The preventive effect of antiplatelet therapy in acute respiratory distress syndrome: a meta-analysis

Wang, Yingqin; Zhong, Ming; Wang, Zhichao; Song, Jieqiong; Wu, Wei; Zhu, Dexiang

doi:10.1186/s13054-018-1988-y

Cited by 23 publications

(18 citation statements)

References 54 publications

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“…Three recent meta-analyses have reported significantly increased survival in ARDS patients prescribed aspirin compared to those who were aspirin free [ [160] , [161] , [162] ]. Furthermore, the effect appear to be greater in critically ill patients and patients with ARDS-related sepsis than a wider group of patients [ 160 , 161 ].…”

Section: Suggestions For Therapeutic Interventionmentioning

confidence: 99%

Preventing the development of severe COVID-19 by modifying immunothrombosis

Morris

Bortolasci

Puri³

et al. 2021

Life Sciences

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Background COVID-19-associated acute respiratory distress syndrome (ARDS) is associated with significant morbidity and high levels of mortality. This paper describes the processes involved in the pathophysiology of COVID-19 from the initial infection and subsequent destruction of type II alveolar epithelial cells by SARS-CoV-2 and culminating in the development of ARDS. Main body The activation of alveolar cells and alveolar macrophages leads to the release of large quantities of proinflammatory cytokines and chemokines and their translocation into the pulmonary vasculature. The presence of these inflammatory mediators in the vascular compartment leads to the activation of vascular endothelial cells platelets and neutrophils and the subsequent formation of platelet neutrophil complexes. These complexes in concert with activated endothelial cells interact to create a state of immunothrombosis. The consequence of immunothrombosis include hypercoagulation, accelerating inflammation, fibrin deposition, migration of NET producing neutrophils into the alveolar apace, activation of the NLRP3 inflammazome, increased alveolar macrophage destruction and massive tissue damage by pyroptosis and necroptosis Therapeutic combinations aimed at ameliorating immunothrombosis and preventing the development of severe COVID19 are discussed in detail.

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Section: Suggestions For Therapeutic Interventionmentioning

confidence: 99%

Preventing the development of severe COVID-19 by modifying immunothrombosis

Morris

Bortolasci

Puri³

et al. 2021

Life Sciences

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“…Platelets have an increasingly recognized role in the inflammatory response, leading to the development of ARDS. The possible mechanisms by which platelets contribute to ARDS include the activation of endothelial cells by the release of pro-inflammatory mediators [ 40 , 41 , 42 , 43 , 44 , 45 , 46 ] and adherence of platelets to lung capillary endothelial cells leading to the activation of attached leukocytes [ 47 ], as shown in Figure 2 .…”

Section: Mechanisms Of Platelet In Lung Inflammationmentioning

confidence: 99%

“…Both the incidence of ARDS (OR: 0.67) and the need for mechanical ventilation (OR: 0.74) were lower in the antiplatelet group [ 113 ]. On the contrary, Wang et al analyzed nine eligible studies, and found that antiplatelet therapy did not significantly decrease hospital mortality in high-risk patients, and an association with the incidence of ARDS remains unclear [ 43 ].…”

Section: Meta-analysis Of Clinical Studiesmentioning

confidence: 99%

Antiplatelet Therapy for Acute Respiratory Distress Syndrome

Chen

Tung

et al. 2020

Biomedicines

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Acute respiratory distress syndrome (ARDS) is a common and devastating syndrome that contributes to serious morbidities and mortality in critically ill patients. No known pharmacologic therapy is beneficial in the treatment of ARDS, and the only effective management is through a protective lung strategy. Platelets play a crucial role in the pathogenesis of ARDS, and antiplatelet therapy may be a potential medication for ARDS. In this review, we introduce the overall pathogenesis of ARDS, and then focus on platelet-related mechanisms underlying the development of ARDS, including platelet adhesion to the injured vessel wall, platelet-leukocyte-endothelium interactions, platelet-related lipid mediators, and neutrophil extracellular traps. We further summarize antiplatelet therapy, including aspirin, glycoprotein IIb/IIIa receptor antagonists, and P2Y12 inhibitors for ARDS in experimental and clinical studies and a meta-analysis. Novel aspirin-derived agents, aspirin-triggered lipoxin, and aspirin-triggered resolvin D1 are also described here. In this narrative review, we summarize the current knowledge of the role of platelets in the pathogenesis of ARDS, and the potential benefits of antiplatelet therapy for the prevention and treatment of ARDS.

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“…A clinical benefit of statins in an emergency situation involving sepsis would require a much more immediate effect than can be produced by this mechanism. Similarly, the effect of aspirin in ARDS revealed from retrospective analysis [17] was not repeated in a prospective trial where no significant difference was found in newly developed ARDS [18].…”

Section: Metforminmentioning

confidence: 99%

Using human experience to identify drug repurposing opportunities: theory and practice

Cavalla

2019

Brit J Clinical Pharma

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Retrospective evidence drawn from real-world experience of a medicine's use outside its labelled indication is one of a number of techniques used in drug repurposing (DRP). Relying as it does on large numbers of real incidences of human experience, rather than individual case reports with limited statistical support, preclinical experiments with poor translatability or in silico associations, which are early-stage hypotheses, it represents the best validated form of DRP. Cancer is the most frequent of such DRP examples (e.g. aspirin in pancreatic cancer, hazard ratio = 0.25). This approach can be combined with pathway analysis to provide first-in-class treatments for complex diseases. Alternatively, it can be combined with prospective preclinical studies to uncover a validated mechanism for a new indication, after which a repurposed molecule is chemically optimized. British Journal of Clinical PharmacologyBr J Clin Pharmacol (2019) 85 680-689 680 with cognitive dysfunction treated with metformin, to determine the relative benefit in situations involving vascular dementia relative to Alzheimer disease. Although case reports are often the bases for repurposing hypotheses, they lack statistical rigour and, for the purposes of this review, are not included in the definition of retrospective human evidence Retrospective data for drug repurposing Br J Clin Pharmacol (2019) 85 680-689 681 Retrospective data for drug repurposing Br J Clin Pharmacol (2019) 85 680-689 683 Retrospective data for drug repurposing Br J Clin Pharmacol (2019) 85 680-689 689

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The preventive effect of antiplatelet therapy in acute respiratory distress syndrome: a meta-analysis

Cited by 23 publications

References 54 publications

Preventing the development of severe COVID-19 by modifying immunothrombosis

Preventing the development of severe COVID-19 by modifying immunothrombosis

Antiplatelet Therapy for Acute Respiratory Distress Syndrome

Using human experience to identify drug repurposing opportunities: theory and practice

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