3区 · 医学
ArticleOA
作者: Herrera, Monica ; Akalin, Enver ; Francisco, Edgar B ; Rodrigues, Hallison ; Gupta, Raavi ; Sacha, Jonah B ; Kelly, Scott ; Seethamraju, Harish ; Mahyari, Eisa ; Kazempour, Kazem ; Lalezari, Jay ; Plassmeyer, Matthew ; Wu, Helen L ; O'Halloran, Jane A ; Hall, Eric ; Park, Byung S ; Webb, Gabriela M ; Pise, Amruta ; Lelic, Alina ; Corley, Michael J ; Pourhassan, Nader ; Alpan, Oral ; Kdouh, Lama ; Bimber, Benjamin N ; Sugai, Christopher ; Pang, Alina P S ; Ndhlovu, Lishomwa C ; Patterson, Bruce K ; Mudd, Philip A ; Dhody, Kush
OBJECTIVE:Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now a global pandemic. Emerging results indicate a dysregulated immune response. Given the role of CCR5 in immune cell migration and inflammation, we investigated the impact of CCR5 blockade via the CCR5-specific antibody leronlimab on clinical, immunological, and virological parameters in severe COVID-19 patients.
METHODS:In March 2020, 10 terminally ill, critical COVID-19 patients received two doses of leronlimab via individual emergency use indication. We analyzed changes in clinical presentation, immune cell populations, inflammation, as well as SARS-CoV-2 plasma viremia before and 14 days after treatment.
RESULTS:Over the 14-day study period, six patients survived, two were extubated, and one discharged. We observed complete CCR5 receptor occupancy in all donors by day 7. Compared with the baseline, we observed a concomitant statistically significant reduction in plasma IL-6, restoration of the CD4/CD8 ratio, and resolution of SARS-CoV2 plasma viremia (pVL). Furthermore, the increase in the CD8 percentage was inversely correlated with the reduction in pVL (r = -0.77, p = 0.0013).
CONCLUSIONS:Our study design precludes clinical efficacy inferences but the results implicate CCR5 as a therapeutic target for COVID-19 and they form the basis for ongoing randomized clinical trials.