Researchers at RCSI University of Medicine and Health Sciences in Ireland have started a clinical trial to assess alpha-1-antitrypsin as a potential treatment for critically ill Covid-19 patients.

The trial will involve patients who are mechanically ventilated in intensive care with Covid-19-related acute respiratory distress syndrome.

Alpha-1-antitrypsin is a natural human protein generated by the liver. It is released into the bloodstream and acts to protect the lungs from damage due to common illnesses.

RCSI medicine professor Gerry McElvaney said: “The current management of severe Covid-19 remains supportive, focusing on supplemental oxygen and ventilator support in the event of acute respiratory failure.

“A greater understanding of how the body’s inflammatory mechanisms are impacted upon by Covid-19 could open the door to several potential therapies, including antiviral medications and targeted immune-modulators such as alpha-1-antitrypsin.”

A study conducted by university researchers found an increase in multiple highly inflamed proteins in infected patients compared to healthy controls. A difference was also observed in the profiles of patients in ICU and patients who were stable.

The note-worthy differentiating factor between these patients was said to be the relative reduction in anti-inflammatory protein levels, which is said to be an indication of failing anti-inflammatory mechanisms.

According to the researchers, alpha-1 protects the airway from damage in case of acute pulmonary infection and is a potent anti-inflammatory that protects the immune system.

In Covid-19, the therapeutic candidate was able to regulate the production and activity of various important pro-inflammatory proteins.

RCSI Anaesthesia and Critical Care professor Ger Curley said: “This finding suggests to us that a therapy which augments the body’s own inflammation resolving mechanisms might have a positive impact.

“We are confident that this clinical trial will demonstrate the potential for Alpha-1 to improve the outcomes for patients with the most severe Covid-19 induced respiratory difficulties.”

This is said to be the first Investigational Medicine Product trial approved in Ireland to assess a therapy for Covid-19.