索未来研究的趋势和前景。为撰写本综述,从科学数据库如Science Direct、Wiley、Springer、PubMed以及书籍中检索了文献。RECOVERY试验是一项大规模、多学科、随机、开放标签试验,主要负责关于COVID-19患者使用皮质类固醇的建议。药物形式的地塞米松和甲泼尼龙等皮质类固醇具有抗炎、镇痛和抗过敏特性,包括抑制免疫系统的能力。这些药物还与其他药物一起被推荐用于治疗多种疾病的症状,如风湿性和自身免疫性疾病、白血病、多发性骨髓瘤以及霍奇金淋巴瘤和非霍奇金淋巴瘤。毒理学研究证明它们通常在低剂量口服或其他给药途径下是安全的。