Critically ill Covid-19 patients in Irish hospitals will be involved in a trial to see if severe inflammation can be reduced using a naturally produced human protein.
Scientists at the Royal College of Surgeons in Ireland have recruited 36 patients in hospitals in Dublin and Galway. They have already recruited patients in Beaumont Hospital, Dublin, for the trial of alpha-1-antitrypsin, a naturally occurring human protein.
Normally, alpha-1-antitrypsin is produced by the liver and released into the bloodstream to protect the lungs from the destructive actions of common diseases.
Researchers at RCSI University of Medicine and Health Sciences will lead a larger study if they can show that using alpha-1-antitrypsin reduces damaging inflammation caused by Covid-19.
In a paper published in the American Journal of Respiratory and Critical Care Medicine, RCSI professors Gerry McElvaney and Ger Curley, describe how the normal inflammatory response changes in patients infected with Covid-19, particularly those admitted to intensive care.
Prof McElvaney said over 500 patients with Covid-19 had been admitted to Beaumont and nearly 50 needed to be admitted to intensive care.
He said the current management of severe Covid-19 patients remains supportive, focusing on supplemental oxygen and ventilator support in the event of acute respiratory failure.
Prof McElvaney said the inflammatory characteristics of patients with Covid-19 is not fully understood yet but could open the door to several potential therapies including antiviral medications and targeted immune-modulators such as alpha-1-antitrypsin.
He said they found that the difference between patients with stable disease and those with a severe form is not the degree of increase in inflammatory proteins but rather the relative decrease in levels of an anti-inflammatory protein, indicating that the patient's anti-inflammatory mechanisms were failing.
“This finding suggests to us that a therapy which augments the body's own inflammation resolving mechanism might have a positive impact."