eISSN: 1731-2531
ISSN: 1642-5758
Anaesthesiology Intensive Therapy
Current issue Archive Manuscripts accepted About the journal Editorial board Journal's reviewers Abstracting and indexing Subscription Contact Instructions for authors Ethical standards and procedures
SCImago Journal & Country Rank

 
1/2020
vol. 52
 
Share:
Share:
more
 
 
abstract:
Letter to the Editor

A possible antiviral effect of amantadine in an AH1N1 influenza-infected patient – a case report

Piotr Palaczyński
,
Magdalena Garus
,
Magdalena Śliwczyńska
,
Hanna Misiołek

Anaesthesiol Intensive Ther 2020; 52, 1: 67–69
Online publish date: 2020/02/21
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Dear Editor,
Acute respiratory infections caused by various viral strains are among the most frequent illnesses across the world [1]. Annual epidemics caused by influenza A viruses are one of the leading factors of morbidity and mortality. Therefore both prophylaxis and antiviral pharmacological treatment are the focal point of many past and ongoing studies.
Amantadine is a tricyclic water soluble amine, a derivative of adamantine. It was the first identified inhibitor of influenza virus that acts by blocking the virus M2 protein ion channel and inhibiting the early stages of virus replication [2]. Historically amantadine played a major role in antiviral treatment and prophylaxis, nowadays reduced due to the emergence of amantadine-resistant influenza strains [3]. The main mechanisms of resistance are based on mutations in the M2 protein that leads to the loss of the possibility of binding or action. Amino acid substitutions in the M2 protein prevent binding to the ion channel or modify its structure to allow it to operate in the presence of an active drug [4]. Most mutations responsible for the drug resistance do not cause deterioration of replicative functions and virulence [5].
In most cases influenza virus infection manifests as an upper airway inflammation, occasionally leading to bronchial hyper-reactivity, distal airway obstruction, impaired diffusion capacity, and severe alveolar inflammation that may cause respiratory failure. Currently treatment of severe influenza disease focuses on prompt antiviral therapy with neuraminidase inhibitors such as oseltamivir or zanamivir due to the fact that most circulating strains are susceptible to these agents. Possible therapeutic interventions also include immunomodulation and extracorporeal membrane oxygenation [6].
Beside its use as an antiviral agent, amantadine is a potent, multipurpose drug used in many clinical settings. Currently the main indications for the use of amantadine are Parkinson’s disease, both in monotherapy and combined with other drugs [7], traumatic brain injury [8], autistic spectrum disorders, attention deficits, hyperactivity disorders, drug-induced extrapyramidal side effects and motor fluctuations during L-DOPA treatment. Current research assesses its use as an antidepressant [9] and antiepileptic drug [10]. Neurological effects are mainly attributed to the impact on the dopaminergic system through enhancement of dopamine release and inhibition of its...


View full text...
Quick links
© 2020 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe