Hacker News Reader

Comment by nikolay | Hacker News Reader

I am sorry, but isn't the mechanism of action that hydroxychloroquine is simply a zinc ionophore, i.e. you need enough free zinc in the blood for this to work? I read doctors suggesting using hydroxychloroquine along with 50mg of ionic zinc.

View on HN

CQ (and HCQ, etc) have multiple potential mechanisms of action. I don't believe we know how it works in this particular case yet, or if it even works at all. It is indeed a zinc ionophore, [1] and those are known to impair the replication of a number of RNA viruses. [2] However, there are a number of other mechanisms at play here as well. [3]

> Both CQ and HCQ are weak bases that are known to elevate the pH of acidic intracellular organelles, such as endosomes/lysosomes, essential for membrane fusion5. In addition, CQ could inhibit SARS-CoV entry through changing the glycosylation of ACE2 receptor and spike protein6. Time-of-addition experiment confirmed that HCQ effectively inhibited the entry step, as well as the post-entry stages of SARS-CoV-2, which was also found upon CQ treatment (Supplementary Fig. S2).

[1] https://journals.plos.org/plosone/article?id=10.1371/journal...

[2] https://journals.plos.org/plospathogens/article?id=10.1371/j...

[3] https://www.nature.com/articles/s41421-020-0156-0

Like Reelin said, it's effectiveness may be related to it's ability to modulate immune activity by affecting pH.

https://www.ncbi.nlm.nih.gov/pubmed/27927040

Course, that'll only work if the symptoms are being caused by an overactive immune system and it's able to mediate that immune response in time.

> Course, that'll only work if the symptoms are being caused by an overactive immune system and it's able to mediate that immune response in time.

Accumulating evidence suggests that a subgroup of patients with severe COVID-19 might have a cytokine storm syndrome [1]. HCQ is known to moderate this reaction.

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

I'm not sure if it would be able to mitigate a cytokine storm, but it could prevent it. When DW was on it for sepsis due to an auto-inflammatory condition, her progression was much slower than what I've read about cytokine storm.

Thanks, I misspoke.

I've read about benefits not related to zinc, in addition to the zinc-related mechanism. It helps zinc get into the cell which prevents the replication of the virus, but there are additional benefits of this chemo medication. I'd have to take some time to find the particulars, if you read the original French study I think it details all the theoretical benefits.

With any chemo drug I suspect it won't have a huge effect on patients who are mild, in fact it could have a negative effect, but I'm no expert.

Hydroxychloroquine is not a chemo drug

It's a chemosensitizer, I'd say it is.

https://en.wikipedia.org/wiki/Chemosensitizer

edit: It's still being researched, but it is an anti-cancer drug, just like how chemo drugs get classed.

https://www.thelancet.com/journals/lanonc/article/PIIS1470-2...

Chemo drugs aren't really a technical category, but it seems like chloroquine will become part of the anti-cancer family soon.

Given our recent discovery that chemotherapy has only gives you a 2% greater chance of survival (again, your immune system fights of cancer just like it fights off viruses), I'm not so hopeful here.

https://www.thelancet.com/journals/lanonc/article/PIIS1470-2...

(summary: chemotherapy actively kills people, some people would have survived without it)

Don't believe everything you watch on youtube.

And what about

Peer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/

Reviewed https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2973827/

Papers? https://www.academia.edu/download/41294025/Zn2_inhibits_coro...

Peer reviewed papers are great, and that’s obviously where medcram got their info from. Whether or not this is the actual mechanism of action for covid-19 has not been demonstrated however.

Reply on news.ycombinator.com