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Methotrexate-LDE (MTX-LDE) is an experimental nanomedicine formulation developed by the University of Sao Paulo General Hospital for the treatment of COVID-19. It consists of the small molecule antifolate methotrexate incorporated into cholesterol-rich, non-protein lipid core nanoparticles (LDE) that mimic low-density lipoprotein (LDL) particles. This delivery system is designed to enhance the targeting of methotrexate to inflamed tissues—which often overexpress LDL receptors—thereby potentially increasing efficacy and reducing the systemic toxicity associated with conventional methotrexate. In COVID-19, the drug is hypothesized to exert potent anti-inflammatory effects to counteract cytokine storms and may also modulate the expression of ACE2, the primary entry receptor for SARS-CoV-2.
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