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Repurposing Inhaled Ibuprofenate, a Non Steroidal Anti‐Inflammatory Drug, as a Potential Adjuvant Treatment for Pneumonia, CARDS and its Aetiological Agent SARS‐CoV‐2

Zurita-Lizza et al., Clinical and Translational Discovery, doi:10.1002/ctd2.204
May 2023  
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Review of the potential mechanisms of action and therapeutic effects of inhaled sodium ibuprofenate for the treatment of COVID-19 pneumonia. Authors describe potential anti-inflammatory, immunomodulatory, antiangiogenic, and virucidal effects that may help reverse pulmonary vasoplegia, correct ventilation/perfusion mismatch, and reduce severe hypoxemia and respiratory failure.
Reviews covering ibuprofen for COVID-19 include Day, Moshawih, Zurita-Lizza.
Zurita-Lizza et al., 16 May 2023, peer-reviewed, 3 authors. Contact: zuritachristian70@yahoo.com.ar.
This PaperIbuprofenAll
Repurposing Inhaled Ibuprofenate, a Non Steroidal Anti‐Inflammatory Drug, as a Potential Adjuvant Treatment for Pneumonia, CARDS and its Aetiological Agent SARS‐CoV‐2
Christian Carlos Zurita‐lizza, Ignacio Rodriguez‐sanchez, Pablo Alexis Doreski
Clinical and Translational Discovery, doi:10.1002/ctd2.204
In this manuscript, we will describe and highlight the most important potential underlying mechanisms of action of the inhaled sodium ibuprofenate in hypertonic saline formulation-NaIHS aerosolisable, as a probable adjuvant treatment for moderate and severe pneumonia and coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome in COVID-19. In both pathological entities, we will refer exclusively to the pulmonary vasoplegic type and we will describe the following therapeutic effects of NaIHS: antiinflammatory, immunomodulatory and antiangiogenic. The synergistic action of these therapeutic effects anti-inflammatory and immunomodulatory together may exert their action at the pulmonary level through the possible reversal of pulmonary vasoplegia and may thereby restore hypoxic pulmonary vasoconstriction, correcting the uncoupling of the ventilation/ perfusion ratio and vasoplegic intrapulmonary shunting and, above all, it may reverse severe hypoxaemia and acute respiratory failure. We will also mention the potential virucidal effects of NaIHS on severe acute respiratory syndrome-coronavirus 2.
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{ 'DOI': '10.1002/ctd2.204', 'ISSN': ['2768-0622', '2768-0622'], 'URL': 'http://dx.doi.org/10.1002/ctd2.204', 'abstract': '<jats:title>Abstract</jats:title><jats:p>In this manuscript, we will describe and highlight ' 'the most important potential underlying mechanisms of action of the inhaled sodium ' 'ibuprofenate in hypertonic saline formulation‐NaIHS aerosolisable, as a probable adjuvant ' 'treatment for moderate and severe pneumonia and coronavirus disease 2019 ' '(COVID‐19)‐associated acute respiratory distress syndrome in COVID‐19. In both pathological ' 'entities, we will refer exclusively to the pulmonary vasoplegic type and we will describe the ' 'following therapeutic effects of NaIHS: anti‐inflammatory, immunomodulatory and ' 'antiangiogenic. The synergistic action of these therapeutic effects anti‐inflammatory and ' 'immunomodulatory together may exert their action at the pulmonary level through the possible ' 'reversal of pulmonary vasoplegia and may thereby restore hypoxic pulmonary vasoconstriction, ' 'correcting the uncoupling of the ventilation/perfusion ratio and vasoplegic intrapulmonary ' 'shunting and, above all, it may reverse severe hypoxaemia and acute respiratory failure. We ' 'will also mention the potential virucidal effects of NaIHS on severe acute respiratory ' 'syndrome‐coronavirus 2 (SARS‐CoV‐2).