Taiwanese researchers have found that combining an existing immunosuppressant drug with the COVID-19 medication remdesivir could suppress the ability of the virus to replicate, and thus could be a possible new treatment for the disease.
Lee Shiow-ju (李秀珠), an investigator with the Institute of Biotechnology and Pharmaceutical Research at the National Health Research Institutes, said remdesivir was once seen as a promising cure for COVID-19, but it never delivered on that promise.
Taiwanese doctors currently only use remdesivir to treat hospitalized COVID-19 patients in need of oxygen therapy and patients put on non-invasive ventilation, Lee said.
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Meanwhile, researchers in Taiwan have been trying to take advantage of existing drugs for their known safety profiles to expedite the discovery of effective and safe COVID-19 treatments.
After screening 230 prescription drugs covered by the National Health Insurance System, Lee said her team found that cyclosporine, an immunosuppressant widely used to prevent organ transplant rejection, could significantly reduce infection by coronaviruses.
Cyclosporine suppresses the activity of the immune system by inhibiting the activity and growth of T cells and the production of interleukin-6 (IL-6), a substance in the body that causes inflammation, Lee said.
In particular, IL-6 has been seen as an inflammatory marker for severe COVID-19 infections through its production of cytokines — small proteins that control the activity of other immune system cells.
A sudden increase in cytokines, known as a cytokine storm, can lead to serious inflammatory syndromes, and it has been associated with severe cases of COVID-19. Cyclosporine inhibits the production of those cytokines.
Cyclosporine has been on the market for years, making it highly accessible locally without the need to import drugs from overseas, Lee said.
Moreover, her team has found in simulations using cell lines (cells that are grown and then used to test candidate drugs) that the combination of cyclosporine and remdesivir are more effective in inhibiting coronaviruses from replicating than when the drugs are used separately.
The finding suggests that the combination of the two drugs merits further study as a possible treatment for COVID-19, she said.
However, follow-up clinical trials need to be conducted to prove the initial findings, Lee said.
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