TABLE 3.
Proposed effect of antagonizing thromboxane A2/TP and prostaglandin D2/DP2 signaling by ramatroban in patients with COVID-19.
| COVID-19 | Thromboxane A2/TP | Prostaglandin D2/DP2 |
|---|---|---|
| Endogenous agonists for the receptors | Thromboxane A2, F2-isoprostane, prostaglandin H2 | Prostaglandin D2, 11-dehydro-thomboxane B2 |
| Acute effects of antagonism (minutes-hours) | Hypoxemia ↓, V/Q mismatch ↓, bronchoconstriction ↓, pulmonary edema ↓, | Hyaluronan accumulation ↓, |
| ⇑ | ⇑ | |
| pulmonary microvascular permeability ↓, pulmonary capillary pressure ↓, pulmonary venous constriction ↓, | IL-13 ↓, | |
| NK cell SARS-CoV-2 killing ↑, | antiviral, | |
| ⇑ | ⇑ | |
| TGFβ ↓ | IFN-λ ↑ | |
| Subacute short-term effect of antagonism (days–weeks) | Thrombosis ↓ | Antiviral activity |
| ⇑ | ||
| Anti-inflammatory (thromboinflammation ↓) | Th1 response ↑, Th2 response ↓ | |
| Long-term effect of antagonism (weeks–months) | Brain fog ↓, headache ↓, brain edema ↓, | Depression ↓, activity ↑ |
| ⇑ | ||
| blood–brain barrier ↑, | ||
| lung fibrosis ↓, | ||
| ⇑ | ||
| TGFβ ↓ |