Many patients affected with COVID-19 experience an overdrive in their immune response. Symptoms in critically ill patients such as high fevers, respiratory distress, and lung damage are a result of this overactive immune reaction, also known as a 'cytokine storm.'
Scientists from the John Hopkins University School of Medicine are currently recruiting individuals for a clinical trial involving the use of alpha-blockers, to see if the drug could break off the cycle of hyper inflammation and immune response ramp up before the disease process gets worse.
The scientists are to include COVID-19 positive patients between the ages of 45 to 85 at the Johns Hopkins Hospital. As a pre-requisite, the individuals need to be mildly or moderately-ill, without necessitating the need for a mechanical ventilator or admission to the intensive care unit.
According to Bert Vogelstein, an investigator from Howard Hughes Medical Institute involved in the study, their trial aims to determine whether the drug could treat COVID-19 patients early on when the cytokine storm hasn't kicked in yet.
According to Chetan Bettegowda, a neurosurgeon at Hopkins, in their clinical trial, COVID-19 patients will take gradually increasing doses of an alpha-blocker called prazosin for six days.
The team will then evaluate whether people who received the drug ended up needing a ventilator or had a lower ICU admission rate compared to the norm. Bettegowda says that they will do a follow up for each patient for 60 days. However, initial data from the first patients could be available within weeks to months, he added.
According to Vogelstein, if the drug proves to be safe and effective, it could help numerous people recover safely from home and lessen the burden on hospital resources.
What is a Cytokine Storm?
According to the National Cancer Institute, a cytokine storm is an intense immune reaction in which the body releases too many cytokines into the blood too quickly.
A cytokine plays a vital role in normal immune responses. However, having a large amount of them released in the body all at once can be damaging. A cytokine storm can arise as a result of an autoimmune condition, infection, or other diseases.
COVID-19 patients aren't the only ones who experience this. People with autoimmune diseases and cancer patients receiving immunotherapy do as well. These responses are also sometimes called macrophage activation syndrome or cytokine release syndrome.
How do Alpha Blockers Work?
Alpha-blockers are used to treat a variety of health conditions. It works by blocking the action of certain nerve impulses. According to the Mayo Clinic, prazosin, the drug used in the study, treats people with hypertension or heart failure by relaxing their blood vessels.
Similarly, in patients with benign prostatic hyperplasia, the drug acts by relaxing the muscles around the bladder and prostate gland to allow urine to pass more quickly.
Furthermore, in patients with Raynaud's disease, prazosin relaxes the blood vessels in the hands to allow blood to reach the fingers more easily. The drug also helps to prevent coldness and stiffness.
Back in 2018, Vogelstein's team reported in the journal Nature that alpha-blockers given to mice with bacterial infections lessened cytokine storms and decreased deaths. Furthermore, their study revealed that the drug didn't seem to affect other aspects of the mice's immune response negatively. With the encouraging results of their previous study in mice, the team hopes that the drug proves to be helpful in humans as well.
