Table 4.
Antineoplastic, antibiotic and antiparasitic drugs for the management of COVID-19 and cytokines they affected.
| Class | Drug | Main Class | Main mechanism of action | Predominant mechanism to management of COVID-19 | Cytokines | Cytokines study type | References |
|---|---|---|---|---|---|---|---|
| Antineoplastic drug | Ibrutinib | Antineoplastic drug | Covalent BTK inhibitors | Prevents both B-cell activation and B-cell-mediated signaling (proposal) |
↓TNF-α ↓IL-6 ↓IL-8 ↓IL-10 |
Clinical In vitro |
[122], [123] |
| Ruxolitinib | Antineoplastic and immunomodulating activities | Janus kinase inhibitors | Janus kinase inhibitors |
↓TNF-α ↓IL-6 |
In vitro | [171], [119] | |
| Antibiotic agent | Azithromycin | Antibiotic agent | Binds to the 50S ribosomal subunit, affecting bacterial protein synthesis |
↓TNF-α ↓IL-6 ↓L-8 ↑IL-10 |
In vitro | [172], [173], [174] | |
| Antiparasitic drugs | Chloroquine | Antimalarial drug | Immunosuppression | Alters the pH in the lysosomes Prevents viral fusion and replication. Spike (S)-protein angiotensin converting enzyme 2 (ACE2) blockers |
↓TNF-α ↓IL-6 ↓IL-18 |
In vivo | [175] |
| Hydroxychloroquine | Antimalarial drug Disease-modifying antirheumatic drugs (DMARDs) |
Immunosuppression | Inhibition of cellular receptor of SARS-CoV (ACE2), membrane fusion of the virus in the host, nucleic acid replication, new virus transport, virus release. |
↓TNF-α ↑IL-4 ↓IL-6 ↑IL-10 ↓IL-18 ↓IFN-γ |
Clinical | [137] | |
| Ivermectin | Antiparasitic agent broad spectrum Anti-viral (in vitro) |
Nuclear transport inhibitory activity | Nuclear transport inhibitory activity |
↓TNF--α ↓IL-1ss ↓IL-4 ↓IL-5 ↓IL-6 ↓IL-13 |
In vitro | [126], [132], [131] | |
| Nitazoxanide (anitta) | Antiprotozoal drug | Potentiates interferon alfa and interferon beta production | Affect viral genome synthesis Prevents viral entry and interferes with N-glycosylation |
↓TNF-α ↓IL-1β (Tizoxanide) ↓IL-6 |
In vivo In vitro |
[176], [177], [178] |
|
| Other | Colchicine | Anti-gout | Microtubule inhibitor (colchicine block microtubule polymerization) |
Non-selective inhibitor of NLRP3 inflammasome Anti-inflammatory action |
↓TNF-α ↓IL-1β ↓IL-6 ↓IL-18 |
Clinical In vitro |
[84], [83], [87], [179] |
BTK: Bruton’s tyrosine kinase; IL: Interleukin; IFNs: Interferons; NLRP3: NOD-, LRR- and pyrin domain-containing protein 3; SARS-CoV-2: Severe Acute Respiratory Syndrome coronavirus 2, Tizoxanide: metabolite of nitazoxanide.