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DPP-4 inhibition and COVID-19: From initial concerns to recent expectations
Dipeptidyl peptidase-4 inhibitors (DPP-4is) have gained a key place in the management of type 2 diabetes mellitus (T2DM) essentially because of their good safety profile even in the frail population. DPP-4, originally known as ‘T-cell antigen CD26’, is expressed in many immune cells and regulates th...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Elsevier Masson SAS.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690941/ https://www.ncbi.nlm.nih.gov/pubmed/33249199 http://dx.doi.org/10.1016/j.diabet.2020.11.005 |
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author | Scheen, André J. |
author_facet | Scheen, André J. |
author_sort | Scheen, André J. |
collection | PubMed |
description | Dipeptidyl peptidase-4 inhibitors (DPP-4is) have gained a key place in the management of type 2 diabetes mellitus (T2DM) essentially because of their good safety profile even in the frail population. DPP-4, originally known as ‘T-cell antigen CD26’, is expressed in many immune cells and regulates their functions, so the initial concern over the use of DPP-4is was the possible increased susceptibility to infections. Furthermore, because of the high affinity between human DPP-4 and the spike (S) receptor-binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it was suspected that this virus, responsible for coronavirus disease 2019 (COVID-19), might be able to use the DPP-4 enzyme as a functional receptor to gain entry into the host. However, DPP-4is also exert anti-inflammatory effects, which could be beneficial in patients exposed to cytokine storms due to COVID-19. Yet, when observational (mostly retrospective) studies compared clinical outcomes in DPP-4i users vs non-users among diabetes patients with COVID-19, the overall results regarding the risk of progression towards more severe forms of the disease and mortality were heterogeneous, thereby precluding any definite conclusions. Nevertheless, new expectations have arisen following recent reports of significant reductions in admissions to intensive care units and mortality in DPP-4i users. However, given the limitations inherent in such observational studies, any available results should be considered, at best, as hypothetical and only suggestive of potentially substantial benefits with DPP-4is in diabetes patients with COVID-19. While the safe use of DPP-4is in COVID-19 patients appears to be an acceptable hypothesis, all such positive findings still need to be confirmed in randomized controlled trials (a few of which are currently ongoing) before any recommendations can be made for clinical practice. |
format | Online Article Text |
id | pubmed-7690941 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier Masson SAS. |
record_format | MEDLINE/PubMed |
spelling | pubmed-76909412020-11-27 DPP-4 inhibition and COVID-19: From initial concerns to recent expectations Scheen, André J. Diabetes Metab Review Dipeptidyl peptidase-4 inhibitors (DPP-4is) have gained a key place in the management of type 2 diabetes mellitus (T2DM) essentially because of their good safety profile even in the frail population. DPP-4, originally known as ‘T-cell antigen CD26’, is expressed in many immune cells and regulates their functions, so the initial concern over the use of DPP-4is was the possible increased susceptibility to infections. Furthermore, because of the high affinity between human DPP-4 and the spike (S) receptor-binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it was suspected that this virus, responsible for coronavirus disease 2019 (COVID-19), might be able to use the DPP-4 enzyme as a functional receptor to gain entry into the host. However, DPP-4is also exert anti-inflammatory effects, which could be beneficial in patients exposed to cytokine storms due to COVID-19. Yet, when observational (mostly retrospective) studies compared clinical outcomes in DPP-4i users vs non-users among diabetes patients with COVID-19, the overall results regarding the risk of progression towards more severe forms of the disease and mortality were heterogeneous, thereby precluding any definite conclusions. Nevertheless, new expectations have arisen following recent reports of significant reductions in admissions to intensive care units and mortality in DPP-4i users. However, given the limitations inherent in such observational studies, any available results should be considered, at best, as hypothetical and only suggestive of potentially substantial benefits with DPP-4is in diabetes patients with COVID-19. While the safe use of DPP-4is in COVID-19 patients appears to be an acceptable hypothesis, all such positive findings still need to be confirmed in randomized controlled trials (a few of which are currently ongoing) before any recommendations can be made for clinical practice. Elsevier Masson SAS. 2021-03 2020-11-26 /pmc/articles/PMC7690941/ /pubmed/33249199 http://dx.doi.org/10.1016/j.diabet.2020.11.005 Text en © 2020 Elsevier Masson SAS. All rights reserved. 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 | Review Scheen, André J. DPP-4 inhibition and COVID-19: From initial concerns to recent expectations |
title | DPP-4 inhibition and COVID-19: From initial concerns to recent expectations |
title_full | DPP-4 inhibition and COVID-19: From initial concerns to recent expectations |
title_fullStr | DPP-4 inhibition and COVID-19: From initial concerns to recent expectations |
title_full_unstemmed | DPP-4 inhibition and COVID-19: From initial concerns to recent expectations |
title_short | DPP-4 inhibition and COVID-19: From initial concerns to recent expectations |
title_sort | dpp-4 inhibition and covid-19: from initial concerns to recent expectations |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690941/ https://www.ncbi.nlm.nih.gov/pubmed/33249199 http://dx.doi.org/10.1016/j.diabet.2020.11.005 |
work_keys_str_mv | AT scheenandrej dpp4inhibitionandcovid19frominitialconcernstorecentexpectations |