Abstract
COVID-19 due to the SARS-CoV-2 infection is a multi-systemic immune syndrome affecting mainly the lungs, oropharyngeal region, and other vascular endothelial beds. There are tremendous ongoing efforts for the aim of developing drugs against the COVID-19 syndrome-associated inflammation. However, currently no specific medicine is present for the absolute pharmacological cure of COVID-19 mucositis. The re-purposing/re-positioning of already existing drugs is a very important strategy for the management of ongoing pandemy since the development of a new drug needs decades. Apart from altering angiotensin signaling pathways, novel drug candidates for re-purposing comprise medications shall target COVID-19 pathobiology, including pharmaceutical formulations that antagonize proteinase-activated receptors (PARs), mainly PAR-1. Activation of the PAR-1, mediators and hormones impact on the hemostasis, endothelial activation, alveolar epithelial cells and mucosal inflammatory responses which are the essentials of the COVID-19 pathophysiology. In this context, Ankaferd hemostat (Ankaferd Blood Stopper, ABS) which is an already approved hemostatic agent affecting via vital erythroid aggregation and fibrinogen gamma could be a potential topical remedy for the mucosal management of COVID-19. ABS is a clinically safe and effective topical hemostatic agent of plant origin capable of exerting pleiotropic effects on the endothelial cells, angiogenesis, cell proliferation and vascular dynamics. ABS had been approved as a topically applied hemostatic agent for the management of post-surgical/dental bleedings and healing of infected inflammatory mucosal wounds. The anti-inflammatory and proteinase-activated receptor axis properties of ABS with a considerable amount of oestrogenic hormone presence highlight this unique topical hemostatic drug regarding the clinical re-positioning for COVID-19-associated mucositis. Topical ABS as a biological response modifier may lessen SARS-CoV-2 associated microthrombosis, endothelial dysfunction, oropharyngeal inflammation and mucosal lung damage. Moreover, PAR-1 inhibition ability of ABS might be helpful for reducing the initial virus propagation and mocasal spread of COVID-19.
【저자키워드】 COVID-19, SARS-CoV-2, Oestrogen, Ankaferd hemostat, PAR-1, 【초록키워드】 Inflammation, Anti-inflammatory, Infection, Angiogenesis, drug, immune, Endothelial dysfunction, Hemostasis, pathophysiology, endothelial cells, management, Lungs, bleeding, fibrinogen, hormone, receptor, Oropharyngeal, medication, signaling pathways, mucosal, Inflammatory response, Inflammatory, cell proliferation, Safe, lung damage, endothelial, Activation, Vascular, syndrome, effort, aggregation, drug candidate, pharmacological, topical, effective, mucositis, highlight, virus propagation, spread of COVID-19, initial, clinically, approved, applied, unique, reducing, affecting, alveolar epithelial cell, biological response modifier, pleiotropic effect, Stopper, the SARS-CoV-2, 【제목키워드】 management, mucosal, syndrome, inhibitory effect,