The potential role of Bromhexine in the management of COVID-19: Decipher and a real game-changer

Hayder M. Al-Kuraishy; Marwa S. Al-Niemi; Nawar R. Hussain; Ali I. Al-Gareeb; Claire Lugnier

doi:10.53517/CMDR.2581-5008.512021212

Hayder M. Al-Kuraishy Department of Clinical Pharmacology, Medicine and Therapeutics, College of Medicine, Al-Mustansiriya University, P.O. Box 14132, Baghdad, Iraq
Marwa S. Al-Niemi Department of Pharmacology, College of Pharmacy, Al-Farahidi University, P.O. Box 14132, Baghdad, Iraq
Nawar R. Hussain Department of Pharmacology, College of Pharmacy, Al-Farahidi University, P.O. Box 14132, Baghdad, Iraq
Ali I. Al-Gareeb Department of Clinical Pharmacology, Medicine and Therapeutics, College of Medicine, Al-Mustansiriya University, P.O. Box 14132, Baghdad, Iraq
Claire Lugnier Unistra, Faculté de Médecine, Institut de Physiologie, EA 3072 “Mitochondrie, stress oxydant et protection musculaire”, 4 Rue Kirschleger, 67085, Strasbourg Cedex, France

DOI: https://doi.org/10.53517/CMDR.2581-5008.512021212

Keywords: Bromhexine COVID-19 Novel coronavirus SARS-CoV-2 TMPRSS2.

Abstract

Primary infection of SARS-CoV-2 (novel coronavirus or 2019-nCoV), which leads to Covid-19, targets specific cells, such as nasal, bronchial epithelial and pneumocytes, through the viral structural spike (S) protein that binds to the angiotensin-converting enzyme 2 (ACE2) receptor. Also, type 2 transmembrane serine protease (TMPRSS2) present in the host cell promotes viral uptake by cleaving ACE2 and triggering the SARS-CoV-2 S protein, which facilitates SARS-CoV-2 entry into host cells. One of the TMPRSS2 inhibitors with a greater distribution capacity into the lung tissue is bromhexine hydrochloride which attenuates the entry and proliferation of SARS-CoV-2. Bromhexine is an effective drug in the management and treatment of Covid-19 pneumonia via targeting ACE2/ TMPRSS2 pathway. However, prospective and controlled clinical trials are recommended to confirm this observation.