Treatment of
            <scp>COVID</scp>
            ‐19 with pentoxifylline: Could it be a potential adjuvant therapy?

Seirafianpour, Farnoosh; Mozafarpoor, Samaneh; Fattahi, Nima; Sadeghzadeh‐Bazargan, Afsaneh; Hanifiha, Melika; Goodarzi, Azadeh

doi:10.1111/dth.13733

Cited by 54 publications

(58 citation statements)

References 21 publications

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“…Taken together, the evidence highlighted here strongly points to the potential benefits of pentoxifylline for the treatment of COVID-19, which can help support patients in critical care and overwhelmed hospital resources in the face of this pandemic. In line with this, other researchers have proposed pentoxifylline as a beneficial drug for the treatment of COVID-19 [23-25].…”

Section: Discussionmentioning

confidence: 85%

Pentoxifylline: A Drug with Antiviral and Anti-Inflammatory Effects to Be Considered in the Treatment of Coronavirus Disease 2019

2020

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In December 2019, a new coronavirus, named SARS-CoV-2, has emerged from China causing pneumonia outbreaks first in the Wuhan region and have now spread worldwide but there are still no “specific drug” available. In the difficulty where new synthesized drug cannot be applied immediately to patients, “conventional drug in new use” becomes a feasible solution. Chloroquine, remdesivir, favipiravi, lopinavir, ribavirin or ritonavir have shown efficacy to inhibit coronavirus in vitro. Pentoxifylline, a drug with anti-inflammatory, immunomodulatory and bronchodilatory effects, previously showed efficacy to inhibit various viral infections. Immunological studies have shown that most patients with severe COVID-19 exhibit substantially elevated serum levels of pro-inflammatory cytokines. Pentoxifylline is a phosphodiesterase inhibitor that increases cyclic adenosine monophosphate levels, which in turn activate protein kinase, leading to a reduction in the synthesis of proinflammatory cytokines and immune cell migration. Here we propose pentoxifylline, a drug with low cost and toxicity, as a possible treatment for COVID-19 in basis of its interesting properties.

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Section: Discussionmentioning

confidence: 85%

Pentoxifylline: A Drug with Antiviral and Anti-Inflammatory Effects to Be Considered in the Treatment of Coronavirus Disease 2019

2020

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“… 80 Therefore, the selection of a molecule(s) backed by years of safety margin, widespread use, and affordability may offer the opportunity to prevent/treat infection and its disabling complications that ensue. Several options, such as tocilizumab, 81 hydroxychloroquine and ivermectin, 82 PDE-4 inhibition, 58 , 59 combined interferon beta-1b, lopinavir-ritonavir, and ribavirin, 83 were raised to manage such pandemic. In addition, camostat mesylate, remdesivir, favipiravir, baricitinib, convalescent plasma, and humanized monoclonal antibodies were suggested as therapeutics for the potential treatment of SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

“…These authors believed that selective PDE4 inhibitors may represent a promising option for the early phase of COVID-19 pneumonia before the cytokine storm and severe multiorgan dysfunction take place. Besides, Seirafianpour et al 59 raised many confirmatory data on proper efficacy of pentoxifylline, a methyl-xanthine derivative that inhibits PDE4, on controlling COVID-19 and its consequences with antiviral, anti-inflammatory, antioxidative, immune-modulatory, bronchodilator, and respiratory supportive effects. PDE5 inhibitors have been demonstrated to be a highly protective agent in preventing lung and kidney damage owing to induced sepsis by the maintenance of the oxidant-antioxidant status and decreased TNF-α.…”

Section: Methodsmentioning

confidence: 99%

Could Oral Phosphodiesterase 5 Inhibitors Have a Potential Adjuvant Role in Combating COVID-19 Infection?

