The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Cytokine. 2020 Sep;133:155151. doi: 10.1016/j.cyto.2020.155151. Epub 2020 May 30.
Patients with COVID-19 who require ICU admission might have the cytokine storm. It is a state of out-of-control release of a variety of inflammatory cytokines. The molecular mechanism of the cytokine storm has not been explored extensively yet. The attachment of SARS-CoV-2 spike glycoprotein with angiotensin-converting enzyme 2 (ACE2), as its cellular receptor, triggers complex molecular events that leads to hyperinflammation. Four molecular axes that may be involved in SARS-CoV-2 driven inflammatory cytokine overproduction are addressed in this work. The virus-mediated down-regulation of ACE2 causes a burst of inflammatory cytokine release through dysregulation of the renin-angiotensin-aldosterone system (ACE/angiotensin II/AT1R axis), attenuation of Mas receptor (ACE2/MasR axis), increased activation of [des-Arg9]-bradykinin (ACE2/bradykinin B1R/DABK axis), and activation of the complement system including C5a and C5b-9 components. The molecular clarification of these axes will elucidate an array of therapeutic strategies to confront the cytokine storm in order to prevent and treat COVID-19 associated acute respiratory distress syndrome.
COVID-19 患者需要入住 ICU 可能会出现细胞因子风暴。这是一种各种炎症细胞因子失控释放的状态。细胞因子风暴的分子机制尚未得到广泛探索。SARS-CoV-2 刺突糖蛋白与血管紧张素转换酶 2(ACE2)作为其细胞受体的结合,引发导致过度炎症的复杂分子事件。在这项工作中,讨论了可能与 SARS-CoV-2 驱动的炎症细胞因子过度产生有关的四个分子轴。病毒介导的 ACE2 下调通过肾素-血管紧张素-醛固酮系统(ACE/血管紧张素 II/AT1R 轴)的失调、Mas 受体(ACE2/MasR 轴)的衰减、[去精氨酸 9]-缓激肽(ACE2/缓激肽 B1R/DABK 轴)的过度激活以及补体系统的激活,包括 C5a 和 C5b-9 成分,导致炎症细胞因子的爆发。这些轴的分子阐明将阐明一系列治疗策略,以应对细胞因子风暴,从而预防和治疗 COVID-19 相关的急性呼吸窘迫综合征。