Journal of Literature Pharmacy Sciences

COVID-19 Tedavisinde Antisitokin Hedefli Yaklaşımlar
Anti-cytokine Targeted Approaches in COVID-19 Treatment
Merve CAMCIa, Nilgün KARALIb
aİstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, Eczacılık Bölümü, İstanbul, TÜRKİYE
bİstanbul Üniversitesi Eczacılık Fakültesi, Eczacılık Meslek Bilimleri Bölümü, Farmasötik Kimya ABD, İstanbul, TÜRKİYE
J Lit Pharm Sci. 2021;10(1):29-37
doi: 10.5336/pharmsci.2020-78243
Article Language: TR
Full Text
ÖZET
 Soğuk algınlıklarının %10-30'undan sorumlu olan koronavirüs [coronavirus (CoV)] ailesinde bugüne kadar insanlarda hastalık meydana getiren 6 tür bilinmektedir. Aralık 2019 tarihinde başlayan pnömoni vakalarına sebep olan etkenin, yeni bir CoV türü olduğu tespit edilmiştir. İnsanlarda enfeksiyona sebep olan 7. CoV türüne şiddetli akut solunum sendromu-koronavirüs-2 [severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)/(2019-nCoV)] adı verilmiş, SARS-CoV-2'ye bağlı hastalık ise koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] olarak tanımlanmıştır. COVID19'un klinik özelliklerine bakıldığında asemptomatik bireylerden, akut solunum sıkıntısı sendromu ve çoklu organ yetersizliğine varan tablolara kadar değişken bir seyir gözlenmektedir. Virüs parçacıkları, öncelikle solunum mukozasını ve zamanla diğer hücreleri de enfekte ederek, vücutta bir dizi bağışıklık tepkisiyle sitokinlerin aşırı üretimini tetiklemektedir. Bu yeni virüse etkili aşının ve antiviral tedavinin eksikliği göz önüne alındığında, sitokin fırtınasını inhibe edecek antisitokin hedefli yaklaşımların hastalığın seyrini olumlu yönde etkileyeceği düşünülmektedir. Tedavide, sistemik kortikosteroidlerden beklenen olumlu yanıtın alınamaması nedeniyle daha spesifik etki gösteren ilaçlara yönelik ilgi artmıştır. İnflamasyon yanıtında ilk sentezlenen sitokin olan interlökin (IL)-1ß yine inflamasyonun başlangıç safhalarında aktive edilen IL-6 ve tümör nekrozis faktör-alfa sitokin fırtınasını inhibe etmede hedef olabilecek yapılardır. Bu çalışmada, antisitokin hedefli tedavide kullanılabilecek ajanlara yönelik değerlendirmeler yapılmıştır.

Anahtar Kelimeler: SARS-CoV-2; COVID-19; sitokin salınım sendromu
ABSTRACT
 In the coronavirus (CoV) family, which is responsible for 10-30% of colds, six species are known to cause disease in humans to date. It was determined that the cause of pneumonia cases that started as of December 2019 is a new type of coronavirus. Seventh type of CoV causing infection in humans was named as severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2/2019- nCoV) and the disease associated with SARS-CoV-2 was defined as coronavirus disease-2019 (COVID-19). When looking the clinical features of COVID-19, a variable course ranges from asymptomatic persons to acute respiratory distress syndrome and multiple organ failure. Virus particles primarily infect the respiratory mucosa and other cells over time, triggering an overproduction of cytokines in the body with a series of immune responses. Given the lack of effective vaccine and the antiviral therapy for this new virus, it is thought that anti-cytokine-targeted approaches to inhibit cytokine storm will positively affect the course of the disease. Due to the lack of positive response from systemic corticosteroids in treatment, interest in drugs with more spesific effects has increased. Interleukin (IL)-1ß,the first synthesized cytokine in the inflammatory response, IL-6 and tumor necrosis factor-alpha, which is activated in the early stages of inflammation, are the structures that can be targeted in inhibiting cytokine storm. In this study, evaluations were made for the agents that can be used in anticytokine-targeted therapy.

Keywords: SARS-CoV-2; COVID-19; cytokine release syndrome
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