Potential Interactions between Increased Cytokines in COVID-19 and Drugs Used to Treat COVID-19
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Date
2021
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Abstract
During COVID-19 infection, virus and host cell interactions lead to the acute production of very strong immunemediators. The clinical status caused by damage throughout the body is mostly due to excessive pro-inflammatorycytokine production from virus-induced macrophages and granulocytes. Under infectious and inflammatoryconditions, clinical and experimental studies have demonstrated that hepatic and extrahepatic cytochrome P450 (CYP)enzymes and carrier proteins responsible for drug metabolism are specifically regulated by many cytokines.Downregulation of these enzymes by cytokines can cause an elevation in plasma drug levels and/or lead to adversedrug reactions and/or toxicity. Based on the knowledge of cytokine-drug interactions occurring in the infection andinflammation stage, the aim of this review was to ascertain the influence of uncontrolled cytokine release on themetabolism of drugs used alone or in combination to treat COVID-19 patients and predict drug-drug interactionscausing adverse effects.