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Navidi Z, Pakzad Moghadam SH, Iravani MM, Orandi A, Orandi A, Ghazi SF, Fallah E, Malekabad ES, Khorramnia S. Remdesivir in solid organ transplant recipients with COVID-19: a systematic review and meta-analysis. CLINICAL TRANSPLANTATION AND RESEARCH 2024; 38:212-221. [PMID: 39344698 PMCID: PMC11464156 DOI: 10.4285/ctr.24.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/25/2024] [Accepted: 09/11/2024] [Indexed: 10/01/2024]
Abstract
Background The use of remdesivir in solid organ transplant recipients (SOTRs) with coronavirus disease 2019 (COVID-19) has been studied. The present systematic review and analysis aimed to assess its effectiveness in this population. Methods A comprehensive search of PubMed, Cochrane Library, Web of Science, Embase, medRxiv, and Google Scholar was conducted to identify relevant articles published up to April 2024. The quality of the included studies was evaluated using the Cochrane assessment tool. Data analysis was performed using the Comprehensive Meta-Analysis software ver. 3.0. Results The meta-analysis included seven eligible retrospective studies, involving a total of 574 SOTRs. The findings indicated no significant differences in mortality rate (odds ratio [OR], 1.19; 95% confidence interval [CI], 0.59-2.39), hospitalization rate (OR, 0.69; 95% CI, 0.10-4.79), need for mechanical ventilation (OR, 0.98; 95% CI, 0.44-2.18), or need for oxygen therapy (OR, 3.73; 95% CI, 0.75-18.34) between the groups that received remdesivir and those that did not. However, a statistically significant difference was observed in the rate of intensive care unit admissions between the two groups (OR, 2.39; 95% CI, 1.24-4.57). Conclusions Our meta-analysis found that remdesivir offers no clinical benefits to SOTRs infected with COVID-19. Additional high-quality research is required to assess the potential clinical advantages of remdesivir for SOTRs with COVID-19.
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Affiliation(s)
- Zia Navidi
- Department of Anesthesiology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Mojgan Mohajeri Iravani
- Department of Anesthesiology, Faculty of Paramedical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Amirhossein Orandi
- Department of Anesthesiology, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirali Orandi
- Department of Anesthesia and Critical Care, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Samrand Fattah Ghazi
- Department of Intensive Care Medicine, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Fallah
- Department of Orthopedics, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | | | - Saeed Khorramnia
- Department of Anesthesiology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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de Sousa Pinto M, Fontoura LGO, da Rosa Borges I, Vieira de Melo Bisneto A, Rosa de Oliveira G, Carneiro LC, Chen Chen L, Vieira de Moraes Filho A. Evaluation of infliximab-induced genotoxicity and possible action on BCL-2 and P53 genes. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2024; 87:752-761. [PMID: 38922576 DOI: 10.1080/15287394.2024.2368619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Although the last pandemic created an urgency for development of vaccines, there was a continuous and concerted effort to search for therapeutic medications among existing drugs with different indications. One of the medications of interest that underwent this change was infliximab (IFM). This drug is used as an anti-inflammatory, predominantly in patients with Crohn 's disease, colitis ulcerative, and rheumatoid arthritis. In addition to these patients, individuals infected with Coronavirus Disease (COVID-19) were administered this chimeric monoclonal antibody (IMF) to act as an immunomodulator for patients in the absence of comprehensive research. Consequently, the present study aimed to examine the genotoxic effects attributed to IFM treatment employing different assays in vivo using mouse Mus musculus. Therefore, IFM was found to induce genotoxic effects as evidenced by the comet assay but did not demonstrate genotoxic potential utilizing mouse bone marrow MN test. The results of evaluating the expression of the P53 and BCL-2 genes using RT-qPCR showed stimulation of expression of these genes at 24 hr followed by a decline at 48 hr. Although the comet assay provided positive results, it is noteworthy that based upon negative findings in the micronucleus test, the data did not demonstrate significant changes in the genetic material that might affect the therapeutic use of IFM. The stimulation of expression of P53 and BCL-2 genes at 24 hr followed by a decline at 48 hr suggest a transient, if any, effect on genetic material. However, there is still a need for more research to more comprehensively understand the genotoxic profile of this medication.
