Inhalation surfactant therapy in the integrated treatment of severe COVID-19 pneumonia

Баутин, А. Е.; Avdeev, S. N.; SEYLIEV, А. А.; Shvechkova, M.V.; Merzhoeva, Zamira M.; Trushenko, Natalia V.; Семенов, А. П.; Lapshin, K. B.; Rozenberg, O. A.

doi:10.21292/2075-1230-2020-98-9-6-12

Cited by 17 publications

(4 citation statements)

References 8 publications

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“…Nonetheless, St-BL was used in asthma, bronchitis, pneumonia, chronic obstructive pulmonary diseases and Tb; more details are in the review by Rozenberg (2019) and the patent by Rozenberg and Seiliev (2019). St-BL was also used in patients with COVID-19 (Bautin et al 2020), where immune and inflammatory reactions might contribute to the "cytokine storm". Bs was used as the delivery method of Sf preparations (Bautin et al 2003(Bautin et al , 2006 Until recently, Oleg Rosenberg had been director of the manufacturing firm Biosurf.…”

Section: Surfactant Therapymentioning

confidence: 99%

Invasive Procedures Used in Tuberculosis With Questionable Indications: Report From Russia

Jargin

2024

Preprint

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Surgical treatment of tuberculosis has been applied in the former Soviet Union more frequently than in other countries. On the contrary to the international practice, tuberculoma has been often operated. There has been a decreasing tendency since the last decades; but the surgery rate is still comparatively high. Surgeries were sometimes performed without preceding chemotherapy. Among others, an argument in favour of the early surgery was non-compliance increasing with time. Compulsory treatments of patients with Tb and/or alcoholism are discussed here. The factors predisposing to the use of invasive procedures with questionable indications included the partial isolation from international scientific community, insufficient consideration of the principles of informed consent, professional autonomy and scientific polemics, as well as paternalistic attitude to patients. The message of this preprint is that patients should not undergo operations to comply with doctrines. Evidence-based clinical indications must be determined individually.

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Section: Surfactant Therapymentioning

confidence: 99%

Invasive Procedures Used in Tuberculosis With Questionable Indications: Report From Russia

Jargin

2024

Preprint

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“…[45,46] Clinical trials of pulmonary surfactants in COVID-19 are in process. [47,48] Surfacen is indicated in the Cuban COVID-19 Protocols for treatment of these patients. [6,49] The potential benefi t of neutrophil elastase inhibitors in patients with severe COVID-19 is being investigated because these inhibitors could mitigate elastase damage on the lung connective tissue and limit the virus spreading capabilities by preventing S protein proteolytic activation.…”

Section: Original Researchmentioning

confidence: 99%

Effect of Cuban Porcine Pulmonary Surfactant (Surfacen) and rCmPI-II Protease Inhibitor on Neutrophil Elastase Activity"

et al. 2022

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INTRODUCTIONIn infl ammatory respiratory diseases, the imbalance between proteases and endogenous protease inhibitors leads to an exacerbated activity of human neutrophil elastase (a protease that destroys the extracellular matrix and stimulates proinfl ammatory cytokine release). Elastase is considered a target in the search for therapeutic treatments for infl ammatory respiratory diseases. Pulmonary surfactant is a promising product for this purpose, because in addition to its biophysical function, it has anti-infl ammatory properties.OBJECTIVE Evaluate eff ect of the Cuban porcine pulmonary surfactant (Surfacen), the rCmPI-II elastase inhibitor, and the Surfacen/rCmPI-II combination on activated neutrophil elastase activity in vitro, and determine if Surfacen's interface property changes in the presence of the inhibitor. METHODSThe anti-elastase eff ect of Surfacen, rCmPI-II and the Surfacen/rCmPI-II combination was evaluated in an in vitro model of activated neutrophils, previously purifi ed from the blood of healthy subjects. The cells were stimulated with LPS/fMLP and were incubated with diff erent concentrations of Surfacen, rCmPI-II and the Surfacen/rCmPI-II combination. Elastase activity was measured. The interface property was determined on a Langmuir surface balance. RESULTSSurfacen at 10 mg/mL inhibited 71% of stimulated neutrophil elastase activity. rCmPI-II at 0.1 μM reduced 20% of elastase activity; at 200 μM-the maximum concentration evaluated-inhibition was 68%. Both products had a dosedependent eff ect. The Surfacen/inhibitor combination (0.5 mg/ mL/80 μM) did not aff ect the surfactant interface property or the inhibitory activity of rCmPI-II against human neutrophil elastase.CONCLUSIONS Surfacen and the rCmPI-II inhibitor have an anti-elastase eff ect on an activated neutrophil model. rCmPI-II does not aff ect Surfacen's interface property and, therefore, both can be evaluated for combined use in treating infl ammatory lung diseases.

