key: cord-0780281-zdzhmn5n authors: Pineda, Benjamin title: Quinacrine, an old drug with potential application as a treatment for novel coronavirus 2019-nCoV/SARSCoV-2 infection date: 2021-06-07 journal: Arch Med Res DOI: 10.1016/j.arcmed.2021.06.002 sha: d8ded2aff939fea0f883741856876e45796afd58 doc_id: 780281 cord_uid: zdzhmn5n nan Among the mechanisms by which Qx induces antiviral effects highlight: a) its ability to intercalate DNA and RNA, thus inhibiting virus replication (8); b) it can increase the pH into the acidic organelles, and c) it can inhibit autophagy (9) . Also, Qx is a potent inhibitor of phospholipase A2, diminishing cysteinyl leukotrienes levels and modulating Th1/Th2 response. Additionally, Qx can inhibit the secretion of proinflammatory cytokines and Toll-Like Receptors 7 and 9, molecules involved in the cytokine storm produced in severe COVID-19 patients (9, 10) . Regarding its potential use in patients, Qx has been daily administrated (100 mg/daily by oral route) for extended periods proven to be well tolerated with few adverse effects even in children (nausea and vomiting). The most frequent and significant adverse effects were dermatitis and corneal edema; however, these effects were reversed when the drug was discontinued (9, 11) . Recently, Qx has been tested in several cancer trials (NCT01839955, NCT00417274, NCT01844076) and prion disease (NCT00183092, NCT00104663). Moreover, it was found that the maximum tolerated dose of Qx was 100 mg twice daily per 21 d in a colorectal cancer study (12) . The vast knowledge about the medical use of Qx and its corroborated efficacy inhibiting virus including SARS-CoV-2 makes Qx a viable candidate to be repurposing and clinical tested in COVID-19 patients of any age range. Considering its pharmacokinetics and set up a record of wellbeing, the safest dose reported, even in children is 100 mg/day for 7 d (13, 14) , which would allow reaching Qx levels in lung tissue above the anti-SARS-CoV-2 EC 50 reported (6) . The author declares that there is no conflict of interest. None. A novel coronavirus outbreak of global health concern Multiple assays in a real-time RT-PCR SARS-CoV-2 panel can mitigate the risk of loss of sensitivity by new genomic variants during the COVID-19 outbreak Could an aminoacridine interfere with the cellular mechanisms involved in the process of human immunodeficiency virus infection? Repurposing Quinacrine against Ebola Virus Infection In vivo Network-based drug repurposing for novel coronavirus 2019-nCoV/SARS-CoV-2 an Antimalarial Drug with Strong Activity Inhibiting SARS-CoV-2 Viral Replication In vitro Identification of SARS-CoV-2 inhibitors using lung and colonic organoids Inhibition of encephalomyocarditis virus and poliovirus replication by quinacrine: implications for the design and discovery of novel antiviral drugs Quinacrine as a potential treatment for COVID-19 virus infection In the eye of the COVID-19 cytokine storm Blood and bone marrow concentration of atabrine and its role in aplastic anemia First-in-Human Phase 1b Trial of Quinacrine Plus Capecitabine in Patients With Refractory Metastatic Colorectal Cancer Beyond DNA binding -a review of the potential mechanisms mediating quinacrine's therapeutic activities in parasitic infections, inflammation, and cancers Furazolidone and quinacrine. Comparative study of therapy for giardiasis in children