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All-trans retinoic acid (ATRA) and isotretinoin (13-cis retinoic acid) are being investigated by Kafrelsheikh University as an inhaled combination therapy for the treatment of severe COVID-19. This small molecule retinoid approach aims to downregulate the expression of Angiotensin-converting enzyme 2 (ACE2) and CD13, which are utilized by SARS-CoV-2 for cellular entry. Furthermore, the therapy is intended to restore exhausted T cell populations, induce mucosal neutralizing antibodies (IgA), and modulate the inflammatory response by reducing cytokines such as IL-6 and affecting bradykinin receptors. The treatment is delivered via aerosol to target the respiratory tract directly, potentially preventing or treating respiratory failure in hospitalized patients.
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