FDA approved Ivermectin in management of COVID-19

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Salient Points

This article focuses on the application of Ivermectin, FDA approved for anti-parasite treatment was found  in vitro to inhibits the replication of SARS-CoV-2 and to effect a  ~5000-fold reduction in viral RNA at 48 hours. It is still in a trial stage and no recommendation can be made on its use in CoVID 19 treatment.

Detailed Summary

Ivermectin is a widely available drug due to its inclusion in the WHO model list of essential medicines.

Mechanism of action / Antiviral effect of Ivermectin

  • Inhibitor of Integrase Protein (IN) and the Importin (IMP)
  • Known to inhibit IN nuclear import of host and HIV-1 replication.
  • Inhibits viral proteins including Simian Virus SV40 large tumor antigen – T-ag
  • Inhibits DENV – Dengue Virus Non Structural Protein
  • Limits infection by RNA Viruses such as DENV, West Nile, Venezuelan Equine Encephalitis, Influenza.
  • Similar effects against DNA viruses such PRV – Pseudo-rabies virus
  • Has Broad spectrum activity believed to be due to the reliance by many different RNA viruses on IMPα/β1 during infection.

SARS-CoV-2 is a single stranded positive sense RNA virus – closely related to SARS-CoV. Studies have shown a potential role for IMPα/β1 during infection in signal dependent nucleocytoplasmic shuttling of the SARS-CoV Nucleocapsid protein that may impact host cell division. In addition, the SARS-CoV accessory protein ORF6 has been shown to antagonise the antiviral activity of the STAT1 transcription factor by sequestering IMPα/β1 on the rough ER/Golgi membrane21.

Conclusion

These reports suggested that ivermectin’s nuclear transport inhibitory activity may be effective against SARS-CoV-2.

Reference Link : https://www.sciencedirect.com/science/article/pii/S0166354220302011

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