Unexpected better outcome in a liver transplant recipient with COVID-19: a beneficial effect of tacrolimus?
Autor: | García-Juárez I; Departamento de Gastroenterología y Hepatología, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México., Campos-Murguía A; Departamento de Gastroenterología y Hepatología, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México., Tovar-Méndez VH; Departamento de Medicina Interna, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México., Gabutti A; Departamento de Radiología, Sección de Radiología Intervencionista, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México., Ruiz I; Instituto Mondor de Investigaciones Biomédicas (IMRB), Hospital Henri Mondor, Universidad de París, Créteil, Francia; Departamento de Hepatología y Trasplante de Hígado, Centro Hospitalario de la Universidad de Montreal, Montreal, Canadá. Electronic address: isaac.ruiz@me.com. |
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Jazyk: | English; Spanish; Castilian |
Zdroj: | Revista de gastroenterologia de Mexico (English) [Rev Gastroenterol Mex (Engl Ed)] 2020 Oct - Dec; Vol. 85 (4), pp. 437-442. Date of Electronic Publication: 2020 Sep 16. |
DOI: | 10.1016/j.rgmx.2020.08.001 |
Abstrakt: | Coronavirus disease 2019 (COVID-19) is a serious respiratory illness caused by SARS-CoV-2. There is controversy about whether their immunosuppressive status is a risk factor or a protective factor for developing severe disease. We report herein the clinical outcome of three family members that had COVID-19 infection, presenting with and without different risk factors that have been described in more severe disease. Paradoxically, the patient with more risks of developing a severe disease, a 64-year-old woman, 2-years liver transplant recipient under treatment with tacrolimus, presented a similar outcome compared to the two other members of the family. She showed shorter hospitalization time, similar clinical outcome with fewer oxygen needs. The present clinical observation raises the question about the possible beneficial effect of tacrolimus in patients with COVID-19. Indeed, tacrolimus (FK-506) have an inhibitory effect on human coronaviruses by: 1) an antiviral effect by binding to the FK-506-binding proteins (FKBP) with a subsequent inhibition of their peptidyl-prolyl cis/trans isomerase (PPIase) activity, which seems to be important for the coronavirus life cycle; and 2) regulating the immune response by the inhibition of the activity of the nuclear factor of activated T-cells (NFAT) required for immunosuppression. The present observation states that liver recipients' patients with COVID-19 may not have worse outcomes when compared with other patients that have COVID-19 risk factors and puts in evidence the two mechanisms related to tacrolimus. (Copyright © 2020 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.) |
Databáze: | MEDLINE |
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