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The CoV-2 outbreak: how hematologists could help to fight Covid-19 #MMPMID32387301
Galimberti S; Baldini C; Barate C; Ricci F; Balducci S; Grassi S; Ferro F; Buda G; Benedetti E; Fazzi R; Baglietto L; Lucenteforte E; Di Paolo A; Petrini M
Pharmacol Res 2020[Jul]; 157 (ä): 104866 PMID32387301show ga
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.