Evidence map›Paper›PMID 37294003›Full record

ReviewBiochemical Society transactions2023

Alpha-1-antitrypsin antagonizes COVID-19: a review of the epidemiology, molecular mechanisms, and clinical evidence.

Xiyuan Bai, Tony Schountz, Ashley M Buckle, Janet L Talbert, Robert A Sandhaus, Edward D Chan

Open access · hybridAbstract readReview
In one paragraph

Review in Biochemical Society transactions, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
3.9field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 20 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Xiyuan BaiDepartment of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, U.S.A.
Tony SchountzDepartment of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, U.S.A.
Ashley M BuckleDepartment of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.
Janet L TalbertDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, U.S.A.
Robert A SandhausDepartment of Medicine, National Jewish Health, Denver, CO, U.S.A.
Edward D ChanDepartment of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, U.S.A.ORCID 0000-0001-7612-7727
National Jewish Health · USAustralian Regenerative Medicine Institute · AUColorado State University · USVanderbilt University Medical Center · US

Funding

Establishing the Therapeutic Efficacy of Alpha-1-Antitrypsin and Enoxaparin Against COVID-19I01BX005651 · VA · VA EASTERN COLORADO HEALTH CARE SYSTEM · PI EDWARD D CHAN · 2023 to 2026
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BLRD VA I01 BX005651
6 · The paper itself

Abstract

Alpha-1-antitrypsin (AAT), a serine protease inhibitor (serpin), is increasingly recognized to inhibit SARS-CoV-2 infection and counter many of the pathogenic mechanisms of COVID-19. Herein, we reviewed the epidemiologic evidence, the molecular mechanisms, and the clinical evidence that support this paradigm. As background to our discussion, we first examined the basic mechanism of SARS-CoV-2 infection and contend that despite the availability of vaccines and anti-viral agents, COVID-19 remains problematic due to viral evolution. We next underscored that measures to prevent severe COVID-19 currently exists but teeters on a balance and that current treatment for severe COVID-19 remains grossly suboptimal. We then reviewed the epidemiologic and clinical evidence that AAT deficiency increases risk of COVID-19 infection and of more severe disease, and the experimental evidence that AAT inhibits cell surface transmembrane protease 2 (TMPRSS2) - a host serine protease required for SARS-CoV-2 entry into cells - and that this inhibition may be augmented by heparin. We also elaborated on the panoply of other activities of AAT (and heparin) that could mitigate severity of COVID-19. Finally, we evaluated the available clinical evidence for AAT treatment of COVID-19.

Indexed as

alpha 1-Antitrypsin DeficiencyCOVID-19HeparinHumansMolecular EpidemiologySARS-CoV-2Heparinalpha-1-antitrypsinCOVID-19heparinSARS-CoV-2serine proteaseserpin

Identifiers

PMID37294003
PMCPMC10317171
OpenAlexW4379967127

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.