Use of Nonsteroidal Anti-inflammatory Drugs for COVID-19 Infection: Adjunct Therapy?

Yolk@Wrinkled-double shell smart nanoreactors: new platforms for mineralization of pharmaceutical wastewater

Nanomaterials with "yolk and shell" "structure" can be considered as "nanoreactors" that have significant potential for application in catalysis. Especially in terms of electrochemical energy storage and conversion, the nanoelectrode has a large specific surface area with a unique yolk@shell structure, which can reduce the volume change of the electrode during the charging and discharging process and fast ion/electron transfer channels. The adsorption of products and the improvement of conversion reaction efficiency can greatly improve the stability, speed and cycle performance of the electrode, and it is a kind of ideal electrode material. In this research, heterojunction nanoreactors (FZT Y@WDS) Fe3O4@ZrO2-X@TiO2-X were firstly synthesized based on the solvothermal combined hard-template process, partial etching and calcination. The response surface method was used to determine the performance of the FZT Y@WDS heterojunction nanoreactors and the effects of four process factors: naproxen concentration (NAP), solution pH, the amount of charged photocatalyst, and the irradiation time for photocatalytic degradation of NAP under visible light irradiation. To maximize the photocatalytic activity, the parameters of the loaded catalyst, the pH of the reaction medium, the initial concentration of NAP, and the irradiation time were set to 0.5 g/L, 3, 10 mg/L, and 60 min, respectively, resulting in complete removal of NAP and the optimum amount was calculated to be 0.5 g/L, 5.246, 14.092 mg/L, and 57.362 min, respectively. Considering the promising photocatalytic activity of FZT Y@WDS under visible light and the separation performance of the nanocomposite, we proposed this photocatalyst as an alternative solution for the treatment of pharmaceutical wastewater.

Nonsteroidal Anti-Inflammatory Drugs in Viral Infections Disease, Specially COVID-19

During the current SARS-CoV-2 (COVID-19) pandemic, some reports were presented based on those nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids may exacerbate symptoms in COVID-19 patients. According to this, we aimed to collate information available in published articles to identify any evidence behind these statements with the aim of helping clinicians on how best to treat patients. We could not find published conclusive evidence for or against the use of NSAIDs in COVID-19 patients. Meanwhile, there appeared to be some evidence that corticosteroids may be beneficial if utilized in the early acute phase of infection, however, conflicting WHO (World Health Organization) evidence surrounding corticosteroid use in certain viral infections means this evidence is not conclusive. Given the current availability of literature, caution should be exercised until further evidence emerges surrounding the use of NSAIDs and corticosteroids in COVID-19 patients. However, the availability of reliable information for clinicians and patients is paramount.

Efficacy and safety profile of corticosteroids and non-steroidal anti-inflammatory drugs in COVID-19 management: A narrative review

Due to the fact that coronavirus disease 2019 (COVID-19) is still prevalent, and current reports show that some parts of the world have seen increase in incidence, it is relevant that health professionals and scientists know about recent or novel trends, especially drug treatments. Additionally, the safety profiles of these drug treatments need to be documented and shared with the public. Some studies have demonstrated the clinical benefits of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids in COVID-19 treatment. On the contrary, others have also reported that NSAIDs and corticosteroids may worsen symptoms associated with COVID-19. While some researchers have suggested that corticosteroids may be helpful if used in the early stages of COVID-19, there are still some conflicting findings regarding the use of corticosteroids in certain viral infections. Our review suggests that methylprednisolone, dexamethasone, and ibuprofen have therapeutic potential in reducing mortality due to COVID-19 among hospitalized patients. This review also highlights the fact that the use of NSAIDs is not associated with adverse outcomes of COVID-19. In reality, evidence suggests that NSAIDs do not increase the risk of COVID-19 infections. Also, the literature reviewed suggests that corticosteroid treatment in COVID-19 was linked with a decrease in all-cause mortality and disease progression, without increase in adverse events when compared to no corticosteroid treatment.

