Background and Objectives: Remdesivir (RDV) is the first antiviral agent approved in Japan for the treatment of coronavirus disease 2019 (COVID-19). The aim of our study was to assess the efficacy and safety of RDV treatment in mildly to moderately ill patients with COVID-19. Materials and Methods: A single-center, retrospective study was performed in Fukuoka University Chikushi Hospital. Patients admitted to our hospital from June to October 2021 for RDV treatment against COVID-19 were enrolled. The primary end point was clinical status on days 10 and 14, using a 6-point ordinal scale ranging from death (category 6) to discharge (category 1). Adverse events were assessed and graded using the Japanese version of Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Results: In total, 47 COVID-19 patients receiving RDV treatment were assessed during the study period. Thirty-four (72.3%) out of 47 patients required oxygen therapy. Out of these 34 patients, 30 (88.2%) showed a 2-point clinical improvement on day 14 after RDV was initiated. Serum alanine aminotransferase levels were elevated in three patients (6.4%) (CTCAE Grade 3) and neutropenia was detected in one patient (2.1%) out of the 47 patients. Conclusions: RDV may be highly effective, with good safety profiles, in patients with COVID-19 requiring oxygen therapy.
In order to investigate the structure-activity relationships between the hydrophobicity, differences in the number of positive charged amino acids and D-amino acids as well as their action mechanism with different bio-membranes, we designed and synthesized two sets of 12-mer model peptides originating from an amphiphilic antimicrobial model peptide and a D-amino acid-containing non-amphiphilic peptide. The introduction of D-amino acid in peptides led not only to decreases in the hydrophobicity, helical content, and hemolytic activity, but to an increase in the antimicrobial activity against Gram-positive and -negative bacteria. The relative peptide hydrophobicity was estimated in terms of the peptide elution time, expressed by linear trifluoroacetic acid (TFA)-water to TFA-acetonitrile gradients on C18 reverse-phase high-performance liquid chromatography (RP-HPLC). The retention behavior of model peptides on RP-HPLC is correlated with the activity and selectivity for mammalian cells, Gram-positive and -negative bacteria: The α-helical amphiphilic structure is required for cytolytic ability against mammalian cells, but is not necessary for bacterial activity. Additionally, the peptides have different hydrophobicity regions in which they show their optimum activity against both bacteria and erythrocytes. In the highest hydrophobisity region the peptides display high levels of hemolytic activity. At medium hydrophobicity levels, the peptides are able to display to high levels of activity against Gram-positive bacteria. In the lowest hydrophobisity regions the peptides are able to display high levels of activity against Gram-negative bacteria. This may be useful in designing clinically effective antimicrobial peptides with highly potent activity and high bacterial selectivity.
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