Researcher believes DPP4 inhibitors could help treat COVID-19

Clinical trials should be considered to see whether DPP4 inhibitors could help treat COVID-19, a top endocrinologist in America has said. 

Dr Gianluca Iacobellis, from the University of Miami, said that early evidence has shown these drugs, sitagliptin, saxagliptin, linagliptin and alogliptin reduce inflammation and the enzyme’s potential role in a COVID-19 therapeutic regimen certainly deserves further research.

He said: “We potentially have a mechanism for how the virus is getting into the body. And we potentially have a way we can partially inhibit that mechanism. We should consider clinical trials for DPP4 for patients who have mild or moderate COVID-19 with type 2 diabetes.”

Inflammatory responses

DPP4 is found throughout the body, but its activity is only partially understood. The enzyme does play significant roles in inflammatory responses and insulin regulation. DPP4 inhibitors increase insulin and GLP-1 secretion and are commonly prescribed for people suffering from type 2 diabetes.

Building on previous research, conducted on earlier coronaviruses, as well as a recent paper that demonstrates DPP4 interaction with COVID-19, Dr Iacobellis believes the enzyme may play a significant role in these outcomes by interfering with the immune response.

Dr Iacobellis said: “The body is overreacting with this inflammatory response to the virus. This could be partially mediated by DPP4. The virus binds to the enzyme and the enzymatic activity of DPP4 over expresses inflammatory cytokines, exaggerating the inflammatory response. Previous studies, of SARS and MERS, showed that, if you blocked DPP4 activity, there was a reduction in the inflammatory response. This could ameliorate the immune response to the virus.”

Dr Iacobellis notes that clinicians will need more data before embracing DPP4 inhibitors to treat people with COVID-19.

He added: “Starting with diabetes patients, we should be conducting randomised studies to test whether treating those with mild or moderate symptoms improves outcomes. These drugs are well tolerated and may provide therapeutic benefit.”

Picture credit:pina messina