SSRIs: Applications in inflammatory lung disease and implications for COVID-19

Neuropsychopharmacol Rep. 2021 Sep;41(3):325-335. doi: 10.1002/npr2.12194. Epub 2021 Jul 13.

Abstract

Selective serotonin reuptake inhibitors (SSRIs) have anti-inflammatory properties that may have clinical utility in treating severe pulmonary manifestations of COVID-19. SSRIs exert anti-inflammatory effects at three mechanistic levels: (a) inhibition of proinflammatory transcription factor activity, including NF-κB and STAT3; (b) downregulation of lung tissue damage and proinflammatory cell recruitment via inhibition of cytokines, including IL-6, IL-8, TNF-α, and IL-1β; and (c) direct suppression inflammatory cells, including T cells, macrophages, and platelets. These pathways are implicated in the pathogenesis of COVID-19. In this review, we will compare the pathogenesis of lung inflammation in pulmonary diseases including COVID-19, ARDS, and chronic obstructive pulmonary disease (COPD), describe the anti-inflammatory properties of SSRIs, and discuss the applications of SSRIS in treating COVID-19-associated inflammatory lung disease.

Keywords: ARDS; COVID-19; NF-κB; lung inflammation; selective serotonin reuptake inhibitor.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • COVID-19 / complications*
  • Humans
  • Pneumonia / drug therapy*
  • Pneumonia / virology
  • SARS-CoV-2
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*

Substances

  • Anti-Inflammatory Agents
  • Serotonin Uptake Inhibitors