Photocatalytic activity of ZrO2/TiO2/Fe3O4 ternary nanocomposite for the degradation of naproxen: characterization and optimization using response surface methodology

In this study, ZrO₂, TiO₂, and Fe₃O₄ components were synthesized by co-precipitation, sol–gel, and co-precipitation methods, respectively. In addition, solid-state dispersion method was used for synthesizing of ZrO₂/TiO₂/Fe₃O₄ ternary nanocomposite. The ZrO₂/TiO₂/Fe₃O₄ nanocomposite was characterized by different techniques including XRD, EDX, SEM, BET, FTIR, XPS, EELS, and Photoluminescence (PL). The FTIR analysis of ZrO₂/TiO₂/Fe₃O₄ photocatalyst showed strong peaks in the range of 450 to 700 cm⁻¹, which represent stretching vibrations of Zr–O, Ti–O, and Fe–O. The results of FTIR and XRD, XPS analyses and PL spectra confirmed that the solid-state dispersion method produced ZrO₂/TiO₂/Fe₃O₄ nanocomposites. The EELS analysis confirmed the pure samples of Fe₃O₄, TiO₂ and ZrO₂. The EDAX analysis showed that the Zr:Ti:Fe atomic ratio was 0.42:2.08:1.00. The specific surface area, pores volume and average pores size of the photocatalyst were obtained 280 m²/g, 0.92 cm³/g, and 42 nm respectively. Furthermore, the performance of ZrO₂/TiO₂/Fe₃O₄ nanocomposite was evaluated for naproxen removal using the response surface method (RSM). The four parameters such as NPX concentration, time, pH and catalyst concentration was investigated. The point of zero charge of the photocatalyst was 6. The maximum and minimum degradation of naproxen using photocatalyst were 100% (under conditions: NPX concentration = 10 mg/L, time = 90 min, pH = 3 and catalyst concentration = 0.5 g/L) and 66.10% respectively. The stability experiment revealed that the ternary nanocatalyst demonstrates a relatively higher photocatalytic activity after 7 recycles.

Natural Products with tandem Anti-inflammatory, Immunomodulatory and Anti-SARS-CoV/2 effects: A Drug Discovery Perspective against SARS-CoV-2

BACKGROUND

COVID-19 is still causing victims with long-term health consequences, mass deaths, and collapsing healthcare systems around the world. The disease has no efficient drugs. However, previous studies revealed that SARS-CoV-2 and SARS-CoV have 96% and 86.5% similarities in cysteine proteases (3CL^pro) and papain-like protease (PL^pro) sequences, respectively. This resemblance could be significant in the search for drug candidates with antiviral effects against SARS-CoV-2.

OBJECTIVE

This paper is a compilation of natural products that inhibit SARS-CoV 3CL^pro and PL^pro and, concomitantly, reduce inflammation and/or modulate the immune system as a perspective strategy for COVID-19 drug discovery. It also presents in silico studies performed on these selected natural products using SARS-CoV-2 3CL^pro and PL^pro as targets to propose a list of hit compounds.

METHOD

The plant metabolites were selected in the literature based on their biological activities on SARS-CoV proteins, inflammatory mediators, and immune response. The consensus docking analysis was performed using four different packages.

RESULTS

Seventy-nine compounds reported in the literature with inhibitory effects on SARS-CoV proteins were reported as anti-inflammatory agents. Fourteen of them showed in previous studies immunomodulatory effects. Five and six of these compounds showed significant in silico consensus as drug candidates that can inhibit PL^pro and 3CL^pro, respectively. Our findings corroborated recent results reported on anti-SARS-CoV-2 in the literature.

CONCLUSION

This study revealed that amentoflavone, rubranoside B, savinin, psoralidin, hirsutenone, and papyriflavonol A are good drug candidate for the search of antibiotics against COVID-19.

Piroxicam Loading onto Mesoporous Silicas by Supercritical CO2 Impregnation

Piroxicam (PRX) is a commonly prescribed nonsteroidal anti-inflammatory drug. Its efficacy, however, is partially limited by its low water solubility. In recent years, different studies have tackled this problem and have suggested delivering PRX through solid dispersions. All these strategies, however, involve the use of potentially harmful solvents for the loading procedure. Since piroxicam is soluble in supercritical CO₂ (scCO₂), the present study aims, for the first time, to adsorb PRX onto mesoporous silica using scCO₂, which is known to be a safer and greener technique compared to the organic solvent-based ones. For comparison, PRX is also loaded by adsorption from solution and incipient wetness impregnation using ethanol as solvent. Two different commercial mesoporous silicas are used (SBA-15 and Grace Syloid^® XDP), which differ in porosity order and surface silanol population. Physico-chemical analyses show that the most promising results are obtained through scCO₂, which yields the amorphization of PRX, whereas some crystallization occurs in the case of adsorption from solution and IWI. The highest loading of PRX by scCO₂ is obtained in SBA-15 (15 wt.%), where molecule distribution appears homogeneous, with very limited pore blocking.

