Elevated Neurokinin 1-Receptor Expression in uterine products of conception is associated with first trimester Miscarriages

Mehboob, Riffat; Gilani, Syed Amir; Hassan, Amber; Tirmazi, Adeel Haider; Ahmad, Fridoon Jawad; Akram, Javed

doi:10.1101/2020.06.27.175273

Cited by 1 publication

(2 citation statements)

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“…20 Previous studies from our own work have also revealed the involvement of SP and NK-1R in cardiorespiratory control 21 , sleep wake cycle 21 , inflammation 22 and involvement in fatal outcomes 17 . Some of our recent unpublished work also reports similar findings of SP/NK-1R involvement in inflammation 23 , pain, pathologies, sudden deaths 24 etc. SP and NK-1R are also found to be involved in immunology 7, 15 , lung inflammation 2, 7 , respiratory network stability 25, 26 , heart failure 27 and neurological and psychiatric disorders 28 .…”

Section: Introductionsupporting

confidence: 67%

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Aprepitant as a combinant with Dexamethasone reduces the inflammation via Neurokinin 1 Receptor Antagonism in severe to critical Covid-19 patients and potentiates respiratory recovery: A novel therapeutic approach

Mehboob

Ahmad

Qayyum³

et al. 2020

Preprint

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Background: Corona virus infection is a respiratory infection, compromising the normal breathing in critical patients by damaging the lungs. Researches are ongoing to find an efficient treatment strategy for this disease by either inactivating the virus or boosting the immune system of patient or by managing the cytokine storm. Aim: To evaluate the clinical outcomes of Substance P receptor Neurokinin 1 antagonist in Covid 19 patients against the usual treatments as controls. Patients and Methods: It is a randomized clinical trial, open label, having two arms, one receiving normal management and care while other receiving Neurokinin 1 Receptor antagonist, Aprepitant, in addition. Dexamethasone, a corticosteroid is also administered orally to both the groups. PCR positive, hospitalized patients with more than 18 years of age, both genders, moderate to critical phase were included. 18 patients were randomly allocated in both arms, having 10 in group A and 8 in group B. Lab investigations were performed in both the groups before and after the intervention. We report preliminary results for the comparison of Aprepitant 80 mg given once daily for 3 to 5 days vs routine management. The primary outcome was total in hospital days and duration of disease. Results: Mean age of patients in group A was 47.63 +12.07years while 60.90+ 9.75 years in group B. There were 3 males in group A and 8 in group B. There were 2 critical patients in group A and 5 in group B. Biochemical and hematological parameters in both groups didnot show much difference except the C reactive protein reduction in the intervention group, indicative of a reduced inflammation. Oxygen saturation also improved but more patients should be enrolled to get a statistically significant data. One patient was discharged from each group within 5 days and one patient expired in each. Conclusions: It is a pilot study but the findings give a strong clue for the therapeutic potential of Aprepitant. Patients who received a combination therapy of Aprepitant and Dexamethasone were recovered earlier and showed improved clinical outcomes, laboratory findings and reduced C reactive protein which is an inflammatory marker. We suggest here a study on larger sample size to get a deeper insight of its potential and efficacy. It may be more effective in severe to critical patients having respiratory difficulties.

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Section: Introductionsupporting

confidence: 67%

“…In our recent study, we have also suggested the similar role for aprepitant. 24 It may also improve the respiratory conditions in pre-mature labour as well as Covid-19 patients. We also suggest Ondansetron, a serotonin receptor antagonist along with these two drugs.…”

Section: Discussionmentioning

confidence: 99%