rhDNAz (Dornase alfa) Nedir, COVID-19 Tedavisinde Yeri Var mıdır?

Nötrofil lökositler (NL) vücutta hastalık yapan mikroorganizmalarla savaşın en ön cephesindeki hücrelerdir ve hemen yanıt verirler. COVID-19 olgularında da NL’lerin hızla yanıt vermesi olumlu, iyileştirici bir faktördür; fakat bu yanıtın istenmeyen aşırı bir noktaya gelmesinin akciğer hasarını artırdığı ve ölüme giden yolu tetiklediği düşünülmektedir. ‘Sitokin fırtınası’ kavramı bu abartılı yanıtın genel adıdır ve birçok hücresel ve biyokimyasal yanıtın ilişkilerinin sonucudur. Akciğerde “neutrophil extracellular traps” (NETs) oluşumu COVID-19 enfeksiyonunun ARDS’ye ve solunum yetmezliğine ilerlemesinin belirleyici sürecidir. rhDNAz (Dornase alfa) burada lökositlerden açığa çıkan DNA’ları parçalayarak süreci geriye çevirebilmektedir. Pahalılığı ve orta şiddetteki hastalarda uygulanamaması şu an çekinceleri oluştursa da gelecek için ümit veren bir tedavi modalitesi olabilir.

Anahtar Kelimeler:

rhDNAz, Dornaz Alfa, Kovid-19, Tedavi

rhDNAse (Dornase alfa) and Its Role in the Management of COVID-19

Neutrophil leukocytes (NL) are the fastest-reacting cells on the front line struggling against pathogenic microorganisms in the body. Swift response by the NLs in the patients with COVID-19 is useful for the body, although the untoward, inadvertently proceeding in this response is thought to enhance life-threatening pulmonary damage and pave the way to death of the patient. The phenomenon known as ‘cytokine storm’ is a general term describing this unwanted reaction by the body and is the result of complicated intriguing cellular and biochemical processes. So-called “neutrophil extracellular traps” (NETs) trigger progressing to ARDS and respiratory failure in critical cases with COVID-19. rhDNAse (Dornase alfa) is an agent postulated to hydrolyze DNA networks released by the killed NLs and thus reverse the deadly process in the lungs. Its major drawbacks are cost and inability to apply to mild-to-moderate cases in order to prevent deterioration to a critical illness. Nonetheless, it can represent a promising new therapeutic modality in the future.

Keywords:

rhDNAse, COVID-19, Dornase alfa, Treatment,

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