Medikamentöse Therapiemaßnahmen bei akuter SARS-CoV-2-Infektion: wer, wann und was?

Sensen, Barbara; Wichmann, Dominic; Kluge, Stefan

doi:10.1055/a-1817-8872

Dtsch Med Wochenschr

2022

DOI: 10.1055/a-1817-8872

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Medikamentöse Therapiemaßnahmen bei akuter SARS-CoV-2-Infektion: wer, wann und was?

Barbara Sensen¹,

Dominic Wichmann²,

Stefan Kluge³

Abstract: Mittlerweile gibt es eine Vielzahl von medikamentösen Therapieoptionen zur Behandlung einer akuten SARS-CoV-2-Infektion. Die aktualisierte S3-Leitlinie „Empfehlungen zur stationären Therapie von Patienten mit COVID-19“ gibt dazu klare Empfehlungen. Welche Therapie für welchen Patienten und in welcher Krankheitsphase am besten geeignet ist, muss individuell anhand der Risikofaktoren, der Komorbiditäten und der Kontraindikationen entschieden werden. Hierüber geben wir in diesem Beitrag einen Überblick.

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2024

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Dexamethasone, Remdesivir and Azithromycin modulate ACE2 and IL-6 in Lung Epithelial Cells

Ulrich-Merzenich,

Shcherbakova,

Pizarro

et al. 2024

Pneumologie

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Background The optimal use of steroids in COVID-19 patients remains challenging. Current S3-guidelines “Recommendations for patients with COVID-19” recommend dexamethasone (DEX) for patients requiring respiratory support, remdesivir (RD) in the early disease phase and azythromycin (AZ) is no longer recommended. We investigated effects of DEX, RD and AZ in a lipopolysaccharide induced inflammation in lung cells in vitro and analyzed publicly available datasets with a focus on the Angiotensin-converting enzyme 2 (ACE2) to better understand drugs’ mechanisms of action. Methods human bronchial (Calu) and alveolar (A549) lung epithelial cells were treated with DEX, AZ or RDV in the presence of lipopolysaccharides (LPS). Gene expression (GE) of ACE2, IL-6 and the IL-6 protein release were measured. Publicly available GE data from lung tissues of COVID-19 patients and from lung cells treated with DEX were analyzed for the GE of ACE2. Results DEX increased and RDV and AZ reduced the GE of ACE2 in LPS-stimulated bronchial and alveolar epithelial cells. Only DEX significantly reduced LPS-induced IL-6 releases in alveolar cells substantially. The database analyses showed an, albeit not always significant, increase in ACE2 for lung tissue or cell lines treated with DEX. Lung tissue from patients after COVID-19 infection as well as bronchial cell cultures after COVID-19 infection showed lower GEs of ACE2. Discussion and Conclusion DEX can increase ACE2 expression in vitro and thereby the portal of entry of SARS-CoV-2 into lung cells during an LPS induced inflammation. Simultaneously the inflammatory marker IL-6 is reduced. Comparative database analyses indicate that these processes can also take place in vivo.

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Dexamethasone, Remdesivir and Azithromycin modulate ACE2 and IL-6 in Lung Epithelial Cells

Ulrich-Merzenich,

Shcherbakova,

Pizarro

et al. 2024

Pneumologie

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show abstract

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Medikamentöse Therapiemaßnahmen bei akuter SARS-CoV-2-Infektion: wer, wann und was?

Cited by 1 publication

References 24 publications

Dexamethasone, Remdesivir and Azithromycin modulate ACE2 and IL-6 in Lung Epithelial Cells

Dexamethasone, Remdesivir and Azithromycin modulate ACE2 and IL-6 in Lung Epithelial Cells

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