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Source: Respiratory Infections  May 29, 2020  2 years ago
Respiratory Infections: Study Warns Glucocorticoids Are Harmful In Treating Acute Respiratory Distress Syndrome Conditions Including Those In COVID-19
Respiratory Infections: Study Warns Glucocorticoids Are Harmful In Treating Acute Respiratory Distress Syndrome Conditions Including Those In COVID-19
Source: Respiratory Infections  May 29, 2020  2 years ago
Respiratory Infections: Finnish researchers are warning against the use of glucocorticoids or corticosteroids to treat respiratory infections caused pathogens and more so to treat acute respiratory distress syndrome conditions including in Covid-19.


Their research findings are published in the medical journal: Intensive Care Medicine. https://link.springer.com/article/10.1007/s00134-020-06086-3
 
Unfortunately currently, glucocorticoids are widely used in treating acute respiratory distress syndrome (ARDS) despite there being no indisputable scientific evidence of their effectiveness. The main reason seems to be that there is no effective treatment for ARDS patients on ventilators. The death rate of these patients differs between 30–40 percent depending on the data.
 
Glucocorticoids are part of the feedback mechanism in the immune system, which reduces certain aspects of immune function, such as inflammation. They are therefore used in medicine to treat diseases caused by an overactive immune system, such as allergies, asthma, autoimmune diseases, and sepsis but their effectiveness in treating respiratory conditions caused by pathogens are questionable.
 
Examples of glucocorticoid drugs include: beclomethasone, betamethasone, budesonide, cortisone, dexamethasone, hydrocortisone, methylprednisolone and prednisolone.
 
Acute respiratory distress syndrome or ARDS is often caused by a serious viral or bacterial infection. Type I interferons alpha and beta (IFNs) are signaling proteins produced by the human body and they are needed in fighting off viral infections. For this reason, IFNs have been used successfully in treating ARDS in early-phase clinical trials. However, in a recently published later-phase clinical trial (INTEREST), this effect was no longer observed. The trial was carried out as an international study covering 300 patients at different medical centers.
 
A detailed analysis revealed that most patients who participated in the study had received glucocorticoids in addition to IFN beta, which proved to be exceedingly harmful. The death rate of patients who were treated only with interferons was 10.6 percent, but the addition of glucocorticoids increased the death rate to 39.7 percent.
 
It was found that Glucocorticoids inhibit interferon signaling and increase mortality.
 
Researchers from the MediCity Research Laboratory of the University of Turku, Finland led by Professor Dr Sirpa Jalkanen and Academy Research Fellow Dr Maija Hollmén investigated what caused this abrupt increase in death rates.
 
The study team found in cell and tissue cultures that glucocorticoids inhibit IFN signaling and prevent both the body's own and administered interferon from fighting against the disease.
 
Dr Jalkanen said, "This is probably the most important observation for saving human lives that I have made in my career. After we overcame the immense disappointment caused by the results of the INTEREST trial, we became sure that there had to be an explanation and now we have found it.”
 
The research findings are extremely important especially du ring the current pandemic, as the COVID-19 disease incapacitates the body's IFN production. Many agencies and health authorities have already forbidden the use of glucocorticoids in treating COVID-19 but more healthcare professionals around the world need to be aware of this.
 
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Feb 05, 2020  2 years ago
Source : Thailand Medical news