Expert comments: Pidotimod,an immunomodulator in management of COVID-19 patients
M3 India newsdesk May 26, 2020
Dr. Pradyut Waghray, an expert Pulmonologist explains the role of Pidotimod, an immunostimulant, immunomodulator and immunoactivator which plays a significant role in the treatment of early COVID-19 by promoting the immune function of the body as specified in recent studies.
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Children and elderly are more vulnerable to infections, because the immune system is immature in children and the immunity falls with ageing. It is the innate immune system which is also called as the in-born immune system. The Lung Innate System comprises of-
- Airway epithelial barrier
- Alveolar macrophages
- Dendritic cells
- Natural killer cells
Innate immunity changes associated with infection
- Epithelium- Junctional barrier integrity, ciliated cell integrity and function, and antimicrobial factor expression are all reduced and impaired
- Macrophage- Number, phagocytic capacity and antimicrobial factor expression are all reduced and impaired
- Dendritic cell- Number, maturation and capacity to activate T-cells are all reduced and impaired
- Neutrophial- Number, chemotaxis and antibacterial potential are all reduced and impaired
- NK cells- Number and activity are reduced and impaired
Killer T cells produce clones of T cells
Killer T cells destroy virus-infected cells. Helper T cells boost immune response by activating killer T cells and stimulating antibody production by B cells. Memory T cells persists in blood stream to protect against future infections. Suppressor T cells protect healthy cells. This decreased immune function results in-
- Increased susceptibility to infections
- Delayed recovery from infections and
- Increase in frequency and recurrence of infection
Pidotimod in COVID-19
The novel coronavirus can cause a severe respiratory Illness, like SARS and MERS and human-to-human transmission is confirmed.
Pidotimod is a synthetic, oral, non-specific immunostimulant which stimulates various components of the immune system, including regulating the cell- mediated immune response. Pharmacokinetic study showed that the drug was absorbed rapidly by oral administration. The bio-availability of human oral administration was 45% and the half-life was 4 hours.
Studies have shown that the drug can stimulate non-specific natural immunity by improving ciliary function, increasing dendritic cell maturity, increasing the activity of Natural Killer (NK) cells, increasing phagocytosis and chemotaxis, improving the Th1/Th2 balance, upregulating TLR-2 and significantly improving the level of IgG and IgA in the body. It can also regulate the function of T- lymphocytes and B-lymphocytes, regulate the generation of antibodies, increase the chemotaxis, phagocytosis and killing of macrophages, enhance the immune function of the body, and achieve the purpose of treating respiratory tract infection.
Pidotimod acts as an immunostimulant, immunomodulator and immunoactivator
Animal and clinical trials have shown that although Pidotimod has no direct anti-bacterial and anti-viral activity, it can play a significant role in the treatment of bacterial and viral infections by promoting the immune function of the body.
The dose of Pidotimod in adults is 800 mg twice daily for 2 weeks, followed by 800 mg once daily for 45 days, taken 1 hour before breakfast.
In children, the dose is 400 mg twice daily for 2 weeks followed by 400 mg once daily for 45 days. There are no significant side-effects, except mild nausea. It is a relatively safe drug, which is in use for a long time. It is available in oral tablets and syrup.
Pidotimod can be safely given to COVID-19 patients in the early stages of their disease, to prevent progression of the disease with its attendant complications. It has a special role in patients with comorbid conditions and also in the close contacts/primary contact of confirmed COVID-19 patients. This drug may definitely be considered for use in both- close contacts and early initiation in COVID-19 confirmed cases.
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Disclaimer- The views and opinions expressed in this article are those of the author's and do not necessarily reflect the official policy or position of M3 India.
The author Dr. Pradyut Waghray is a professor and HOD of Pulmonary Medicine at a reputed medical college inTelangana.
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