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Something already in medicine cabinets around the world could help relieve COVID-19 symptoms in warfighters. Clinical evidence implicates high doses of famotidine—a common, over-the-counter antacid with the trade names Pepcid AC, Fluxid, and Act—could treat COVID-19 disease by attaching to Histamine-2 (H2) receptors on mast cells, blocking histamine release, and helping to subdue the self-amplifying and destructive aftermath seen in severe COVID-19.
Recent studies show that 50% to 80% of people infected with SARS-CoV-2 do not progress to moderate or severe COVID-19 disease.1-3 Although COVID-19 disease requires SARS-CoV-2 infection, there are other factors needed to launch the full onset of disease symptoms. The Defense Threat Reduction Agency’s (DTRA) Chemical and Biological Technologies Department in its role as the Joint Science and Technology Office (JSTO) for Chemical and Biological Defense under the Discovery of Medical Countermeasures Against New and Emerging (DOMANE) threats program made significant progress toward unraveling ways in which famotidine can help treat COVID-19 disease.
How can famotidine, which is normally used to treat gastric reflux, or heartburn, relieve COVID-19 disease symptoms? In addition to regulating stomach acid-producing cells, this H2 receptor is also on mast cells, which are important immune cells that are generally found in the upper and lower respiratory tract, lungs, intestines, under the skin, and near blood and lymph vessels. Mast cells are critical in asthma, allergies, wound healing, immunity, and defense against a large variety of bacteria and viruses.
When histamine activates mast cells, additional histamine is released which binds H2 receptors in the local tissues in response to a relatively small activation signal. However, when released in large quantities or in multiple areas of the body, histamine can make the body react in a way that mirrors many of the severe systems of COVID-19 disease.
A recent publication in the peer-reviewed journal Frontiers in Pharmacology4 documents this multi-institutional research effort and is important as it reveals a candidate supportive treatment option for COVID-19 patients. Famotidine was approved by the U.S. Food and Drug Administration over two decades ago for indigestion. It is globally available and sold at a low cost, making it a COVID-19 treatment candidate that could meet current White House goals to defeat this disease worldwide.5
Famotidine pills may already be in home medicine cabinets around the world. These observations reveal a nuance to the viral disease process that may also occur for other types of infections as well as broader physiological complications such as acute respiratory distress syndrome. The DOMANE team is currently testing famotidine in combination with other widely available drugs in clinical trials to gather additional evidence of its utility in COVID-19 treatment.
1. Wu, D., Wu, T., Liu, Q., and Yang, Z. (2020b). The SARS-CoV-2 outbreak: What we know. Int J Infect Dis 94, 44-48. DOI: 10.1016/j.ijid.2020.03.004
https://www.sciencedirect.com/science/article/pii/S1201971220301235
2. Wu, Z., and McGoogan, J.M. (2020). Characteristics of and Important Lessons From the
Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314
Cases from the Chinese Center for Disease Control and Prevention. JAMA. DOI: 10.1001/jama.2020.2648
https://jamanetwork.com/journals/jama/fullarticle/2762130
3. Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., et al. (2020). A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 382(8), 727-733. DOI: 10.1056/NEJMoa2001017
https://www.nejm.org/doi/full/10.1056/nejmoa2001017
4. Malone et al, Frontiers in Pharmacology “COVID-19: Famotidine, Histamine, Mast Cells, and Mechanisms.” Front Pharmacol. 2021 Mar 23;12:633680. DOI: 10.3389/fphar.2021.633680
https://www.frontiersin.org/articles/10.3389/fphar.2021.633680/full
5. Executive Order on Organizing and Mobilizing the United States Government to Provide a Unified and Effective Response to Combat COVID-19 and to Provide United States Leadership on Global Health and Security, January 20, 2021. (EO 13997)
https://www.govinfo.gov/content/pkg/FR-2021-01-26/pdf/2021-01858.pdf
POC: Revell Phillips, Ph.D., l.r.phillips.civ@mail.mil
| Date Taken: | 07.29.2021 |
| Date Posted: | 07.29.2021 23:09 |
| Story ID: | 402086 |
| Location: | FT. BELVOIR, VIRGINIA, US |
| Web Views: | 7,448 |
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