Jun 30, 2020
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Alpha blockers will test for the possibility of preventing a cytokine storm

Johns Hopkins University School of Medicine is preparing a study that will test drugs that target an overactive immune response with COVID-19.

The team will be led by cancer researcher at Howard Hughes Medical Institute, Howard Hughes Medical Institute, Bert Vogelstein. At the moment, they are engaged in the selection of study participants - patients at the Johns Hopkins hospital aged 45 to 85 years old with diagnosed coronavirus, who have not yet reached the intensive care unit and are not connected to the ventilator. Vogelstein intends to test the hypothesis that alpha blockers (or alpha adrenergic blockers) can stop systemic organ inflammation before a cytokine storm sets in, a potentially lethal response of the immune system to infection.

Within six days, participants in the experiment will take gradually increasing doses of prazosin. Scientists will then evaluate how much the number of patients who did not require intensive care has decreased compared to patients receiving standard treatment. Monitoring the status of each participant in the study will be carried out for 60 days, but preliminary results will be available no sooner than after a few weeks.

In the future, the Vogelstein team hopes to conduct a similar experiment involving people with confirmed coronavirus who have not yet been hospitalized. Scientists urged colleagues from other hospitals to join forces and join the trials in order to collect data on a large number of patients as quickly as possible.

“We want to develop an approach to treating patients with a high risk of severe disease in the early stages of COVID-19, that is, before they have serious symptoms. If the efficacy and safety of alpha-blockers is proven in the course of the study, many people will be able to get treatment at home, which will reduce the burden on healthcare, ”says Vogelstein.

Vogelstein noted that a highly active immune response can occur not only with COVID-19, but also with autoimmune and oncological diseases. Before the pandemic, the Vogelstein team was already studying ways to weaken the overactive immune system using alpha-blockers, which are prescribed for diseases of the prostate gland and hypertension, and also affect the transmission of signals by cells that cause the cytokine storm. In 2018, the team published the results of its study in the journal Nature, during which alpha blockers were tested on mice infected with bacterial infections. Scientists have been able to reduce the risk of a cytokine storm and reduce mortality, while not harming other aspects of the immune response.

“If our experiment is successful, treatment with alpha-blockers may become a secondary form of prevention. This is especially important now, as long as there is no vaccine, which will certainly be the main prevention, ”says Vogelstein.

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