Why the hydroxychloroquine and the antiviral treatments are most commonly used against the coronavirus from a list of 70 drugs in study

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The pandemic coronavirus is becoming more and more aggravated from day to daywhile science seeks alternatives to put a stop to it. With more than a million contagions and already outdated the 61.000 deaths, the disease COVID-19 it has become a nightmare for the thousands of researchers who are looking for a side the best possible treatment with multiple drugs, and on the other side an effective vaccine for those who still have not been infected.

This week, the medicines regulatory authority of the united States (FDA) approved the limited use of emergency of two drugs against malariathat the president of the united States, Donald Trump has promoted, to treat the coronavirus.

The FDA allowed the drug “they are distributed and are prescribed by doctors to patients adolescents and adults hospitalized with COVID-19, in a proper manner”. But several researchers including dr. Anthony Fauci, the leading expert of infectious diseasesthey called on the public to be cautious until clinical trials to validate studies more thorough.

This drug is available from years ago, and relatively inexpensive could be the solution to the pandemic that has in vilo to the humanity.

Around the world, the countries expanded access to the hydroxychloroquine (HCQ) and chloroquine (CQ), two synthetic compounds of quinine, which in turn it comes from the trees of quina and that is used to treat malaria. The HCQ is less toxic of the two and is also used as an anti-inflammatory to treat conditions such as rheumatoid arthritis and lupus.

There are over 70 substances found in analysis due to its potential anti-SARS-CoV-2, and among them, which aroused great expectations, following some preliminary studies, it was the combination of the hydroxychloroquine together the antiviral lopinavir/ritonavir. Hydroxychloroquine is an active ingredient in anti-malarial drug, also used in autoimmune pathologies such as rheumatoid arthritis and lupus.

According to the doctor master’s degree in Nutrition Milton Dan, “hydroxychloroquine is a drug of prescription is not free from contraindications and adverse effects, although they tend to be well-tolerated, in no way can be automedicada”.

Finally, the united States freed the use of hydroxychloroquine, the “out of label” (prescription out-of-indication) to be used in patients with COVID-19.

Two days ago, a study pointed out that zinc in combination with the drugs mentioned, could serve against the COVID-19 What is the role of zinc and the basis of the combination?

Regarding the use of zinc as part of treatment, Dan clarified that “various studies showed the capacity of the zinc as an inhibitor of viral replication, even found jobs as the one developed by the University of Oklahoma, which confirm this effect on the family of coronaviruses”.

The doctor Roger Seheult, professor of the University of California and a specialist in pneumology explained that “in order to achieve the blocking of viral replication in the body, zinc is its great barrier, they cannot access the intracellular level that requires to be able to act on the viral replication. You would need to have a transporter, something that allows you to step, inside the cell”.

“This is where hydroxychloroquine plays its main role, acting as an ionophore, allowing the zinc to the infected cell” according to studies. In addition to this action, hydroxychloroquine, would alter the PH cell, making it even harder for the survival of the virus at the cellular level.

“Hydroxychloroquine differs from chloroquine by the presence of a hydroxyl group at the end of the side chain. It is considered that its activity is similar to that of chloroquine, and its current use is growing, mainly due to its better safety profile. Has pharmacokinetics similar, with quick gastrointestinal absorption and is eliminated by the kidney,” explains the doctor Lautaro de Vedia in a document released days ago on the website of the Argentine society of Infectology.

“Research various have shown that chloroquine exerts antiviral effects through different mechanisms —says De Vedia—. On the one hand, you can change the pH value of the endosomes (…) After entering the cell, chloroquine mediates the increase in pH of the lysosome in vivo, slows the release of transferrin iron ions, reduces the intracellular content of iron ions and interfere with the intracellular replication of the DNA. As a result, has an inhibitory effect significant on the viral infections that invade the cells through the pathway from the endosome, as the virus of Borna disease virus, avian flu, and the virus Zika”.

“Two independent research teams found that the chloroquine has activity anti-SARS-CoV to the cellular level. The results of the University of Leuven in Belgium showed that chloroquine phosphate can inhibit the replication of the virus in the cell line Vero E6 induced by SARS-CoVwith a 50% inhibitory concentration, close to that achieved during the treatment of acute malaria. A study conducted by the CDC of the USA found that chloroquine inhibits the replication of the virus by reducing the glycation terminal of the receptors of the angiotensin-converting enzyme 2 (ACE2) on the surface of Vero E6 cells and interfere with the binding of the receptor of SARS-CoV and ACE2,” says De Vedia.

In fact, the chinese physicians knew of the potential of this drug and tested it on their patients. The results in more than one hundred cases showed that the chloroquine helps to inhibit the exacerbation of pneumonia and shortens the course of the disease. But what is more important is that there were no serious adverse effects in patients.

The positive data that begin to arise

It was in France, where they met the first results of a small study led by dr. Didier Raoult, of the Mediterranean Institute of Infections in Marseille. In the test conducted used the combination of the drug hydroxychloroquine and azithromycin, and reported that in 80 treated patients had positive changes: the eighth day of treatment, 93% had negativizado the virus.

The azithromycin is a broad-spectrum antibiotic, although it does not have action on the virus itself, its action is preventive fundamentally about bacterial infections added that can aggravate the box. These data add to previous reports with positive results, made in China, Korea and Australia.

While in the united States begins with the completion of a large clinical trial on the application of the protocol hydroxychloroquine, zinc and azitroimicina, appeared voices of doctors, as in the case of dr. Danny Pulido, pulmonologist from Baptist Medical Center, which he said he is surprised by the improvements made in patients using the combination.



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