Glucocorticoids are widely used in treating acute respiratory
distress syndrome (ARDS) despite there being no indisputable scientific
evidence of their effectiveness. The main reason seems to be that there
is no effective treatment for ARDS patients on ventilators. The death
rate of these patients differs between 30-40 percent depending on the
data.
ARDS is often caused by a serious viral or bacterial infection. Type I
interferons alpha and beta (IFNs) are signalling proteins produced by
the human body and they are needed in fighting off viral infections. For
this reason, IFNs have been used successfully in treating ARDS in
early-phase clinical trials. However, in a recently published
later-phase clinical trial (INTEREST), this effect was no longer
observed. The trial was carried out as an international study covering
300 patients at different medical centres.
A closer analysis revealed that most patients who participated in the
study had received glucocorticoids in addition to IFN beta, which
proved to be exceedingly harmful. The death rate of patients who were
treated only with interferons was 10.6 percent, but the addition of
glucocorticoids increased the death rate to 39.7 percent.
Glucocorticoids inhibit interferon signalling and increase mortality
At the MediCity Research Laboratory of the University of Turku,
Finland, the research groups of Academician, Professor Sirpa Jalkanen
and Academy Research Fellow Maija Hollmén investigated what caused this
abrupt increase in death rates.
The researchers demonstrated with cell and tissue cultures that
glucocorticoids inhibit IFN signalling and prevent both the body’s own
and administered interferon from fighting against the disease.
“This is probably the most important observation for saving human
lives that I have made in my career. After we overcame the immense
disappointment caused by the results of the INTEREST trial, we became
sure that there had to be an explanation – and now we have found it”,
says Professor Sirpa Jalkanen.
The findings are extremely important especially during the current
pandemic, as the COVID-19 disease incapacitates the body’s IFN
production. WHO has already forbidden the use of glucocorticoids in
treating COVID-19.
https://www.eurekalert.org/pub_releases/2020-05/uot-gah052920.php
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