Classical Drug Digitoxin Inhibits Influenza Cytokine Storm, With Implications for Covid-19 Therapy

In Vivo. 2020 Nov-Dec;34(6):3723-3730. doi: 10.21873/invivo.12221.

Abstract

Background/aim: Influenza viruses, corona viruses and related pneumotropic viruses cause sickness and death partly by inducing cytokine storm, a hyper-proinflammatory host response by immune cells and cytokines in the host airway. Based on our in vivo experience with digitoxin as an inhibitor of TNFα-driven NFĸB signaling for cytokine expression in prostate cancer in rats and in cystic fibrosis in humans, we hypothesize that this drug will also block a virally-activated cytokine storm. Materials Methods: Digitoxin was administered intraperitoneally to cotton rats, followed by intranasal infection with 107TCID50/100 g of cotton rat with influenza strain A/Wuhan/H3N2/359/95. Daily digitoxin treatment continued until harvest on day 4 of the experiment.

Results: The cardiac glycoside digitoxin significantly and differentially suppressed levels of the cytokines TNFα, GRO/KC, MIP2, MCP1, and IFNγ, in the cotton rat lung in the presence of influenza virus.

Conclusion: Since cytokine storm is a host response, we suggest that digitoxin may have a therapeutic potential not only for influenza and but also for coronavirus infections.

Keywords: COVID-19; GRO/KC; IFNγ; MCP1; MIP-2; RNA-virus; SARS; TNFα; Virus; cardiac glycosides; coronavirus; cytokine storm; digitoxin; digoxin; inflammation; influenza; oleandrin; ouabain.

MeSH terms

  • Animals
  • Betacoronavirus / pathogenicity
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / pathology
  • Coronavirus Infections / virology
  • Cytokines / biosynthesis
  • Cytokines / genetics
  • Digitoxin / pharmacology*
  • Disease Models, Animal
  • Humans
  • Influenza, Human / drug therapy
  • Influenza, Human / metabolism
  • Influenza, Human / virology
  • Lung / pathology
  • Lung / virology*
  • Male
  • NF-kappa B / genetics
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / pathology
  • Pneumonia, Viral / virology
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / virology
  • Rats
  • SARS-CoV-2
  • Tumor Necrosis Factor-alpha / genetics

Substances

  • Cytokines
  • NF-kappa B
  • Tumor Necrosis Factor-alpha
  • Digitoxin