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2020 ; 144
(ä): 109850
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A potential role for cyclophosphamide in the mitigation of acute respiratory
distress syndrome among patients with SARS-CoV-2
#MMPMID32526511
Revannasiddaiah S
; Kumar Devadas S
; Palassery R
; Kumar Pant N
; Maka VV
Med Hypotheses
2020[Nov]; 144
(ä): 109850
PMID32526511
show ga
While humanity struggles to develop a vaccine against SARS-CoV-2, it is
imperative that effective and affordable therapeutic strategies be evolved. Since
a majority of the SARS-CoV-2 deaths are due to acute respiratory distress
syndrome (ARDS), a strategy to mitigate the same could save countless lives.
Since SARS-CoV-2 related ARDS has a strong immunological component, many
investigators are utilizing monoclonal antibodies against IL-6, TNF-alpha and
CCR5. However, targeting a single cytokine with an expensive monoclonal antibody
could be a less pragmatic approach. We propose the use of cyclophosphamide as an
immunomodulator, given its proven role in various settings including autoimmune
diseases, and in the post-haploidentical stem cell transplant. Cyclophosphamide
could deplete cytotoxic and effector T cell populations while relatively sparing
the regulatory T cells (Tregs). Cyclophosphamide could tip the balance away from
the overtly pro-inflammatory and could be a less expensive and effective
alternative to the currently investigated monoclonal antibodies.