In , researchers in Belgium found that chloroquine inhibited replication of SARS in cell culture. The following year, however, another team at Utah State University and the Chinese University of Hong Kong evaluated a gamut of compounds against SARS replication in mice infected with the virus, finding that chloroquine was only effective as an anti-inflammatory agent. They recommended that it could be used in combination with compounds that prevent replication.
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In the Cell Research paper, the researchers found that the drug was effective at inhibiting the virus as it was both entering and exiting cells. The second compound, remdesivir, is a nucleoside analog discovered in that inhibits viral polymerase activity, shutting down transcription and synthesis of viral RNA. This gives it antiviral activity against a broad range of retroviruses, including Ebola for which the drugmaker Gilead developed and tested it, unsuccessfully, during the epidemic in the Democratic Republic of the Congo and coronaviruses.
The Wuhan Institute of Virology submitted a patent Jan. In their filing, the institute noted that they did not apply to patent chloroquine phosphate because it has been marketed in China and has an extant supply chain. Lednicky is optimistic about the prospects for treating the new coronavirus with remdesivir and chloroquine.
FDA: Studies Underway to Evaluate Chloroquine for COVID - The Cardiology Advisor
The biggest question regarding chloroquine he said, is at how many days into an infection it can be effectively administered to someone sick with the new coronavirus. But the indication so far, based on this paper and past work with SARS, is that it might be a useful drug. Researchers report a novel mechanism of controlling synthesis of the essential vitamin K2 in the bacterial pathogen that causes tuberculosis. Researchers at the University of Cincinnati College of Medicine have found a way to produce in the laboratory a human protein that plays an important role in metabolizing and clearing excess levels of triglycerides from the bloodstream.
Melioidosis is a bacterial infection that quietly causes thousands of deaths each year.
Meet the doctor who made it his mission to make the world take notice. Does the key to safe, effective pain treatments lie in modified tarantula venom? Editor's note: Do not take any form of chloroquine or hydroxychloroquine without medical supervision.
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By John Arnst. Two additional patients, who did not wish to take corticosteroids, received hydroxychloroquine. All patients who received chloroquine or hydroxychloroquine had thorough eye evaluation, including a slit-lamp examination, at 3-month intervals by an ophthalmologist experienced in managing ocular sarcoidosis. Response to treatment was assessed by history, neurological and ocular examination, measurement of serum and cerebrospinal fluid CSF angiotensin-converting enzyme ACE , computed tomography, magnetic resonance MR imaging, and gallium 67 67 Ga scanning.
Twelve patients, 6 women and 6 men from 20 to 49 years of age, formed the basis of this study. Seven were of African American origin. The diagnosis of sarcoidosis was based on the presence of noncaseating granulomas in the brain in 3 patients, in the lung in 5, in the lymph nodes in 2, in the nasal mucosa in 1, and in the skin in 1 patient. The Kveim-Siltzbach test was positive in the 1 patient in whom it was performed. Cerebrospinal fluid lymphocytosis and increased protein level were seen in 3 patients. Electromyographic changes consistent with axonal neuropathy were seen in 4 patients.
In 2 patients the disease progressed regardless of the type of therapy. One of the patients showed evidence of pigmented epithelial retinal deposits without any involvement of macula or fovea. Two had transient localized retro-orbital pain that subsided after discontinuing the drug. These 2 patients received a thorough examination including slit-lamp evaluation and MR imaging of the brain. No evidence of optic neuritis, papilledema, or retinal damage was observed. The pain did not return after the therapy was resumed.
One patient patient 4 developed bleaching of her hair. In , a year-old man developed numbness of his left foot, pain in the left calf muscles associated with diminishing muscle strength, and difficulty walking. He paid little attention to his symptoms. In , because of nonspecific chest symptoms of tightness and cough, a chest x-ray film was obtained. It showed bilateral hilar adenopathy and pulmonary infiltration. A transbronchial lung biopsy showed noncaseating granulomas. Because he was not sufficiently symptomatic, he did not accept any treatment.
In , a repeated chest x-ray film and computed tomograms disclosed the changes seen in His chest tightness, cough, and symptoms of neuropathy were still present but not severe enough for the patient to accept therapy. In , his condition worsened and he agreed to receive treatment. He was given prednisone, 60 mg daily, with instructions to continue treatment for 6 months. After 2 weeks, the patient developed severe corticosteroid-induced side effects psychosis, insomnia, memory loss, muscle weakness, and weight gain.
He discontinued the drug and did not come for a follow-up visit until At that time, he had been receiving no treatment for more than a year. His ataxia had worsened to the degree that he was nearly totally incapacitated. Neurological examination showed marked distal wasting of muscles, loss of touch and pain sensation over the hands and feet, and impairment of vibration sense distally.
An electromyogram demonstrated severe, diffuse axonal loss, and sensorimotor neuropathy, involving sensory more than motor nerves and lower extremities more than upper extremities. The gradient distribution of abnormal findings in distal rather than proximal muscles was consistent with axonal polyneuropathy rather than mononeuritis multiplex. Magnetic resonance images of the brain, cervical spine, and thoracic spine and total-body gallium study were normal.
He was given chloroquine phosphate, mg twice a day, for 6 months. He also received azathioprine, mg daily, for 3 months. There was no response to either chloroquine or azathioprine. Subsequently, he received methotrexate, 20 mg orally, once a week for 3 months. No benefit occurred, and the patient's condition continued to deteriorate. In January , a year-old woman developed distal weakness involving both arms and the left leg. There was some tingling associated with paresthesias.
These symptoms lasted for about 2 weeks and slowly resolved. Three months later, left facial palsy appeared. Once again, she complained of vague muscle spasms and weakness of her left leg. Parotid glands were not enlarged.
Other notable findings included left upper- and lower-limb weakness, clonus, right lid ptosis, and up-going toes on both sides. A chest x-ray film showed hilar adenopathy and pulmonary infiltrate. Examinations of the CSF originally showed no white blood cells, but progressed to show 16 lymphocytes on the second and fourth taps.
The CSF protein level ranged between 0.
Cultures of the CSF were negative for acid-fast bacilli and fungi. Results of serological studies including VDRL test, antinuclear antibody, anti—smooth muscle antibody, and anti—striated muscle antibody were normal. Magnetic resonance images of the brain and cervical, thoracic, and lumbar spine and bone scans were normal.
Doctors Turn to Malaria Drugs as Potential Coronavirus Treatment
Electroencephalograms showed attenuation of alpha rhythm and occasional theta activity. Somatosensory evoked potentials of the left posterior tibial nerve were normal. Right posterior tibial nerve results were borderline nomal, indicating a possible disturbance at the cortex. A transbronchial lung biopsy specimen showed noncaseating granulomas. An abnormal lung biopsy specimen, elevated ACE level, and CSF abnormality supported the diagnosis of neurosarcoidosis.
She did not tolerate the drug and developed mood swings, acne, and weight gain. Chloroquine phosphate, mg twice a day, was started and continued for 6 months.
When last seen in , the patient was asymptomatic.
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