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新型冠状病毒病 2019(COVID-19)及其神经侵袭能力:褪黑素是否该登场了?

Coronavirus Disease 2019 (COVID-19) and Its Neuroinvasive Capacity: Is It Time for Melatonin?

机构信息

Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040, Madrid, Spain.

Faculty of Health Sciences, University Camilo José Cela, C/ Castillo de Alarcón 49, 28692, Villanueva de la Cañada, Madrid, Spain.

出版信息

Cell Mol Neurobiol. 2022 Apr;42(3):489-500. doi: 10.1007/s10571-020-00938-8. Epub 2020 Aug 9.

Abstract

The world faces an exceptional new public health concern caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), subsequently termed the coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). Although the clinical symptoms mostly have been characterized, the scientific community still doesn´t know how SARS-CoV-2 successfully reaches and spreads throughout the central nervous system (CNS) inducing brain damage. The recent detection of SARS-CoV-2 in the cerebrospinal fluid (CSF) and in frontal lobe sections from postmortem examination has confirmed the presence of the virus in neural tissue. This finding reveals a new direction in the search for a neurotherapeutic strategy in the COVID-19 patients with underlying diseases. Here, we discuss the COVID-19 outbreak in a neuroinvasiveness context and suggest the therapeutic use of high doses of melatonin, which may favorably modulate the immune response and neuroinflammation caused by SARS-CoV-2. However, clinical trials elucidating the efficacy of melatonin in the prevention and clinical management in the COVID-19 patients should be actively encouraged.

摘要

世界正面临着由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的特殊新公共卫生关注,世界卫生组织(WHO)随后将其命名为 2019 年冠状病毒病(COVID-19)。尽管临床症状大多已经得到描述,但科学界仍不清楚 SARS-CoV-2 如何成功到达并扩散到中枢神经系统(CNS),从而导致大脑损伤。最近在脑脊液(CSF)和尸检的额叶切片中检测到 SARS-CoV-2,证实了病毒在神经组织中的存在。这一发现为寻找 COVID-19 合并基础疾病患者的神经治疗策略开辟了新的方向。在这里,我们从神经侵袭的角度讨论 COVID-19 的爆发,并建议使用大剂量褪黑素进行治疗,褪黑素可能有利于调节由 SARS-CoV-2 引起的免疫反应和神经炎症。然而,应该积极鼓励开展临床试验,以阐明褪黑素在 COVID-19 患者中的预防和临床管理中的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6bd/11441197/18a7435006df/10571_2020_938_Fig1_HTML.jpg

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