Inferring molecular mechanisms of dexamethasone therapy in severe COVID-19 from existing transcriptomic data

Dexamethasone, a synthetic glucocorticoid, has previously shown mortality benefit in severe coronavirus disease 2019 (COVID-19) in a randomized controlled trial. As the illness is considered to reflect a hyperinflammatory state, this therapeutic effectiveness is presumably ascribed to broad anti-inflammatory activities of glucocorticoids. Here, an unbiased analysis of available transcriptomic data on lung and blood immune cells from severe COVID-19 patients and matching cellular models of dexamethasone treatment is presented that supports this presumption. Comparison of differentially expressed genes in severe COVID-19 with that in dexamethasone treated cells reveals a small set of genes that are regulated in opposite direction between the disease and the drug, and are enriched for genes and processes related to glucocorticoid pathway and receptor binding. This expression signature differentiates as a whole various cytokines from a set of anti-cytokine/anti-inflammatory agents, with the former resembling COVID-19 and the latter dexamethasone in gene regulation. The signature apparently relates to TNF- α, IL-1α, IL-1β, IFN-α, IFN-β, and IFN-γ signaling, but not IL-6 signaling, suggesting that therapeutic effect of dexamethasone in COVID-19 does not involve IL-6 pathway. However, as all these observations are purely based on bioinformatic analysis, experimental evidence will be required to validate the inferences drawn. In conclusion, the present analysis seems to provide a proof of concept for therapeutic mechanisms of dexamethasone in COVID-19.

Clinical management of patients with rheumatoid arthritis during the COVID-19 pandemic

Introduction: Coronavirus disease 2019 (COVID-19) pandemic raises a great challenge in the management of patients with rheumatoid arthritis (RA), which are generally more susceptible to infection events because of the autoimmune condition itself and the treatment with immunomodulatory drugs. The use of disease-modifying anti-rheumatic drugs (DMARDs), including biologics and targeted-synthetic DMARDs, has aroused particular interest because of both their immunosuppressive effects and their hypothetical potential in COVID-19 treatment.Areas covered: For this narrative review, a literature search was conducted between December 2019 and February 2021 on PubMed including epidemiological studies, gathering the main evidence available to date about the impact of COVID-19 on RA patients and the influence of anti-rheumatic drugs on patients' susceptibility to this infection. We also summarize the recommendations from the international guidelines on the management of rheumatic diseases and treatments in this pandemic context, especially focused on RA.Expert opinion: About a year after the outbreak of the pandemic, we are able to answer some of the most relevant questions regarding patients with RA and their management in this pandemic context. Our efforts must now be directed toward consolidating the currently available data with more rigorous studies and facing new issues and challenges including, foremost, vaccination.

Challenges and Opportunities from Targeting Inflammatory Responses to SARS-CoV-2 Infection: A Narrative Review

The novel coronavirus disease 2019 (COVID-19) is a global pandemic that continues to sweep across the world, posing an urgent need for effective therapies and prevention of the spread of the severe acute respiratory syndrome related to coronavirus-2 (SARS-CoV-2). A major hypothesis that is currently guiding research and clinical care posits that an excessive and uncontrolled surge of pro-inflammatory cytokines (the so-called “cytokine storm”) drives morbidity and mortality in the most severe cases. In the overall efforts made to develop effective and safe therapies (including vaccines) for COVID-19, clinicians are thus repurposing ready-to-use drugs with direct or indirect anti-inflammatory and immunomodulatory activities. Speculatively, there are many opportunities and challenges in targeting immune/inflammatory processes in the evolving settings of COVID-19 disease because of the need to safely balance the fight against virus and aggressive inflammation versus the suppression of host immune defenses and the risk of additional harms in already compromised patients. To this end, many studies are globally underway to weigh the pros and cons of tailoring drugs used for inflammatory-driven conditions to COVID-19 patient care, and the next step will be to summarize the growing clinical trial experience into clean clinical practice. Based on the current evidence, anti-inflammatory drugs should be considered as complementary approaches to anti-viral drugs that need to be timely introduced in the management of COVID-19 according to disease severity. While drugs that target SARS-CoV-2 entry or replication are expected to confer the greatest benefits at the early stage of the infection, anti-inflammatory drugs would be more effective in limiting the inflammatory processes that drive the worsening of the disease.