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The CoV-2 outbreak: how hematologists could help to fight Covid-19

2020; Elsevier BV; Volume: 157; Linguagem: Inglês

10.1016/j.phrs.2020.104866

1096-1186

Sara Galimberti, Chiara Baldini, Claudia Baratè, Federica Ricci, Serena Balducci, Susanna Grassi, Francesco Ferro, Gabriele Buda, E. Benedetti, Rita Fazzi, Laura Baglietto, Ersilia Lucenteforte, Antonello Di Paolo, Mario Petrini,

Inflammasome and immune disorders

COVID-19 is a medical emergency, with 20 % of patients presenting with severe clinical manifestations. From the pathogenetic point of view, COVID-19 mimics two other well-known diseases characterized by cytokine storm and hyper-activation of the immune response, with consequent organ damage: acute graft-versus-host disease (aGVHD) and macrophage activation syndrome (MAS). Hematologists are confident with these situations requiring a prompt therapeutic approach for switching off the uncontrolled cytokine release; here, we discuss pros and cons of drugs that are already employed in hematology in the light of their possible application in COVID-19. The most promising drugs might be: Ruxolitinib, a JAK1/2 inhibitor, with a rapid and powerful anti-cytokine effect, tyrosine kinase inhibitors (TKIs), with their good anti-inflammatory properties, and perhaps the anti-Cd26 antibody Begelomab. We also present immunological data from gene expression experiments where TKIs resulted effective anti-inflammatory and pro-immune drugs. A possible combined treatment algorithm for COVID-19 is here proposed.