Novel treatment for respiratory distress due to SARS-CoV2 infection

治疗 SARS-CoV2 感染引起的呼吸窘迫的新疗法

基本信息

批准号：
10284733
负责人：
Cynthia Ann Derdeyn
金额：
$ 23.46万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-06-11 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10284733
关键词：
2019-nCoV ACE2 Ablation Acute Renal Failure with Renal Papillary Necrosis Adult Respiratory Distress Syndrome Affect Animal Model Animals Anticoagulation Antineoplastic Agents Arteries Attenuated Binding Biological Markers Blood Blood capillaries Blood coagulation COVID-19 COVID-19 patient COVID-19 treatment COVID-19/ARDS Cell Cycle Regulation Cell Nucleus Cell membrane Cells Clinic Clinical Clinical Treatment Clinical Trials Coagulation Process Cytoskeletal Modeling DNA Repair Data Depressed mood Disease Down-Regulation Drug Targeting Edema Endothelial Cells Endothelium Exhibits Extracellular Matrix Extravasation Fibrin fragment D Fibrin split products Focal Adhesions Functional disorder Gelatinase A Genetic Heart failure Hemorrhage Impairment In Vitro Individual Infiltration Inflammation Inflammatory Inflammatory Response Injections Investigation Ischemia Ischemic Stroke Laboratories Leukocytes Lipopolysaccharides Liquid substance LoxP-flanked allele Lung Maintenance Malignant Neoplasms Matrix Metalloproteinases Metabolic Middle Cerebral Artery Occlusion Mitochondria Multiple Organ Failure Mus NADPH Oxidase Organ failure Outcome Pathology Pathway interactions Patients Permeability Pharmacology Polymerase Production Proteins Pseudomonas aeruginosa Reactive Oxygen Species Respiratory distress SARS-CoV-2 infection Stroke Structure of parenchyma of lung TNF gene TNFSF5 gene Tail Testing Thrombosis Thrombus Tissues Toxic effect Translating blood-brain barrier disruption cytokine cytokine release syndrome improved in vivo lung injury monocyte mouse model neutrophil novel preservation prevent receptor recruit response response to injury severe COVID-19 therapeutic target

项目摘要

SUMMARY Clinical sequelae of COVID-19 patients include not only acute respiratory distress syndrome (ARDS), but also often acute kidney injury and heart failure. These pathologies share endothelial activation as a common underlying early response to injury, and endothelial cells express high levels of angiotensin converting enzyme 2 (ACE2), a functional receptor for SARS-CoV-2. Activated endothelium not only attracts and promotes leukocyte infiltration into tissues and contributes to the cytokine storm resulting in capillary leakage and edema, but is also prothrombotic. Together, these mechanisms result in tissue inflammation and ischemia, leading to organ failure. Our laboratory discovered that polymerase delta interacting protein 2 (Poldip2) is a novel and important regulator of inflammation, endothelial permeability and potentially coagulation in mice. Mice heterozygous for Poldip2 are largely protected from lipopolysaccharide (LPS)- or P. aeruginosa-induced ARDS. Here, we hypothesize that Poldip2 may be a novel target for treatment of SARS-CoV-2-infected individuals, as downregulation of Poldip2 not only reduces ARDS complications such as edema and the cytokine storm, but also potentially may inhibit thrombosis. To test this hypothesis, we propose to treat SARS-CoV-2-infected mice with an anti-cancer agent undergoing clinical trials that we have recently shown to reduce Poldip2 levels and restore endothelial barrier function. In the first Aim, we will use this agent to downregulate Poldip2 and test its ability to preserve endothelial barrier function and reduce inflammation in response to SARS-CoV-2 infection in mice. The second aim will focus on determining the effect of the anticancer agent and genetic ablation of Poldip2 on basal coagulation and that induced by SARS-CoV-2 infection. We anticipate that pharmacological downregulation of Poldip2 will represent a promising new treatment for COVID-19 patients that can be rapidly translated to the clinic.

概括 COVID-19患者的临床后遗症不仅包括急性呼吸窘迫综合征（ARDS），还包括经常急性肾脏受伤和心力衰竭。这些病理共享内皮激活是一种常见潜在的对损伤的早期反应，而内皮细胞表达高水平的血管紧张素转化酶 2（ACE2），SARS-COV-2的功能受体。活化的内皮不仅吸引和促进白细胞浸润到组织中，并导致细胞因子风暴，导致毛细管泄漏和水肿，但也是实肢的。这些机制一起导致组织炎症和缺血，导致器官故障。我们的实验室发现，聚合酶三角洲相互作用蛋白2（Poldip2）是一种新颖，小鼠炎症，内皮通透性和潜在凝血的重要调节剂。老鼠 POLDIP2的杂合子在很大程度上受到脂多糖（LPS）或铜绿假单胞菌诱导的ARD的保护。在这里，我们假设Poldip2可能是治疗SARS-COV-2感染者的新目标，因为 POLDIP2的下调不仅减少了弧菌并发症，例如水肿和细胞因子风暴，而且还会减少也可能抑制血栓形成。为了检验该假设，我们建议治疗SARS-COV-2感染的小鼠通过正在进行临床试验的抗癌剂，我们最近证明了降低POLDIP2水平和恢复内皮屏障功能。在第一个目标中，我们将使用该代理下调Poldip2并测试其能够保留内皮屏障功能并减少响应SARS-COV-2感染的炎症老鼠。第二个目标将重点用于确定抗癌药的作用和Poldip2的遗传消融在基底凝结和由SARS-COV-2感染引起的。我们预计药理学 POLDIP2的下调将代表与19例患者的有希望的新治疗方法翻译成诊所。