Aripiprazole as a candidate treatment of COVID-19 identified through genomic analysis

Abstract

BackgroundAntipsychotics suppress expression of inflammatory cytokines and inducible inflammatory enzymes. Elopiprazole (a phenylpiperazine antipsychotic drug in phase 1) has been characterized as a therapeutic drug to treat SARS-CoV-2 infection in a repurposing study. We aim to investigate the potential effects of aripiprazole (an FDA approved phenylpiperazine) on COVID19-related immunological parameters.MethodsDifferential gene expression profiles of non-COVID versus COVID RNA-Seq samples (CRA002390 project in GSA database) and drug-naïve patients with psychosis at baseline and after three months of aripiprazole treatment was identified. An integrative analysis between COVID and aripiprazole immunomodulatory antagonist effects was performed.Findings82 out the 377 genes (21.7%) with expression significantly altered by aripiprazole have also their expression altered in COVID-19 patients and in 93.9% of these genes their expression is reverted by aripiprazole. The number of common genes with expression altered in both analyses is significantly higher than expected (Fisher’s Exact Test, two tail; P value=3.2e-11). 11 KEGG pathways were significantly enriched with genes with altered expression both in COVID-19 patients and aripiprazole medicated schizophrenia patients (P adj<0.05). The most significant pathways were associated to the immune system such as the “inflammatory bowel disease (IBD)” (the most significant pathway with a P adj of 0.00021), “Th1 and Th2 cell differentiation” and “B cell receptor signaling pathway”, all three related to the defense against infections.InterpretationThis exploratory investigation may provide further support to the notion that protective effect is exerted by phenylpiperazine by modulating the immunological dysregulation associated to COVID-19. Along with many ongoing studies and clinical trials, repurposing available medications could be of use in countering SARS-CoV-2 infection, but require further studies and trials.

Neuropsychiatric Drugs Against COVID-19: What is the Clinical Evidence?

“…Moreover, in a genome-wide association study, a substantial overlap of genes relevant for signaling and inflammation was seen between COVID-19 and psychiatric disorders 83 . A genomic analysis linked inflammatory genes altered by aripiprazole treatment with genes altered in COVID-19 patients 84 .…”

Aripiprazole as a Candidate Treatment of COVID-19 Identified Through Genomic Analysis

“…This manuscript has been released as a pre-print at medRxiv. Available at: https://doi.org/ 10.1101/2020.12.05.20244590 (Crespo-Facorro et al, 2020).…”

Estimation of Immunological and Physiological Parameters in Diabetic Patients with COVID-19

“…The Human Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) was detected first in September 2019 in female patients in Wuhan (Hubei Province, China) suffered from Sevier respiratory illness and that disease has been popularized as corona-virus disease or COVID-19. The disease was declared an international public health emergency on January 30, 2020; a few months later, on March 11, 2020, it was declared a pandemic by the World Health Organization 1 . In patients with COVID-19, an excessive or un-controlled innate immune response leads to cytokine storm status and acute respiratory distress syndrome; the S protein of COVID-19 ligament to the angiotensin-converting enzyme receptor (ACE2) on the host cell and causes it to appear of genomic RNA (dsRNA) in the cytoplasm of the infected host cell 2 .…”