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“…Endobronchial instillations of porcine Sf were accompanied by an augmentation of eosinophilic inflammation in patients with bronchial asthma [91]. Rosenberg et al used St-BL in asthma, bronchitis, pneumonia, chronic obstructive pulmonary diseases and Tb (more references are in the review and patent [89,92]), as well as in COVID-19 [93], where immune and inflammatory reactions might contribute to the "cytokine storm" and collagen synthesis. Bs was used as the delivery method of Sf [92,[94][95][96][97][98][99][100][101] with a biopsy of lung tissue in [95]; other studies used inhalations.…”

Section: Repeated Hemoptysis or Secondary Infectionmentioning

confidence: 99%

Some Aspects of the Surgical and Endoscopic Treatment of Tuberculosis in Russia

2021

J Surg

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26,000, while 85% of the operations were lung resections [6]. In the period 1986-1988, 17,000-18,000 operations for pulmonary Tb were performed in Russia yearly only in specialized tuberculosis hospitals [3]. In 2003, 10,479 surgeries were performed in Russia for respiratory Tb, which was deemed "extremely insufficient" [7]. In 2006, 12,286 operations were carried out for pulmonary Tb including 9300 (75.7%) lobectomies and other resections as well as 399 (3.2%) pneumonectomies [4]. According to another report, the forms of Tb most frequently treated by resections and pneumonectomies were cavitary Tb (52.2%) and tuberculoma (43.9%) [8].The abovenamed surgeries were performed and recommended also for patients with inactive post-tuberculous fibrosis including cases with sparse symptoms [9]. At the same time, surgeries were performed in the active phase of Tb. In some provinces (Kemerovo, Chelyabinsk, Mordovia), 25-40% of patients with destructive Tb were operated on [10]. At the time of initial Tb diagnosis, an operation was deemed reasonable in 15-20% of patients [3]. According to another paper by the same authors, indications for surgery were found in 20-30% of patients at the initial diagnosis and/or among cases of active Tb [11].In Yekaterinburg and surrounding province (2006)(2007)(2008), indications for surgery were determined in 1784 from 4402 (40.5%) patients with pulmonary Tb while 1079 (24.5%) were operated on. Among reasons of the comparatively "low" surgery rate were the patients' non-compliance and unavailability [12]. In the international literature, corresponding figures are generally lower e.g. <5% of pulmonary Tb patients were supposed to require surgery [13]. The same percentage is given in the reviews [14,15]. The topic of Tb surgery may become more relevant due to the multidrug resistance. According to a current estimate from Russia, the need for surgery has increased from 5% to 15% over the last twenty years [16]. However, the recent systematic review and metaanalysis concluded that, compared with chemotherapy alone, the survival benefit of pulmonary resection combined with chemotherapy is not significant, although the quality of data was deemed "relatively poor" [17]. According to another metaanalysis, partial lung resection, but not pneumonectomy, was associated with improved treatment success in multidrug-resistant Tb. It was not excluded, however, that "healthier" patients were preferentially chosen for surgery, leading to a bias. The confounding by indication, as patients most likely to benefit are selected for the treatment, has been a limitation in many

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Inhalation surfactant therapy in the integrated treatment of severe COVID-19 pneumonia

Cited by 17 publications

References 8 publications

Invasive Procedures Used in Tuberculosis With Questionable Indications: Report From Russia

Invasive Procedures Used in Tuberculosis With Questionable Indications: Report From Russia

Effect of Cuban Porcine Pulmonary Surfactant (Surfacen) and rCmPI-II Protease Inhibitor on Neutrophil Elastase Activity"

Some Aspects of the Surgical and Endoscopic Treatment of Tuberculosis in Russia

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