Tradjenta, other DPP-4 inhibitors may help against COVID-19

A University of Miami researcher has suggested that Tradjenta and other DPP-4 inhibitors may help against COVID-19, the sometimes deadly disease caused by the SARS-CoV-2 coronavirus.

Gianluca Iacobellis, M.D., Ph.D. argued in a commentary that the DPP-4 enzyme is a potential target which should be analyzed further regarding its role in COVID-19.

DPP-4 inhibitors on the market include Tradjenta, Januvia and Janumet. Iacobellis urges that these drugs be tested to see if they can lower inflammation in type 2 diabetes patients with COVID-19. Type 2 diabetes patients are disproportionately experiencing severe COVID-19 symptoms.

A 2013 Nature study found that DPP-4 was a functional receptor for the MERS coronavirus’ spike protein. The MERS coronavirus binds to the DPP-4 receptor and interacts with nuclear factors and T cells which are involved with inflammation. SARS-CoV-2 uses its spike protein to infect host cells, just like the MERS coronavirus.

A 2019 JCI Insight study involved developing a mouse model which could be infected by MERS-CoV by expressing human DPP-4.

DPP-4 inhibition apparently doesn’t reduce infection risk or reduce viral load, but DPP-4 inhibitors have been associated with anti-inflammatory effects. Iacobellis says that might be able to help diabetes patients control immune overreactions caused by COVID-19.

DPP-4 “may represent a potential target for preventing and reducing the risk and the progression of the acute respiratory complications that Type 2 diabetes may add to the COVID-19 infection,” Iacobellis said.

“The body is overreacting with this inflammatory response to the virus,” Iacobellis said. “This could be partially mediated by DPP-4. The virus binds to the enzyme and the enzymatic activity of DPP4 overexpresses inflammatory cytokines, exaggerating the inflammatory response.”

A warning was added to Tradjenta’s label by the U.S. Food and Drug Administration in 2016. It warned of DPP-4 inhibitors being associated with bullous pemphigoid cases requiring hospitalization. Bullous pemphigoid is a rare skin condition which involves large, fluid-filled blisters. It must be treated quickly because it can cause infection and sepsis.

Bullous pemphigoid symptoms include:

• Skin that is itchy prior to blister formation

• Large blisters that do not burst easily when they are touched

• The skin around the blisters can be reddish or darker than usual

• Eczema

• A rash resembling hives

• Blisters or small sores in the mouth or other mucous membranes

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Nadrich & Cohen, LLP

Nadrich & Cohen, LLP is a California personal injury law firm with offices in Los Angeles, San Francisco, Modesto, Fresno, Tracy and Palm Desert. The firm has been representing victims of dangerous drugs since 1990 and has recovered over $350,000,000 on behalf of clients in that time.

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