Tülün ÖZTÜRK, Tuğba ÇAVUŞOĞLU, Canet İNCİR, Yeşim TUNÇOK

COVİD-19 da Sitokinler ve COVİD- 19 Tedavisinde Kullanılan İlaçlar Arasında Potansiyel İlaç Etkileşimleri.

COVID-19 infeksiyonu sırasında virus ve konakçı hücrel etkileşimleri, çok güçlü immun mediyatörlerin akut üretilmesine yol açar. Klinik durumdaki bozulma, virüsün indüklediği makrofaj ve granülositlerin ürettiği aşırı proinflammatuar sitokinlere bağlanmaktadır. İndüksiyon ve inflammasyon koşulları altında, klinik ve deneysel çalışmalar, ilaç metabolizmsından sorımlu hepatik ve ekstrahepatik sitokrom P450 enzimleri ve taşıyıcı proteinlerin spesifik olarak pek çok sitokinler tarafından düzenlendiğini göstermektedir. Bu enzimlerin sitokinler tarafından down regülasyonu plazma ilaç düzeylerinde yükselmeye neden olabilir ve/veya istenmeyan ilaç reaksiyonlarına ve/veya toksisiteye yol açabilir. İnflamasyon ve infeksiyon durumunda oluşan sitokin-ilaç etkileşimleri temelinde, bu derlemenin amacı , COVİD 19 hastalarını tedavi etmek için tek başına veya kombinasyonda kullanılan ilaçların metabolizması üzerine, hastalığın seyrinde ortaya çıkan kontrolsüz sitokin salınımının etkisini anlamaktır.

Anahtar Kelimeler:

Sitpkin, İlaç etkileşimleri, sİtokrom P450

Interactions between Cytokines and Drugs in COVID-19 Potential Interactions between Increased Cytokines in COVID-19 and Drugs used to Treat COVID-19

Abstract During COVID-19 infection, virus and host cell interactions lead to the acute production of very strong immune mediators. The clinical status caused by damage throughout the body is mostly due to excessive pro-inflammatory cytokine production from virus-induced macrophages and granulocytes. Under infectious and inflammatory conditions, clinical and experimental studies have demonstrated that hepatic and extrahepatic cytochrome P450 (CYP) enzymes and carrier proteins responsible for drug metabolism are specifically regulated by many cytokines. Downregulation of these enzymes by cytokines can cause an elevation in plasma drug levels and/or lead to adverse drug reactions and/or toxicity. Based on the knowledge of cytokine-drug interactions occurring in the infection and inflammation stage, the aim of this review was to ascertain the influence of uncontrolled cytokine release on the metabolism of drugs used alone or in combination to treat COVID-19 patients and predict drug-drug interactions causing adverse effects.

Keywords:

cytokine, drug interactions, COVİD-19, cytochrome P450,

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