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Feng S, Luan X, Wang Y, Wang H, Zhang Z, Wang Y, Tian Z, Liu M, Xiao Y, Zhao Y, Zhou R, Zhang S. Eltrombopag is a potential target for drug intervention in SARS-CoV-2 spike protein. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2020; 85:104419. [PMID: 32540428 PMCID: PMC7290210 DOI: 10.1016/j.meegid.2020.104419] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/27/2020] [Accepted: 06/09/2020] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a current global threat for which there is an urgent need to search for an effective therapy. The transmembrane spike (S) glycoprotein of SARS-CoV-2 directly binds to the host angiotensin-converting enzyme 2 (ACE2) and mediates viral entrance, which is therefore considered as a promising drug target. Considering that new drug development is a time-consuming process, drug repositioning may facilitate rapid drug discovery dealing with sudden infectious diseases. Here, we compared the differences between the virtual structural proteins of SARS-CoV-2 and SARS-CoV, and selected a pocket mainly localizing in the fusion cores of S2 domain for drug screening. A virtual drug design algorithm screened the Food and Drug Administration-approved drug library of 1234 compounds, and 13 top scored compounds were obtained through manual screening. Through in vitro molecular interaction experiments, eltrombopag was further verified to possess a high binding affinity to S protein plus human ACE2 and could potentially affect the stability of the ACE2-S protein complex. Hence, it is worth further exploring eltrombopag as a potential drug for the treatment of SARS-CoV-2 infection.
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Affiliation(s)
- Siqin Feng
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaodong Luan
- School of Medicine, Tsinghua University, Haidian District, Beijing, China,Tsinghua-Peking Center for Life Sciences, Tsinghua University, Beijing, China
| | - Yifei Wang
- School of Medicine, Tsinghua University, Haidian District, Beijing, China
| | - Hui Wang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhiyu Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yiyang Wang
- School of Medicine, Tsinghua University, Haidian District, Beijing, China
| | - Zhuang Tian
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Meixi Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Xiao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yong Zhao
- Beijing Beike Deyuan Bio-Pharm Technology Co. Ltd, Beijing, China
| | - Ruilin Zhou
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuyang Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China; School of Medicine, Tsinghua University, Haidian District, Beijing, China; Tsinghua-Peking Center for Life Sciences, Tsinghua University, Beijing, China.
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Bidika E, Fayyaz H, Salib M, Memon AN, Gowda AS, Rallabhandi B, Cancarevic I. Romiplostim and Eltrombopag in Immune Thrombocytopenia as a Second-Line Treatment. Cureus 2020; 12:e9920. [PMID: 32968581 PMCID: PMC7505620 DOI: 10.7759/cureus.9920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by platelet count less than 100×109/L and an increased risk of bleeding. The risk of bleeding increases in proportion with the degree of thrombocytopenia. Although several medications are used for primary thrombocytopenia treatment, refractoriness remains a concern. Romiplostim and eltrombopag, two relatively new drugs, have been shown to be successful in ITP treatment after standard treatment failure. The current guidelines recommend their use as a second-line treatment. In this article, we have tried to compare which of these two medications is the best option considering clinical effectiveness, cost-effectiveness, adverse effects, and the possibility of switching between them in case of ineffectiveness. The studies used in this article were found in the PubMed database. All the studies are limited to adults. Based on these studies, both medications seem to be a largely effective, safe option. Romiplostim appears to have slightly fewer adverse effects and higher costs. Switching between thrombopoietin receptor agonists (TRAs) is a successful way to overcome adverse effects and inadequacy according to the currently available literature. We believe that more detailed studies are needed to determine which of these drugs should be considered the first choice, to report long term efficacy and adverse effects, and to determine if treatment guidelines can change regarding the use of TRAs as first-line treatment.
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Affiliation(s)
- Erjola Bidika
- Internal Medicine, California Institute of Behavorial Neurosciences & Psychology, Fairfield, USA
| | - Hafsa Fayyaz
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Marina Salib
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Areeba N Memon
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Asavari S Gowda
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Bhavana Rallabhandi
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ivan Cancarevic
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Lozano ML, Mingot-Castellano ME, Perera MM, Jarque I, Campos-Alvarez RM, González-López TJ, Carreño-Tarragona G, Bermejo N, Lopez-Fernandez MF, de Andrés A, Valcarcel D, Casado-Montero LF, Alvarez-Roman MT, Orts MI, Novelli S, Revilla N, González-Porras JR, Bolaños E, Rodríguez-López MA, Orna-Montero E, Vicente V. Deciphering predictive factors for choice of thrombopoietin receptor agonist, treatment free responses, and thrombotic events in immune thrombocytopenia. Sci Rep 2019; 9:16680. [PMID: 31723222 PMCID: PMC6853922 DOI: 10.1038/s41598-019-53209-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 10/25/2019] [Indexed: 02/06/2023] Open
Abstract
Very few data exist on when a particular thrombopoietin-receptor agonist (TPO-RA) is favored in clinical practice for the treatment of patients with immune thrombocytopenia (ITP), about novel risk factors for vascular events (VE) with these drugs, nor about predictive factors for therapy free responses (TFR). We conducted an observational, retrospective, long-term follow-up multicenter study from November 2016 to January 2018 of 121 adult ITP patients initiating TPO-RA between January 2012 to December 2014. Data reflected that a platelet count ≤25 × 109/l at the time when the TPO-RA was initiated was associated with a 2.8 higher probability of receiving romiplostim vs. eltrombopag (P = 0.010). VE on TPO-RA was related to previous neoplasia in patients over 65 years (50% vs. 2.2%, P < 0.001), and to previous splenectomy in younger patients (100% vs. 33%, P = 0.001). Receiving romiplostim as first TPO-RA with no subsequent TPO-RA switching was associated with a 50% likelihood of TFR after 2.9 years of therapy (3.3 years in chronic ITP patients). These real-world data help deciphering some areas of uncertainty, and offer insight into some of the most relevant challenges of ITP which may help clinicians make appropriate treatment decisions in the management of adult ITP patients with TPO-RA.
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Affiliation(s)
- Maria L Lozano
- Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain.
| | | | - María M Perera
- Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
| | - Isidro Jarque
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | | | | | | | | | - Aurora de Andrés
- Complexo Hospitalario Universitario de Santiago, A Coruña, Spain
| | - David Valcarcel
- Vall d'Hebron Institute of Oncology (VHIO), University Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | | | | | - Nuria Revilla
- Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Jose R González-Porras
- Hospital Universitario de Salamanca (HUSAL/IBSAL), and IBMCC (USAL-CSIC), Salamanca, Spain
| | | | | | - Elisa Orna-Montero
- Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Badalona, Spain
| | - Vicente Vicente
- Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain
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