Table 1.
List of potential anti-inflammatory drugs against Cytokine storm of COVID-19
| Name of drug | Target regions | Mechanism of action | Diseases are previously known for | Side effects | References |
|---|---|---|---|---|---|
| Fedratinib | JAK2 | Reduces cytokine load by inhibiting JAK2 required for TH17 cell differentiation | Primary and secondary Myelofibrosis | It can inhibit INF-γ required for curbing the virus activity | [25] |
| Tocilizumab (TCZ) | IL-6 | A recombinant monoclonal antibody designed to block both membrane-bound and soluble IL-6 receptors and their associated signaling pathways | Rheumatoid diseases and immunotherapy in cancer patients | No toxicity is reported with its use | [46–48] |
| Emapalumab | INF-γ | IgG1 human monoclonal antibody has a high affinity towards INF-γ receptors and thus blocks it signaling | Multiple organ failure caused by hyper inflammation | Susceptibility to infection | [49, 50] |
| Plerixafor | Antagonist of CXCR4 | Attenuation of TH17 cells and reduction of inflammatory cells into the airway prevents acute lung injuries | Stem cell transplantation | No adverse effects have been reported so far | [51, 52] |
| Mycophenolate | IL-6, TNF-α, and IL-1β | Inhibits the mRNA expression of various pro-inflammatory cytokines such as IL-6, TNF-α, and IL-1β | An immunosuppressive agent was used during a kidney transplant | Diarrhea, urinary infections, and leukopenia | [53–56] |
| Anakinra | The antagonist of IL-1 receptor | Blocks the receptors of IL-1β and IL-1α and further the signaling cascade for the cytokine storm production | Rheumatoid arthritis (RA) | It may cause infection at the site of injection | [57–59] |
| VR23 | Proteasome inhibitor | Reduces IL-6 levels, secretion of TNF-α, tissue inflammation, and neutrophil migration improving the acute lung injury induced by LPS | Rheumatoid arthritis (RA) | Peripheral neuropathy | [60] |
| CYM-5442 and RP-002 | Sphingosine-1-Phosphate (S1p) receptor agonist | Reduces the cytokine production and inhibits the infiltration of innate immune cells. The cytokines that are inhibited involved IL-1α, IL-1β, IL-6, IL-10, MCP-1, TNF-α, and GM-CSF | Influenza and other Coronavirus infections | No toxicity is associated with its use | [61–64] |
| Infliximab and Etanercept | TNF-α | Infliximab is a monoclonal antibody that targets TNF-α and Etanercept is a protein that fuses with the TNF-α receptor causing its inactivation | Rheumatoid arthritis and other immune disorders | The risk of infections is associated with its use | [65–69] |
IL interleukin, TNF tumor necrosis factor, MCP monocyte chemoattractant protein, IFNγ interferon, GM-CSF granulocyte–macrophage colony-stimulating factor, TH17 T helper cells, JAK janus kinase, S1p sphingosine-1-phosphate, LPS lipopolysaccharide, CXCR4 C-X-C-chemokine receptor type 4, TCZ tocilizumab, RA Rheumatoid arthritis
References as cited within the text