Commonly prescribed BP medication called alpha blockers might prevent ‘cytokine storm’ in critically ill COVID-19 patients
A hyperactive immune system or ‘Cytokine storm’ is the reason for persistent high fevers, severe respiratory distress, and lung damage seen in some critically ill COVID-19 patients.
Investigator Bert Vogelstein and his team at the Johns Hopkins University School of Medicine are currently recruiting individuals for the trial who have COVID-19 but who aren’t on a ventilator or in the ICU.
Their treatment, a common type of prescription drug called an alpha blocker, might break a cycle of hyperinflammation before it ramps up, their findings from mouse studies and a recent analysis of medical claims data suggest.
A hyperactive immune response isn’t unique to COVID-19. People with autoimmune diseases and cancer patients receiving immunotherapy can experience similar symptoms. These responses are referred to as macrophage activation syndrome, cytokine release syndrome or simply “cytokine storms.”
drugs called alpha blockers, which are widely prescribed for prostate conditions and high blood pressure may interfere with the release of catecholamines that trigger cytokine storms
When macrophages and other kinds of immune cells detect virus particles, they send out alert messages by releasing various proteins known as cytokines. Those cytokines recruit other immune cells and an inflammatory response occurs – that, in moderation, helps the body fight off a virus. But macrophages can also release other signaling molecules, called catecholamines, that amplify this response further, triggering the release of more cytokines. “It seems that once this process starts, there’s this inability to properly switch it off,” said Maximilian Konig, a rheumatologist at Hopkins who is helping to coordinate the trial.
The researchers found that drugs called alpha blockers, which are widely prescribed for prostate conditions and high blood pressure may interfere with the release of catecholamines that trigger cytokine storms.
In a previous study published in the journal Nature in 2018, Vogelstein’s team had reported that giving mice with bacterial infections an alpha blocker lessened cytokine storms and decreased deaths. The treatment didn’t seem to harm other aspects of the immune response.
As the number of critically ill COVID-19 patients presenting with cytokine storm symptoms have increased in recent weeks, the idea of testing alpha blockers in humans was discussed by Vogelstein’s team in the Journal of Clinical Investigation.
This treatment, if it works, would be a secondary form of prevention, Vogelstein said, mitigating symptoms before they become severe, rather than stopping infection in the first place.
