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Neutrophil elastase inhibitor (sivelestat) may be a promising therapeutic option for management of acute lung injury/acute respiratory distress syndrome or disseminated intravascular coagulation in COVID‐19
Author(s) -
Sahebnasagh Adeleh,
Saghafi Fatemeh,
Safdari Mohammadreza,
Khataminia Masoud,
Sadremomtaz Afsaneh,
Talaei Zeinab,
Rezai Ghaleno Hassan,
Bagheri Mahdi,
Habtemariam Solomon,
Avan Razieh
Publication year - 2020
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.13251
Subject(s) - ards , medicine , coagulopathy , disseminated intravascular coagulation , neutrophil elastase , diffuse alveolar damage , sepsis , lung , inflammation , acute respiratory distress
Abstract What is known and objective This article summarizes the effects of sivelestat on acute lung injury/acute respiratory distress syndrome (ALI/ARDS) or ARDS with coagulopathy, both of which are frequently seen in patients with COVID‐19. Comment COVID‐19 patients are more susceptible to thromboembolic events, including disseminated intravascular coagulation (DIC). Various studies have emphasized the role of neutrophil elastase (NE) in the development of DIC in patients with ARDS and sepsis. It has been shown that NE inhibition by sivelestat mitigates ALI through amelioration of injuries in alveolar epithelium and vascular endothelium, as well as reversing the neutrophil‐mediated increased vascular permeability. What is new and conclusions Sivelestat, a selective NE inhibitor, has not been evaluated for its possible therapeutic effects against SARS‐CoV‐2 infection. Based on its promising beneficial effects in underlying complications of COVID‐19, sivelestat could be considered as a promising modality for better management of COVID‐19–induced ALI/ARDS or coagulopathy.