The Biological function of Aviptadil

Description

Aviptadil is a synthetic Vasoactive Intestinal Peptide (VIP) that has been studied in respiratory disease conditions like asthma, acute lung injury, pulmonary arterial hypertension, sarcoidosis, and idiopathic pulmonary fibrosis and is designated as an 'Orphan Drug' by USFDA and EMA. Recent clinical trials conducted in the USA and India have shown encouraging results in ARDS associated with COVID-19 patients in terms of reduction in mortality rate and hospital stay[1-2].

Biological function

The primary function of Aviptadil is observed in the alveolar sac in the lungs. Additionally, it causes coronary vasodilatation in CVS, thus reducing vaso-spasticity and lowering BP[3]. On the other hand, it exerts ionotropic (increases heart contractions) and chronotropic (increases heart rate) effects due to stimulation of β1 adrenergic receptors. VIP, thus, is likely to play a significant role in the vagal cardiac accelerator system. Immunologically, Aviptadil, in turn, blocks the release of TNFα and IL-6. It causes a reduction in edema, which HCL causes. Aviptadil helps to generate TH2 and CD8+  cells, which are significant components of the destructive immune response team. However, it decreases the activation of CD4+  cells. It promotes the TH2 pathway as well as TREGS. Aviptadil is predominantly considered for application in COVID treatment since it impacts damaged cells in the respiratory system and strengthens the respiratory barrier. Aviptadil is an injectable form of a vasoactive intestinal polypeptide (VIP) in combination with adrenergic phentolamine. It is mainly used in combination (phentolamine and with other drugs) for the treatment of erectile dysfunction. The only drawbacks reported are significant adverse effects like low BP and increased cardiac output.

References

[1] Agam Vora. “Aviptadil: A promising treatment option for acute respiratory distress syndrome.” Indian Journal of Tuberculosis 70 4 (2023): Pages 510-511.

[2] S. Beshay. “Rapid Clinical Recovery from Critical COVID-19 Pneumonia with Vasoactive Intestinal Peptide Treatment.” Journal of Heart and Lung Transplantation 40 1 (2021): S501–S501.

[3] Tuhin Mukherjee. “Anticipated pharmacological role of Aviptadil on COVID-19.” Environmental Science and Pollution Research 29 6 (2021): 8109–8125.