Scientists Describe Known Approaches to Treating SARS-CoV-2 Infection

Researchers from the University of Sechenov together with Russian and Iranian colleagues described currently known approaches for the treatment of SARS-CoV-2 infection. In the article published in Journal of Molecular MedicineThey wrote about how the different groups of drugs worked and how promising each approach was.

SARS-CoV-2, a coronavirus that caused the pandemic in early 2020, is a close relative of two other viruses (SARS-CoV and MERS-CoV) that triggered epidemics in 2003 and 2013-2015.

Most often, the disease is accompanied by fever, dry cough, increased fatigue, and loss of taste and smell. Most symptoms are associated with an overreaction of the patient’s immune system that, in severe cases, causes lung tissue damage and systemic inflammation.

The first approach considered in the article is immunotherapy. It is known that antibodies contained in the serum of people who have had a viral illness can accelerate the recovery of other patients.

Despite the simplicity of this method, it has several limitations: the number of potential donors is still small, the activity of the antibodies decreases with time (so the serum of patients who had the disease long ago is less valuable ) and the antibodies themselves can help the virus spread through the body, a phenomenon known as an antibody-dependent surge in infection.

Similarly, we can use T lymphocytes, cells that can destroy damaged or infected cells in the body. Scientists have noted that the number of T cells from the CD8 + subpopulation is significantly reduced in COVID-19 patients, and the more severe the disease, the lower this number. T cells directed against a specific virus can be produced in vitro and offered to patients as therapy.

Another area of ​​research is related to the suppression of certain enzymes, in particular AAK1 and GAK, which are necessary for the virus to enter a cell.

Some of the drugs that act as inhibitors of these enzymes have already been tried and used, albeit for another purpose, such as the treatment of rheumatoid arthritis (this approach is called “drug reuse”).

Analysis of clinical trials registered on ClinicalTrials.gov has shown a wide variety of therapeutic agents that are offered for the treatment of COVID-19. And, of course, most of them are associated with the use of previously known drugs used in the treatment of other diseases. “

Anastasia Shpichka, study author and principal investigator, Institute of Regenerative Medicine, Sechenov University

There are other ways to prevent the virus from entering cells. Since the receptor that is integrated into the cell membrane and allows the virus to enter (this is the ACE2 protein) is known, it is possible to create an analog that binds to the viral particles and ‘distracts’ them from the patient’s cells.

Such ACE2 receptor analogs have already been developed, tested, and shown to slow the spread of the virus in the body, but do not stop it, indicating the presence of other entry points into human cells.

The use of antiviral drugs gives conflicting results. Remdesivir, which showed good efficacy against SARS-CoV-2 in some studies, did not provide notable benefits in others.

Chloroquine, used to treat malaria, was considered a promising drug, but its side effects do not allow its recommendation for the treatment of COVID-19. Attempts to use anti-HIV drugs against SARS-CoV-2 also have mixed results.

One more direction in the fight against COVID-19 is the suppression of the excessive reaction of the immune system, which especially affects the lung tissue. One treatment option may be mesenchymal stem cells, used in the treatment of inflammatory and autoimmune diseases.

Studies are already underway on the efficacy of this method in treating COVID-19. Another class of drugs that limit the inflammatory response are corticosteroids. They can reduce mortality among patients with severe disease.

Despite the efforts of scientists around the world to find an effective COVID-19 treatment, the optimal algorithm has yet to be found.

The key to creating a medicine may be a discovery as part of one of these approaches or a new solution, for example found at the intersection of scientific disciplines or drawn from the experience of treating other diseases.