Centre for Biomedical Research, School of Medicine, University of Castilla-La Mancha, Albacete, Spain.
Hospital General La Mancha Centro, Servicio de Salud de Castilla-La Mancha, Ciudad Real, Spain.
Front Immunol. 2020 Jun 11;11:1359. doi: 10.3389/fimmu.2020.01359. eCollection 2020.
SARS-CoV-2 is a new coronavirus that has caused a worldwide pandemic. It causes severe acute respiratory syndrome (COVID-19), which is fatal in many cases, and is characterized by a cytokine release syndrome (CRS). Great efforts are currently being made to block the signal transduction pathway of pro-inflammatory cytokines in order to control this "cytokine storm" and rescue severely affected patients. Consequently, possible treatments for cytokine-mediated hyperinflammation, preferably within approved safe therapies, are urgently being researched to reduce rising mortality. One approach to inhibit proinflammatory cytokine release is to activate the cholinergic anti-inflammatory pathway through nicotinic acetylcholine receptors (α7nAchR). Nicotine, an exogenous α7nAchR agonist, is clinically used in ulcerative colitis to counteract inflammation. We have found epidemiological evidence, based on recent clinical SARS-CoV-2 studies in China, that suggest that smokers are statistically less likely to be hospitalized. In conclusion, our hypothesis proposes that nicotine could constitute a novel potential CRS therapy in severe SARS-CoV-2 patients.
SARS-CoV-2 是一种新型冠状病毒，已在全球范围内引发大流行。它会引起严重的急性呼吸综合征（COVID-19），在许多情况下是致命的，其特征是细胞因子释放综合征（CRS）。目前正在努力阻断促炎细胞因子的信号转导途径，以控制这种“细胞因子风暴”并拯救受严重影响的患者。因此，正在紧急研究细胞因子介导的过度炎症的可能治疗方法，最好是在批准的安全治疗方法内，以降低不断上升的死亡率。抑制前炎症细胞因子释放的一种方法是通过烟碱型乙酰胆碱受体（α7nAchR）激活胆碱能抗炎途径。尼古丁是一种外源性α7nAchR 激动剂，临床上用于治疗溃疡性结肠炎以对抗炎症。我们根据最近在中国进行的 SARS-CoV-2 临床研究发现了流行病学证据，表明吸烟者住院的可能性统计学上较小。总之，我们的假设提出，尼古丁可能成为严重 SARS-CoV-2 患者的新型潜在 CRS 治疗方法。
