Cytochrome P450-mediated drug interactions in COVID-19 patients: Current findings and possible mechanisms
Cytochrome P450-mediated drug interactions in COVID-19 patients: Current findings and possible mechanisms
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DOI：
10.1016/j.mehy.2020.110033
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发表时间：
2020-11-01
影响因子：
4.7
通讯作者：
El-Kadi, Ayman O. S.
中科院分区：
文献类型：
--
作者：
El-Ghiaty, Mahmoud A.;Shoieb, Sherif M.;El-Kadi, Ayman O. S.
2019年底，全世界见证了中国武汉冠状病毒家族新成员的诞生。从那时起，严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）迅速侵入地球的每个角落。截至2020年4月底，全球已报告近350万例病例，死亡人数约25万人。目前公认的是，患者的免疫反应在2019冠状病毒病（COVID-19）的发病机制中起着关键作用。这种炎症因子通过其升高的介质来证明，在严重的情况下，在细胞因子风暴中达到其峰值。与报告的肝损伤标志物一起，这种炎症过度状态可能引发肝细胞色素P450代谢机制的显著紊乱，以及随后可能导致意外治疗/毒性反应的药物清除调节。我们假设，COVID-19患者可能容易受到显著的疾病-药物相互作用的影响，因此，应实施适当的给药指南和治疗药物监测，以确保最佳的临床结局。
At the end of 2019, the entire world has witnessed the birth of a new member of coronavirus family in Wuhan, China. Ever since, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has swiftly invaded every corner on the planet. By the end of April 2020, almost 3.5 million cases have been reported worldwide, with a death toll of about 250,000 deaths. It is currently well-recognized that patient's immune response plays a pivotal role in the pathogenesis of Coronavirus Disease 2019 (COVID-19). This inflammatory element was evidenced by its elevated mediators that, in severe cases, reach their peak in a cytokine storm. Together with the reported markers of liver injury, such hyperinflammatory state may trigger significant derangements in hepatic cytochrome P450 metabolic machinery, and subsequent modulation of drug clearance that may result in unexpected therapeutic/toxic response. We hypothesize that COVID-19 patients are potentially vulnerable to a significant disease-drug interaction, and therefore, suitable dosing guidelines with therapeutic drug monitoring should be implemented to assure optimal clinical outcomes.