in: Coronavirus Disease: From Molecular to Clinical Perspectives, Yıldız Dinçer, Editor, NOVA Science Publishers Inc. , New York, pp.283-299, 2021
Coronaviruses are a family of enveloped RNA viruses that cause diseases in various mammals and birds. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus identified as the cause of a global infectious disease called coronavirus disease 2019 (COVID-19). To date, there are currently no specific antiviral drugs that have been shown to effectively treat COVID-19. Moreover, vaccines based on viral-encoded peptides may not be effective against COVID-19, as virus mutations could make them futile. Many therapeutic strategies can be predicted in controlling and preventing the SARS-CoV-2 infections, such as oligonucleotide-based therapy, neutralizing monoclonal antibody therapy, autophagy pathway as therapeutic targets, chimeric antigen receptor T-cell (CAR-T) therapy, and mesenchymal-derived exosome therapy. Synthetic oligonucleotide-based therapeutic options containing small interfering RNA (siRNA) and antisense oligonucleotide (ASO) target the virus itself and mediate the silencing of its genome. Neutralizing monoclonal antibodies that target the receptor-binding motif (RBM) can prevent the virus from binding to angiotensin-converting enzyme 2 (ACE2), and are therefore promising antiviral drugs. On the other hand, vaccines and drugs can be developed to target the spike (S) glycoprotein of the coronavirus.
plays an important role in viral infection. Autophagosomes can induce apoptotic
cell death of virally infected cells and disrupt the virus replication cycle.
CAR-T treatment is a successful therapeutic option for patients with relapsed
and/or refractory hematologic malignancies. Increased interleukin-6 (IL-6) is
related to cytokine storm syndrome (CSS) in COVID-19 patients. CAR-T therapy is
used successfully in the blocking of IL-6. Therefore, IL-6 can be a specific
target for CAR-T therapy in SARS-CoV-2 infected patients. Mesenchymal-derived
exosomes demonstrate anti-inﬂammatory and immunomodulatory effects. MSC-derived
exosomes can modulate the activity of T cells. MSC-derived exosomes may inhibit
pro-inflammatory cytokines and increase the levels of anti-inflammatory
cytokines such as IL-10 in SARS-CoV-2 infection. MSC-derived exosomes have been
considered a specific therapeutic option for COVID-19 patients. Future preclinical
and clinical investigations are needed to understand the critical roles of
these therapy approaches in COVID-19.