Author : Saadat, Seyed Hassan

Two-Phase Immune Responses of COVID-19 and Therapeutic Approaches

Seyed Hassan Saadat

Canadian Journal of Medicine, 2020, Volume 2, Issue 1, Pages 0-0
DOI: 10.33844/cjm.2020.60492

The novel coronavirus disease 2019 spread rapidly worldwide and disease was announced a pandemic by the WHO. Standard therapeutic strategy against COVID-19 is lacking. Regarding to the two-phase pathogenesis of the COVID-19 (immune defense-based protective and postinitial inflammation-driven damaging phases, different therapeutic regimens including antiviral agents (e.g., lopinavir/ritonavir, remdesivir, ribavirin, oseltamivir, and sofosbuvir, etc.), some antibiotics and immunomodulatory (chloroquine/hydroxychloroquine) and anti inflammatory agents (corticosteroids) have been considered in hospitals for COVID-19 patients, but balancing their
benefits and potential risk is of great importance [1-7].
Immune-boosting strategies (e.g., anti-sera or pegylated IFNα) and antiviral therapy may be of great importance in the initial phase or non-severe stages, while immunosuppressive or immunomodulatory approaches can be used for halting tissue damage and managing the symptoms in the inflammatory phase. There are conflicting results in prescribing corticosteroids or immunomodulation for COVID-19 patients due to paradoxical negative effects (risk of death, secondary bacterial infections and longer hospitalization) [8-9]. Activation of coagulation pathways
is also associated with increased proinflammatory cytokines, resulting in multiorgan injury. Severe COVID‐19 had disseminated intravascular coagulation, leading to the risk of venous thromboembolism [10], where naproxen (for antiplatelet and anti-inflammatory and anticoagulative effects) and low molecular weight heparin (LMWH; anti-inflammatory properties) may be considered for patients. It has been suggested that LMWH is contemplated because of concerns because of the presence of thrombi in the pulmonary circulation for those in patients with
raised d-dimer.
However, effective therapeutic approach requires balancing harmful and beneficial effects of regimens, to be prescribed by precision. Also, two-phase pathophysiology and immune responses of COVID-19 should not be underemphasized for treatment of patients.

Necessity of Evaluation of Non-coding RNAs in Clinical Trial for Target Therapy

Seyed Hassan Saadat

Canadian Journal of Medicine, 2019, Volume 1, Issue 1, Pages 0-0
DOI: 10.33844/cjm.2019.60486

Genomic and proteomic approaches have improved the understanding of the mechanisms
involved in cancer. Genomic mutations in cancer indicate that many mutations or altered copy
numbers in cancer often occur in non-coding regions of the DNA including microRNAs
(miRNAs), long noncoding RNAs (lncRNAs), small interfering RNAs (siRNAs), and antisense
RNAs (Li et al, 2017; Yoon & Rossi, 2018; Yu, Jian, Allan, & Tu, 2019).
Noncoding RNAs, including lncRNAs and miRNAs, are potential therapeutic targets because they
have the potential to be applied in the diagnosis and prognosis of a number of cancers. Furthermore,
their regulations are implicated in development and progression of many kinds of malignancies e.g.,
proliferation, invasion, metastasis, angiogenesis and drug resistance, thus suggesting its potential in
targeted therapy (Smolle, Calin, Pichler, & Calin, 2017; Vo et al., 2019; Zhang & Xin, 2018).
Therefore, RNA profiling using bioinformatics tools and the development of databases can be helpful
in development of targeted research in this regard, where in-depth understanding of their multiple
mechanisms will be helpful in clarifying their substantial role in regulation of many genes involved
in cancer. For instance, anti-miRNA oligonucleotides (AMO) are considered to be capable of
suppressing the function of oncomirs, leading to inhibition of tumor growth. Clinical trials and
increased success rates in noncoding RNAs therapy are considered to be an opportunity for cancer