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Is there a role for insulin-like growth factor inhibition in the treatment of COVID-19-related adult respiratory distress syndrome?
Adult respiratory distress syndrome (ARDS) is the leading cause of death associated with SARS-CoV-2 infection and COVID-19. IGF-1 has been implicated in ARDS, yet its role in relation to COVID-19-related lung injury has not been investigated. We hypothesize that blockage of the IGF-1 receptor (IGF-1...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Eden Press
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413200/ https://www.ncbi.nlm.nih.gov/pubmed/32795835 http://dx.doi.org/10.1016/j.mehy.2020.110167 |
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author | Winn, Bryan J. |
author_facet | Winn, Bryan J. |
author_sort | Winn, Bryan J. |
collection | PubMed |
description | Adult respiratory distress syndrome (ARDS) is the leading cause of death associated with SARS-CoV-2 infection and COVID-19. IGF-1 has been implicated in ARDS, yet its role in relation to COVID-19-related lung injury has not been investigated. We hypothesize that blockage of the IGF-1 receptor (IGF-1R) mitigates lung injury and decreases the risk of death in patients COVID-19-related ARDS. Patients with fibroproliferative ARDS have been shown to have increased IGF-1 and IGF-1R staining in lung tissue specimens. Rising levels of IGF-1 in bronchioalveolar fluid (BAL) and increased IGF-1 mRNA expression in lung tissues (but declining serum IGF-1 levels) have been found in late stage ARDS compared with early lung injury. Blockage of IGF-1R decreases lung tissue damage and increases survival in bleomycin-induced as well as H1N1 influenza-related lung injury in animal models. Teprotumumab is a monoclonal antibody directed against the IGF-1R that was FDA-approved in 2020 for the treatment of Graves’ orbitopathy. In order to determine if teprotumumab may reduce lung injury and death related to ARDS in the setting of COVID-19, preliminary clinical data is needed. IGF-1 levels in serum and BAL fluid must be measured in patients with COVID-19-related ARDS. Histopathology from lung samples from patients with COVID-19-related ARDS must be examined for increased expression of the IGF-1R. Once these are ascertained, and if the data support IGF-1 involvement, a randomized, placebo-controlled phase 2A trial of teprotumumab therapy in the setting of COVID-19-related ARDS and non-COVID-19-related ARDS designed to generate initial data on short-term efficacy, safety, dosing and administration should be performed. |
format | Online Article Text |
id | pubmed-7413200 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Eden Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-74132002020-08-10 Is there a role for insulin-like growth factor inhibition in the treatment of COVID-19-related adult respiratory distress syndrome? Winn, Bryan J. Med Hypotheses Article Adult respiratory distress syndrome (ARDS) is the leading cause of death associated with SARS-CoV-2 infection and COVID-19. IGF-1 has been implicated in ARDS, yet its role in relation to COVID-19-related lung injury has not been investigated. We hypothesize that blockage of the IGF-1 receptor (IGF-1R) mitigates lung injury and decreases the risk of death in patients COVID-19-related ARDS. Patients with fibroproliferative ARDS have been shown to have increased IGF-1 and IGF-1R staining in lung tissue specimens. Rising levels of IGF-1 in bronchioalveolar fluid (BAL) and increased IGF-1 mRNA expression in lung tissues (but declining serum IGF-1 levels) have been found in late stage ARDS compared with early lung injury. Blockage of IGF-1R decreases lung tissue damage and increases survival in bleomycin-induced as well as H1N1 influenza-related lung injury in animal models. Teprotumumab is a monoclonal antibody directed against the IGF-1R that was FDA-approved in 2020 for the treatment of Graves’ orbitopathy. In order to determine if teprotumumab may reduce lung injury and death related to ARDS in the setting of COVID-19, preliminary clinical data is needed. IGF-1 levels in serum and BAL fluid must be measured in patients with COVID-19-related ARDS. Histopathology from lung samples from patients with COVID-19-related ARDS must be examined for increased expression of the IGF-1R. Once these are ascertained, and if the data support IGF-1 involvement, a randomized, placebo-controlled phase 2A trial of teprotumumab therapy in the setting of COVID-19-related ARDS and non-COVID-19-related ARDS designed to generate initial data on short-term efficacy, safety, dosing and administration should be performed. Eden Press 2020-11 2020-08-07 /pmc/articles/PMC7413200/ /pubmed/32795835 http://dx.doi.org/10.1016/j.mehy.2020.110167 Text en Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Winn, Bryan J. Is there a role for insulin-like growth factor inhibition in the treatment of COVID-19-related adult respiratory distress syndrome? |
title | Is there a role for insulin-like growth factor inhibition in the treatment of COVID-19-related adult respiratory distress syndrome? |
title_full | Is there a role for insulin-like growth factor inhibition in the treatment of COVID-19-related adult respiratory distress syndrome? |
title_fullStr | Is there a role for insulin-like growth factor inhibition in the treatment of COVID-19-related adult respiratory distress syndrome? |
title_full_unstemmed | Is there a role for insulin-like growth factor inhibition in the treatment of COVID-19-related adult respiratory distress syndrome? |
title_short | Is there a role for insulin-like growth factor inhibition in the treatment of COVID-19-related adult respiratory distress syndrome? |
title_sort | is there a role for insulin-like growth factor inhibition in the treatment of covid-19-related adult respiratory distress syndrome? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413200/ https://www.ncbi.nlm.nih.gov/pubmed/32795835 http://dx.doi.org/10.1016/j.mehy.2020.110167 |
work_keys_str_mv | AT winnbryanj istherearoleforinsulinlikegrowthfactorinhibitioninthetreatmentofcovid19relatedadultrespiratorydistresssyndrome |