Mostafa

2021

Sexual Medicine Reviews

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Introduction The recent global outbreak of coronavirus disease 2019 (COVID-19) has become a pandemic with a lot of sufferers. Excessive inflammation, exaggerated immune response, with ultimate apoptosis contribute to COVID-19 pathology that progress to acute lung acute respiratory distress. Objective To shed a light on the likely beneﬁts of the oral phosphodiesterase 5 (PDE5) inhibitor adjuvant role in combating COVID-19 infection. Methods A literature review was performed in the PubMed/Medline database, Scopus, Cochrane Library, EMBASE, Academic Search Complete, Google Scholar, and CINAHL databases using the keywords COVID-19; phosphodiesterase-5 inhibitors; cytokine storm; respiratory distress. Results Despite the worsening trends of COVID-19, still no drugs are validated to have significant clinical efficacy in the treatment of patients with COVID-19 in large-scale studies. While the progress toward a curative agent and/or vaccine is certainly hopeful, the principal limiting factor in such public health emergencies is always the time. Therefore, a preexisting licensed therapeutic(s) might offer a reprieve to the healthcare systems operating at the edge of capacity. In this context, the innovation of oral PDE5 inhibitors with their valuable effects on erection have provided a breakthrough in the treatment of erectile dysfunction and opened new fields of clinical application for this class of drugs. Oral PDE5 inhibitors have been demonstrated to possess many beneficial useful additional implications with acknowledged anti-inflammatory, antioxidant, immune response regulation, and antiapoptotic properties. These properties have been elucidated through the nitric oxide/soluble guanylyl cyclase/cyclic guanylate monophosphate pathway in addition to the emerged hemeoxygenase-1 enzyme as well as hydrogen sulfide pathways. These properties could support repurposing oral PDE5 inhibitors' potential adjuvant use in targeting different aspects of COVID-19 infection. Conclusion Oral PDE5 inhibitors retain several acknowledged off-labeled useful implications with anti-inflammatory, antioxidant, immune response regulation, and antiapoptotic properties. These properties may support repurposing oral PDE5 inhibitors' potential adjuvant use in the protocols combating COVID-19 manifestations. Mostafa T. Could Oral Phosphodiesterase 5 Inhibitors Have a Potential Adjuvant Role in Combating Coronavirus Disease 2019 Infection? Sex Med Rev 2021;9:15–22.

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“…In addition, the field of COVID is of interest of the authors of this study and the author have been focused on other multi-potential drugs and specific manifestation of COVID and COVID in patients with specific disorders. [ 112 113 114 ]…”

Section: Discussionmentioning

confidence: 99%

N-acetylcysteine and coronavirus disease 2019: May it work as a beneficial preventive and adjuvant therapy? A comprehensive review study

et al. 2020

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Background: Coronaviruses are major pathogens of respiratory system causing different disorders, including the common cold, Middle East respiratory syndrome, and severe acute respiratory syndrome. Today's global pandemic coronavirus disease 2019 (COVID-19) has high mortality rate, with an approximate of 20% in some studies, and is 30–60 times more fatal than the common annual influenza, However, there is still no gold standard treatment for it. N-acetylcysteine (NAC) is a well-known multi-potential drug with hypothetically probable acceptable effect on COVID-related consequences, which we completely focused in this comprehensive review. Materials and Methods: PubMed, Scopus, Science Direct, and Google Scholar have been searched. Study eligibility criteria: efficacy of NAC in various subclasses of pathogenic events which may occur during COVID-19 infection. Efficacy of NAC for managing inflammatory or any symptoms similar to symptoms of COVID-19 was reviewed and symptom improvements were assessed. Results: Randomized clinical trials introduced NAC as an antioxidant glutathione analog and detoxifying agent promoted for different medical conditions and pulmonary disorders to alleviate influenza and reduce mortality by 50% in influenza-infected animals. The beneficial effects of NAC on viral disorders, including Epstein–Barr virus, HIV and hepatitis, and well-known vital organ damages were also exist and reported. Conclusion: We classified the probable effects of NAC as oxidative-regulatory and apoptotic-regulatory roles, antiviral activities, anti-inflammatory roles, preventive and therapeutic roles in lung disorders and better oxygenation functions, supportive roles in intensive care unit admitted patients and in sepsis, positive role in other comorbidities and nonpulmonary end-organ damages or failures and even in primary COVID-associated cutaneous manifestations. Based on different beneficial effects of NAC, it could be administered as a potential adjuvant therapy for COVID-19 considering patient status, contraindications, and possible drug-related adverse events.

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Treatment of COVID ‐19 with pentoxifylline: Could it be a potential adjuvant therapy?

Cited by 54 publications

References 21 publications

Pentoxifylline: A Drug with Antiviral and Anti-Inflammatory Effects to Be Considered in the Treatment of Coronavirus Disease 2019

Pentoxifylline: A Drug with Antiviral and Anti-Inflammatory Effects to Be Considered in the Treatment of Coronavirus Disease 2019

Could Oral Phosphodiesterase 5 Inhibitors Have a Potential Adjuvant Role in Combating COVID-19 Infection?

N-acetylcysteine and coronavirus disease 2019: May it work as a beneficial preventive and adjuvant therapy? A comprehensive review study

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