Abstract

The 2019 coronavirus (COVID-19) pandemic is still in progress, and a significant number of patients have presented with severe illness. Recently introduced vaccines, antiviral medicines, and antibody formulations can suppress COVID-19 symptoms and decrease the number of patients exhibiting severe disease. However, complete avoidance of severe COVID-19 has not been achieved, and more importantly, there are insufficient methods to treat it. Adrenomedullin (AM) is an endogenous peptide that maintains vascular tone and endothelial barrier function. The AM plasma level is markedly increased during severe inflammatory disorders, such as sepsis, pneumonia, and COVID-19, and is associated with the severity of inflammation and its prognosis. In this study, exogenous AM administration reduced inflammation and related organ damage in rodent models. The results of this study strongly suggest that AM could be an alternative therapy in severe inflammation disorders, including COVID-19. We have previously developed an AM formulation to treat inflammatory bowel disease and are currently conducting an investigator-initiated phase 2a trial for moderate to severe COVID-19 using the same formulation. This review presents the basal AM information and the most recent translational AM/COVID-19 study.

Highlights

  • The novel coronavirus disease (COVID-19) pandemic is sweeping the globe, and it is impossible to foresee how it might end

  • A significant MR-proADM increase has been reported in patients with COVID-19, especially in severe conditions, such as acute respiratory distress syndrome (ARDS) [26,27,28,29,30,31,32,33,34,35,36]

  • After the COVID-19 pandemic, we started an investigator-initiated clinical trial for Initially, we focused on patients with severe pneumonia who required mechanical ventilation because an alternative resolution is frequently required for this critical condition

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Summary

Introduction

The novel coronavirus disease (COVID-19) pandemic is sweeping the globe, and it is impossible to foresee how it might end. AM administration in mice considerably decreased lung injury and suppressed liver and intestinal tract disorders [25]. AM could organ damage in patients severe caused by treatment for COVID-19. 1 category have pneumonia or dyspnea but do not need oxygen support, while those in Patients classified as having the severe form of the disease receive ventilatory support the moderate 2 category require supplemental oxygen. Major therapeutics in the early and severe form of the disease receive ventilatory support and/or are admitted to the intensive mild phases of COVID-19 are sufficient, but there are limited or only partially effective care unit (ICU).

Biosynthesis of AM acid and Its
Results compared to WT mice
Overview of Therapies for COVID-19
AM and COVID-19
Progress of Clinical Trials Using AM
Phase 2a Clinical Trial for COVID-19
Conclusions
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