Iloprost for COVID-19-related vasculopathy

Moezinia, Carine J; Ji‐Xu, Antonio; Azari, Arianna E; Horlick, Serena; Denton, Christopher P.; Stratton, Richard

doi:10.1016/s2665-9913(20)30232-0

Cited by 17 publications

(19 citation statements)

References 10 publications

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“…Since iloprost possesses antithrombotic, anti-inflammatory, and anti-fibrotic properties, it was proposed as the adjunctive therapy for COVID-19-associated vasculopathy (Stratton, Shiwen, et al, 2001;Czeslick, Simm, et al, 2003). Moezinia, Ji-Xu, et al (2020) have added iloprost to standard care of three COVID-19 hospitalized patients. They revealed that iloprost can improve digital ischemia and cardiorespiratory parameters in patients with COVID-19-related vasculopathy.…”

Section: Discussionmentioning

confidence: 99%

Organ-Specific Treatment for COVID-19: Rationale, Evidence, and Potential Candidates

rahmanian¹,

Mousavi²,

Sami

2020

Preprint

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<div><b>Background and Purpose:</b> COVID-19 has become the ongoing public health crisis of our time. Although it was first presented as a respiratory infection, extrapulmonary manifestations are increasingly reported. However, no effective therapeutic strategy for COVID-19 extrapulmonary involvement is currently available. The current study aims to analyze the pathogenesis of COVID-19 extrapulmonary complications to evaluate the rationale for proposing organ-specific treatment as a novel therapeutic strategy to manage these multisystemic complications.</div><div><b>Experimental Approach:</b> In this study, differentially expressed genes (DEGs) of SARS-CoV-2 infected extrapulmonary organs including human pluripotent stem cells (hPSCs)-derived liver organoids, hPSCs-derived pancreatic endocrine cells, and human-induced pluripotent stem cells (hiPSCs)-derived choroid plexus organoids were analyzed. First, pathway enrichment analysis is done based on the identified DEGs to compare the underlying biological pathways enriched upon SARS-CoV-2 infection in different organs to confirm the need for developing organ-specific treatment strategies. Then, these lists of DEGs are used in a connectivity map-based drug repurposing experiment to propose novel organ-specific therapeutic options.</div><div><b>Key Results:</b> The results reveal different biological pathways and networks responsible for SARS-CoV-2 multisystemic pathogenesis based on the organ involved that highlight the need for considering organ-specific treatments. Besides, some FDA-approved drugs are proposed as the potential therapeutic candidates for each infected cell line.</div><div><b>Conclusion and Implications:</b> Although COVID-19 extrapulmonary manifestations are increasing, management of these complications is still challenging. Traditional therapeutic strategies and already repurposed antiviral agents are not effective. In this situation, organ-specific treatment, or in other words personalized therapy might be a promising solution.</div>

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Section: Discussionmentioning

confidence: 99%

Organ-Specific Treatment for COVID-19: Rationale, Evidence, and Potential Candidates

rahmanian¹,

Mousavi²,

Sami

2020

Preprint

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“…Given the lack of scientific data, efforts are focused on an empirical search for therapeutic strategies to ensure the adequate gas exchange, including methods that can be applied in intensive care unit (ICU) setting. Iloprost is a synthetic analogue of prostacyclin and recent studies investigated its efficacy when applied via infusion in the context of COVID-19 [2,3]. In addition, inhaled iloprost is a wellknown option for the treatment of pulmonary hypertension (PH) [4].…”

Section: To the Editormentioning

confidence: 99%

“…In the context of COVID-19, still limited literature sources highlighted the usage of iloprost as potential therapeutic option [ 2 , 3 ]. In the line with the literature, our findings revealed promising effects of inhaled iloprost with improved oxygenation parameters in patients with COVID-19-associated ARDS.…”

mentioning

confidence: 99%

Inhaled iloprost improves gas exchange in patients with COVID-19 and acute respiratory distress syndrome

et al. 2021

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“…Further studies need to be conducted to determine the effect of this antiinflammatory that is often used to treat other peripheral vasculopathies. 48 Crizanlizumab, a monoclonal antibody against P-selectin, is another pharmacotherapy undergoing clinical trial. By blocking P-selectin, and consequently platelet adherence and leukocyte rolling, Crizanlizumab may be able to prevent vascular inflammation.…”

Section: Rickettsial Parkeri Rickettsiosis Is Mainly Transmitted Bymentioning

confidence: 99%

Recognition and treatment of devastating vasculopathic systemic disorders: Coronavirus disease 2019 and rickettsioses

Mittal

Elias

Schwartz

et al. 2021

Dermatologic Therapy

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Cutaneous involvement can be an important sign of both COVID‐19 and rickettsioses. Rickettsial infections may be first evident as an exanthem with eschars as a key finding. In contrast, eschars and necrotic lesions can be seen in critically ill COVID‐19 patients. Both illnesses share a similar mechanism of infecting endothelial cells resulting in vasculopathy. Rickettsia parkeri and Rickettsia 364D are both characterized by eschars unlike Rickettsia rickettsii . Other eschar causing rickettsioses such as Rickettsia conorii , Rickettsia africae , and Orientia tsutsugamushi are commonly diagnosed in people from or having traveled through endemic areas. While there is no consensus on treatment for COVID‐19, rickettsioses are treatable. Due to possibly serious consequences of delayed treatment, doxycycline should be administered given an eschar‐presenting patient's travel history and sufficient suspicion of vector exposure. The proliferation of COVID‐19 cases has rendered it critical to differentiate between the two, both of which may have overlapping vasculopathic cutaneous findings. We review these diseases, emphasizing the importance of cutaneous involvement, while also discussing possible therapeutic interventions.

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Iloprost for COVID-19-related vasculopathy

Cited by 17 publications

References 10 publications

Organ-Specific Treatment for COVID-19: Rationale, Evidence, and Potential Candidates

Organ-Specific Treatment for COVID-19: Rationale, Evidence, and Potential Candidates

Inhaled iloprost improves gas exchange in patients with COVID-19 and acute respiratory distress syndrome

Recognition and treatment of devastating vasculopathic systemic disorders: Coronavirus disease 2019 and rickettsioses

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