Can bilirubin nanomedicine become a hope for the management of COVID-19?. (April 2021)

• Record Type: Journal Article
• Authors: Khurana, Isha; Allawadhi, Prince; Khurana, Amit; Srivastava, Amit Kumar; Navik, Umashanker; Banothu, Anil Kumar; Bharani, Kala Kumar
• Is Part Of: Medical hypotheses. Volume 149(2021)
• Publication Date: 2021-04
• Subjects: COVID-19 -- Bilirubin -- Biliverdin -- Nanomedicine -- Anti-inflammatory -- Antioxidant; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Medicine; Periodicals; 610
• DOI: 10.1016/j.mehy.2021.110534
• Languages: English
• ISSNs: 0306-9877

Abstract

Highlights: Bilirubin nanomedicine (BNM) possesses promising anti-inflammatory activity. Moderately higher levels of bilirubin is positively associated with reduced risk of chronic diseases. Bilirubin reduces M1 macrophage polarization, reduces proinflammatory cytokines and improves gut barrier integrity. BNMs may reduce the complications of SARS-CoV-2 infection by suppression of cytokines, MAPKs and NFκB signaling. BNM may be delivered in various dosage forms for COVID-19 therapy based on patient need. Abstract: Bilirubin has been proven to possess significant anti-inflammatory, antioxidant and antiviral activities. Recently, it has been postulated as a metabolic hormone. Further, moderately higher levels of bilirubin are positively associated with reduced risk of cardiovascular diseases, diabetes, metabolic syndrome and obesity. However, due to poor solubility the therapeutic delivery of bilirubin remains a challenge. Nanotechnology offers unique advantages which may be exploited for improved delivery of bilirubin to the target organ with reduced risk of systemic toxicity. Herein, we postulate the use of intravenous administration or inhalational delivery of bilirubin nanomedicine (BNM) to combat systemic dysfunctions associated with COVID-19, owing to the remarkable preclinical efficacy and optimistic results of various clinical studies of bilirubin in non-communicable disorders. BNM may be used to harness the proven preclinical pharmacological efficacy of bilirubin against COVID-19 related systemic complications.