Материалы и методы

pulmo

Пульмонология

PULMONOLOGIYA

0869-01892541-9617

Scientific and Practical Journal “PULMONOLOGIYA” LLC

10.18093/0869-0189-2021-31-5-636-644

pulmo-2883

Research Article

КЛИНИЧЕСКАЯ ФАРМАКОЛОГИЯ

CLINICAL PHARMACOLOGY

Важность противовирусных препаратов, содержащих H₂S, в протоколах лечения COVID-19

Importance of antiviral H₂S in treatment protocols for COVID-19

https://orcid.org/0000-0003-2124-8745

Van Hezik

Ed. J.

Van Hezik

Ed. J.

van Hezik E.J. – доктор медицины, старший внештатный пульмонолог

2235TD-10, Валкенбург

тел.: +3 (161) 829-92-09

Ed J. van Hezik, M.D. Senior Consultant Chest Physician

2235TD-10 Valkenburg ZH

tel.: +3 (161) 829-92-09

WaterfrontClinicalConsultants@gmx.com

Некоммерческая рабочая группа Waterfront at SeaНидерландыNon-profit working group Waterfront at SeaNetherlands

2021

20102021

315636644

2021

van Hezik E.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://journal.pulmonology.ru/pulm/article/view/2883

Целью исследования явилось предложение нового типа противовирусной терапии для больных COVID-19 в ожидании выведения на рынок разработанных вакцин в обход устойчивости к вакцинам новых мутаций вируса. Поиск средств для профилактики и ранней терапии был сосредоточен на низкомолекулярных препаратах или перепрофилировании безопасных пероральных недорогих препаратов, подходящих для применения в т. ч. в странах с низким уровнем доходов.

Материалы и методы

Материалы и методы. При поиске публикаций в рецензируемых журналах рассматривались работы о механизмах защиты от вируса, описанных у животных. Для дальнейшего подробного клинического анализа обнаружены 2 клинических исследования на следующие темы: 1) успешное применение высоких доз N-ацетилцистеина (NAC) при очень тяжелой пневмонии COVID-19; 2) подтверждение прогностической роли сывороточного уровня H2S (сероводорода) в организме хозяина.

Результаты

Результаты. После объединения результатов указанных исследований поэтапно описаны 3 основных аспекта – как H2S работает при вирусных респираторных заболеваниях; как H2S воздействует на уязвимости вируса SARS-CoV-2 по крайней мере 3 типов; как и под действием каких лекарств вырабатывается H2S. Обнаружено более 3 десятков успешных примеров применения этого механизма с подробными клиническими данными.

Заключение

Заключение. При использовании NAC в качестве донора H2S эндогенный противовирусный H2S реактивирует врожденный иммунитет, который противодействует COVID-19. С учетом того, что противовирусный H2S может быть включен в некоторые основные протоколы клинических испытаний, необходимы дальнейшие рандомизированные контролируемые исследования.

Aim

Aim. To propose a new type of antiviral treatment for COVID-19, pending the rollout of the developed vaccines and bypassing vaccine resistance of the new upcoming mutated virus variants. Aiming for prophylaxis and early therapy, the search focused on small molecules or repurposed, safe, oral and inexpensive drugs, also suitable for low-income countries.

Methods

Methods. A search in peer-reviewed literature for preclinical antiviral mechanisms highlighted at last two clinical studies for further detailed clinical analysis: 1) High dose N-acetylcysteine (NAC) was successfully applied in very severe COVID-19-pneumonia; 2) The discovery of serum level H2S (hydrogen sulfide) as a prognostic host factor.

Results

Results. Combining of these two findings resulted in a step-by-step approach with 3 perspectives that describes how H2S works in viral respiratory diseases, how H2S targets at least three vulnerabilities in the SARS-CoV-2 virus; finally, how H2S can be generated and with which drugs. More than 3 dozen successful, clinically well-documented applications have already been found.

Conclusion

Conclusion. By using NAC as the H2S donor, the generated endogenous antiviral H2S reactivates the collapsed innate immunity, providing a therapy regimen for COVID-19. Further randomized controlled trials are warranted, considering antiviral H2S for inclusion in some master trial protocols.

H2SN-ацетилцистеинпротивовирусное средствоCOVID-19

H2SN-acetylcysteineantiviralCOVID-19

Автор благодарит компанию Van der Hallen & Sons за консультации и пристрастную вычитку этого документа.

The author gratefully acknowledges Van der Hallen & Sons for Light in the tunnel and diligently proofreading this document.

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The authors declare that there are no conflicts of interest present.