</jats:p><jats:p>There are available three retrospective ' 'observational studies in moderate and severe COVID‐19 pneumonia, carried out in Argentina, ' 'with all three studies concluding that there was a significant reduction in mortality. The ' 'most important of these was conducted with the approval of the Institutional Review Board of ' 'the National Bureau of Economic Research of Harvard and Columbia Universities, which analysed ' 'data from 5146 patients and concluded that NaIHS reduced mortality by 48.7%, although ' 'randomized clinical trials are still needed to confirm these emerging data and enable the ' 'rise of NaIHS as a new adjuvant treatment.</jats:p><jats:p>Conclusively, we deem essential to ' 'reuse known drugs, such as ibuprofen, in COVID‐19, due to the constant emergence of variants ' 'and subvariants of concern secondary to mutations and immune escape mechanisms of ' '(SARS‐CoV‐2), since effective medical treatments are currently scarce and many of them are ' 'controversial or not available worldwide.</jats:p>', 'alternative-id': ['10.1002/ctd2.204'], 'assertion': [ { 'group': {'label': 'Publication History', 'name': 'publication_history'}, 'label': 'Received', 'name': 'received', 'order': 0, 'value': '2023-03-15'}, { 'group': {'label': 'Publication History', 'name': 'publication_history'}, 'label': 'Accepted', 'name': 'accepted', 'order': 1, 'value': '2023-05-06'}, { 'group': {'label': 'Publication History', 'name': 'publication_history'}, 'label': 'Published', 'name': 'published', 'order': 2, 'value': '2023-05-16'}], 'author': [ { 'ORCID': 'http://orcid.org/0000-0001-8969-4261', 'affiliation': [ { 'name': 'Hospital General de Agudos Dr Cosme Argerich, Intensive Care ' 'Unit Buenos Aires Argentina'}], 'authenticated-orcid': False, 'family': 'Zurita‐Lizza', 'given': 'Christian Carlos', 'sequence': 'first'}, { 'affiliation': [{'name': 'Universidad de Buenos Aires (UBA) Buenos Aires Argentina'}], 'family': 'Rodriguez‐Sanchez', 'given': 'Ignacio', 'sequence': 'additional'}, { 'affiliation': [ { 'name': 'Fundación Respirar Clinical Research Unit Buenos Aires ' 'Argentina'}], 'family': 'Doreski', 'given': 'Pablo Alexis', 'sequence': 'additional'}], 'container-title': 'Clinical and Translational Discovery', 'container-title-short': 'Clinical and Translational Dis', 'content-domain': {'crossmark-restriction': True, 'domain': ['onlinelibrary.wiley.com']}, 'created': {'date-parts': [[2023, 5, 17]], 'date-time': '2023-05-17T06:09:39Z', 'timestamp': 1684303779000}, 'deposited': { 'date-parts': [[2024, 1, 20]], 'date-time': '2024-01-20T11:58:17Z', 'timestamp': 1705751897000}, 'indexed': {'date-parts': [[2024, 1, 20]], 'date-time': '2024-01-20T13:08:57Z', 'timestamp': 1705756137914}, 'is-referenced-by-count': 0, 'issue': '3', 'issued': {'date-parts': [[2023, 5, 16]]}, 'journal-issue': {'issue': '3', 'published-print': {'date-parts': [[2023, 6]]}}, 'language': 'en', 'license': [ { 'URL': 'http://creativecommons.org/licenses/by/4.0/', 'content-version': 'vor', 'delay-in-days': 0, 'start': { 'date-parts': [[2023, 5, 16]], 'date-time': '2023-05-16T00:00:00Z', 'timestamp': 1684195200000}}], 'link': [ { 'URL': 'https://onlinelibrary.wiley.com/doi/pdf/10.1002/ctd2.204', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '311', 'original-title': [], 'prefix': '10.1002', 'published': {'date-parts': [[2023, 5, 16]]}, 'published-online': {'date-parts': [[2023, 5, 16]]}, 'published-print': {'date-parts': [[2023, 6]]}, 'publisher': 'Wiley', 'reference': [ {'DOI': '10.1016/j.mehy.110079', 'doi-asserted-by': 'publisher', 'key': 'e_1_2_10_2_1'}, {'DOI': '10.1111/joim.12256', 'doi-asserted-by': 'publisher', 'key': 'e_1_2_10_3_1'}, {'DOI': '10.31488/EJRM.132', 'doi-asserted-by': 'publisher', 'key': 'e_1_2_10_4_1'}, {'DOI': '10.1007/s40121‐021‐00527‐2', 'doi-asserted-by': 'publisher', 'key': 'e_1_2_10_5_1'}, { 'DOI': '10.3386/w30084', 'doi-asserted-by': 'crossref', 'key': 'e_1_2_10_6_1', 'unstructured': 'CalonicoS Di TellaR Lopez del ValleJC Causal inference during a ' 'pandemic: evidence on the effectiveness of nebulized ibuprofen as an ' 'unproven treatment for COVID‐19 in Argentina. 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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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