COVID-19 is a medical emergency, with 20 % of patients presenting with severe clinical manifestations. From the pathogenetic point of view, COVID-19 mimics two other well-known diseases characterized by cytokine storm and hyper-activation of the immune response, with consequent organ damage: acute graft-versus-host disease (aGVHD) and macrophage activation syndrome (MAS). Hematologists are confident with these situations requiring a prompt therapeutic approach for switching off the uncontrolled cytokine release; here, we discuss pros and cons of drugs that are already employed in hematology in the light of their possible application in COVID-19. The most promising drugs might be: Ruxolitinib, a JAK1/2 inhibitor, with a rapid and powerful anti-cytokine effect, tyrosine kinase inhibitors (TKIs), with their good anti-inflammatory properties, and perhaps the anti-Cd26 antibody Begelomab. We also present immunological data from gene expression experiments where TKIs resulted effective anti-inflammatory and pro-immune drugs. A possible combined treatment algorithm for COVID-19 is here proposed.Copyright © 2020. Published by Elsevier Ltd.
About The Expert
Sara Galimberti
Chiara Baldini
Claudia Baratè
Federica Ricci
Serena Balducci
Susanna Grassi
Francesco Ferro
Gabriele Buda
Edoardo Benedetti
Rita Fazzi
Laura Baglietto
Ersilia Lucenteforte
Antonello Di Paolo
Mario Petrini
References
PubMed