Department of Pharmacology, Howard University College of Medicine, Washington, DC, USA.
Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, USA.
FEBS J. 2020 Sep;287(17):3656-3663. doi: 10.1111/febs.15521. Epub 2020 Aug 25.
There is an urgent need to address the devastating pandemic, COVID-19, caused by SARS-CoV-2. The efforts to understand the details of this disease in hope of providing effective treatments are commendable. It is clear now that the virus can cause far more damage in patients with comorbid conditions-particularly in those with respiratory, cardiovascular, or immune-compromised system-than in patients without such comorbidities. Drug use can further exacerbate the condition. In this regard, the ill effects of smoking are amply documented, and no doubt can be a confounding factor in COVID-19 progression. Although conflicting hypotheses on the potential role of nicotine in COVID-19 pathology have recently been offered, we believe that nicotine itself, through its interaction with the nicotinic cholinergic system, as well as ACE2, may not only be of use in a variety of neuropsychiatric and neurodegenerative diseases, but may also be of potential use in COVID-19. Thus, on one hand, while we strongly support smoking cessation as a means of harm reduction associated with COVID-19, on the other hand, we support a potential therapeutic role for nicotine, nicotinic agonists, or positive allosteric modulators of nicotinic cholinergic receptors in COVID-19, owing to their varied effects including mood regulation, anti-inflammatory, and purported interference with SARS-CoV-2 entry and/or replication.
目前迫切需要解决由 SARS-CoV-2 引起的破坏性大流行病 COVID-19。人们为了理解这种疾病的细节，希望能提供有效的治疗方法，这些努力是值得称赞的。现在很明显，病毒在有合并症的患者中会造成比没有合并症的患者更大的损害——特别是在有呼吸道、心血管或免疫系统受损的患者中。药物使用会进一步加重病情。在这方面，吸烟的不良影响有充分的记录，而且无疑可以成为 COVID-19 进展的一个混杂因素。尽管最近提出了关于尼古丁在 COVID-19 病理中潜在作用的相互矛盾的假设，但我们认为，尼古丁本身通过与烟碱型乙酰胆碱能系统以及 ACE2 的相互作用，不仅可能在各种神经精神和神经退行性疾病中有用，而且在 COVID-19 中也可能有潜在的用途。因此，一方面，虽然我们强烈支持将戒烟作为与 COVID-19 相关的减少危害的手段，但另一方面，我们支持尼古丁、烟碱激动剂或烟碱型乙酰胆碱能受体的正变构调节剂在 COVID-19 中的潜在治疗作用，因为它们具有多种作用，包括调节情绪、抗炎，以及据称可以干扰 SARS-CoV-2 的进入和/或复制。