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Affiliation(s)
- Murillo de Sousa Pinto
- Faculty of Pharmacy, Graduate Program in Health Assistance and Evaluation, Federal University of Goiás, Goiânia, Brazil
- Institute of Health Sciences, Alfredo Nasser University Center, Goiânia, Goiás, Brazil
| | | | | | - Abel Vieira de Melo Bisneto
- Institute of Biological Sciences, Department of Genetics, Laboratory of Radiobiology and Mutagenesis, Federal University of Goiás, Goiânia, Brazil
| | | | - Lílian Carla Carneiro
- Department of Biotechnology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Lee Chen Chen
- Institute of Biological Sciences, Department of Genetics, Laboratory of Radiobiology and Mutagenesis, Federal University of Goiás, Goiânia, Brazil
| | - Aroldo Vieira de Moraes Filho
- Faculty of Pharmacy, Graduate Program in Health Assistance and Evaluation, Federal University of Goiás, Goiânia, Brazil
- Institute of Health Sciences, Alfredo Nasser University Center, Goiânia, Goiás, Brazil
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Khorramnia S, Navidi Z, Orandi A, Iravani MM, Orandi A, Malekabad ES, Moghadam SHP. Tixagevimab/cilgavimab prophylaxis against COVID-19 in solid organ transplant recipients: a systematic review and meta-analysis. CLINICAL TRANSPLANTATION AND RESEARCH 2024; 38:136-144. [PMID: 38904088 PMCID: PMC11228381 DOI: 10.4285/ctr.24.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/27/2024] [Accepted: 05/07/2024] [Indexed: 06/22/2024]
Abstract
Background Tixagevimab/cilgavimab (Tix/Cil) shows promise as a prophylactic treatment against coronavirus disease 2019 (COVID-19) in solid organ transplant recipients (SOTRs). This study was performed to assess the effectiveness of Tix/Cil for preexposure prophylaxis against COVID-19 in this population. Methods We systematically searched the Cochrane Library, Web of Science, PubMed, and Embase databases to identify articles relevant to our study up to December 15, 2023. Comprehensive Meta-Analysis (ver. 3.0) was used for data analysis. Results The meta-analysis included seven eligible retrospective studies, encompassing a total of 4,026 SOTRs. The analysis revealed significant differences in SOTRs who received Tix/Cil preexposure prophylaxis relative to those who did not. Specifically, these differences were observed in the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.15-0.60), hospitalization (OR, 0.24; 95% CI, 0.08-0.70), and intensive care unit admission (OR, 0.07; 95% CI, 0.02-0.22). However, mortality rate did not differ significantly between the two groups (P=0.06). Conclusions The evidence supporting the effectiveness of Tix/Cil as preexposure prophylaxis against SARS-CoV-2 in SOTRs is of a low to moderate level. Further high-quality research is necessary to understand its effects on this population.
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Affiliation(s)
- Saeed Khorramnia
- Department of Anesthesiology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zia Navidi
- Department of Anesthesiology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Amirhossein Orandi
- Department of Anesthesiology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Mohajeri Iravani
- Department of Anesthesiology, Paramedical Faculty, Hajar Hospital, AJA University of Medical Sciences, Tehran, Iran
| | - Amirali Orandi
- Department of Anesthesia and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Mansour HM. The interference between SARS-COV-2 and Alzheimer's disease: Potential immunological and neurobiological crosstalk from a kinase perspective reveals a delayed pandemic. Ageing Res Rev 2024; 94:102195. [PMID: 38244862 DOI: 10.1016/j.arr.2024.102195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/22/2024]
Abstract
Coronavirus disease 2019 (COVID-19) has infected over 700 million people, with up to 30% developing neurological manifestations, including dementias. However, there is a lack of understanding of common molecular brain markers causing Alzheimer's disease (AD). COVID-19 has etiological cofactors with AD, making patients with AD a vulnerable population at high risk of experiencing more severe symptoms and worse consequences. Both AD and COVID-19 have upregulated several shared kinases, leading to the repositioning of kinase inhibitors (KIs) for the treatment of both diseases. This review provides an overview of the interactions between the immune system and the nervous system in relation to receptor tyrosine kinases, including epidermal growth factor receptors, vascular growth factor receptors, and non-receptor tyrosine kinases such as Bruton tyrosine kinase, spleen tyrosine kinase, c-ABL, and JAK/STAT. We will discuss the promising results of kinase inhibitors in pre-clinical and clinical studies for both COVID-19 and Alzheimer's disease (AD), as well as the challenges in repositioning KIs for these diseases. Understanding the shared kinases between AD and COVID-19 could help in developing therapeutic approaches for both.
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Affiliation(s)
- Heba M Mansour
- General Administration of Innovative Products, Central Administration of Biological, Innovative Products, and Clinical Studies (Bio-INN), Egyptian Drug Authority (EDA), Giza, Egypt.
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Abstract
INTRODUCTION As the third year of the SARS-CoV-2 pandemic approaches, COVID-19 continues to cause substantial morbidity and mortality due to waning vaccine efficacy and the emergence of new, highly contagious subvariants and better therapies are urgently needed. AREAS COVERED Hospitalized patients who develop hypoxia due to SARS-CoV-2 infection are typically treated with an antiviral agent, remdesivir, as well as an immunomodulator, dexamethasone, but mortality rates for severe COVID-19 remain unacceptably high. Mounting evidence suggests a second immunomodulator added to the standard of care may benefit some hospitalized patients; however, the optimal treatment remains controversial. EXPERT OPINION On 2 June 2022, the United States National Institutes of Health reported results from a large, randomized placebo-controlled clinical trial known as ACTIV-1. The study found a mortality benefit and substantially improved clinical status for adults hospitalized with COVID-19 who were treated with infliximab, a chimeric monoclonal antibody that binds to and inhibits TNF-α, and is widely used to treat a variety of autoimmune conditions, including rheumatoid arthritis, Crohn's disease, and ulcerative colitis. This manuscript reviews what is known about infliximab as an immunomodulator for patients with COVID-19 and explores how this agent may be used in the future to address the SARS-CoV-2 pandemic.
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Affiliation(s)
- Matthew P Velez
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
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Imatinib as a Tool Against COVID-19: A Balancing Act Between Effectiveness and Cardiac Safety. J Cardiovasc Pharmacol 2022; 80:779-780. [PMID: 35998027 DOI: 10.1097/fjc.0000000000001356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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