RCSI team to start trial for promising Covid-19 therapy for severe infections

29 Jun 2020

Image: © tilialucida/Stock.adobe.com

RCSI is set to begin clinical trials for a promising drug therapy that could benefit those with severe Covid-19 infections.

Researchers in Ireland are hoping to add to the growing list of drug candidates for the treatment of patients with severe Covid-19 infection. A team from the Royal College of Surgeons in Ireland (RCSI) has published a paper in the American Journal of Respiratory and Critical Care Medicine describing a promising therapy that is now set to undergo a clinical trial.

The randomised double-blind placebo controlled clinical trial will use alpha-1 antitrypsin to treat critically ill Covid-19 patients who are being mechanically ventilated in ICU. Alpha-1 antitrypsin is a naturally occurring human protein produced by the liver and released into the bloodstream, which normally acts to protect the lungs from the destructive actions of common illnesses.

This is the first investigational medicine product trial to be approved in Ireland to test a Covid-19 therapy.

“The current management of severe Covid-19 remains supportive, focusing on supplemental oxygen and ventilator support in the event of acute respiratory failure,” said RSCI’s Prof Gerry McElvaney, who co-led the recent study.

“Despite the implications for global health, the inflammatory characteristics of patients with Covid-19 are not yet fully understood. A greater understanding of how the body’s inflammatory mechanisms are impacted upon by Covid-19 could open the door to several potential therapies including antiviral medications and targeted immune-modulators such as alpha-1 antitrypsin.”

‘A potent anti-inflammatory’

In the study, the researchers found that a number of highly inflamed proteins were increased in infected patients compared to healthy controls. There was also a difference in the profiles of patients in ICU and those who were infected but stable.

According to Prof Ger Curley, the most surprising discovery between stable and severe cases of Covid-19 was not the degree of increase in inflammatory proteins, but rather the relative decrease in levels of an anti-inflammatory protein. This suggested that the patients’ anti-inflammatory mechanisms were failing.

“Alpha-1 protects the airway from damage during acute pulmonary infection. It is also a potent anti-inflammatory and acts to protect the immune system,” Curley said.

“Of particular relevance to Covid-19, it has been shown to modulate the production and activity of several key pro-inflammatory proteins. We are confident that this clinical trial will demonstrate the potential for alpha-1 to improve the outcomes for patients with the most severe Covid-19-induced respiratory difficulties.”

Colm Gorey was a senior journalist with Silicon Republic