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Repurposing low-dose naltrexone (LDN) for the prevention and treatment of immunothrombosis in COVID-19.

Title
Repurposing low-dose naltrexone (LDN) for the prevention and treatment of immunothrombosis in COVID-19.
Publication Type
Journal Article
Research Type
Human
Reported as
Review
Date
February 18, 2022
Authors
B Pitt, AM Tate, D Gluck, RS Rosenson, SN Goonewardena
Institution
University of Michigan; Weill Cornell School of Medicine; Icahn School of Medicine at Mount Sinai
Link
Abstract

Coronavirus disease 2019 (COVID-19) is characterized by striking dysregulation of the immune system, with evidence of hyperinflammation, an impaired induction of interferons, and delayed adaptive immune responses. In addition to dysfunctional immune responses, thrombosis is a hallmark of severe COVID-19. Because traditional anticoagulation strategies are associated with increased bleeding, novel strategies that address both the immune and thrombotic dysfunction associated with COVID-19 would be of tremendous benefit. In this commentary, we discuss the unique properties of low dose naltrexone (LDN) which could be leveraged to reduce the immune-mediated thrombotic complications in COVID-19. Mechanistically, LDN can blunt innate immune responses and Toll-like receptor (TLR) signaling, reducing interleukin1 (IL-1), tumor necrosis factor-alpha (TNF-α), and interferon (IFN) levels. Because of the immune-mediated thrombotic mechanisms that underlie COVID-19, we hypothesize that the immune-modulating and known pharmacologic properties of LDN could be leveraged as a novel therapeutic strategy in COVID-19.

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