Department of Brain Sciences, Division of Neuroscience, Imperial College London, London, UK.
Nat Rev Neurol. 2020 Nov;16(11):645-652. doi: 10.1038/s41582-020-0402-y. Epub 2020 Aug 25.
COVID-19 is an infectious disease caused by the coronavirus SARS-CoV-2, which was first reported in Wuhan, China, in December 2019 and has caused a global pandemic. Acute respiratory distress syndrome (ARDS) is a common feature of severe forms of COVID-19 and can lead to respiratory failure, especially in older individuals. The increasing recognition of the neurotropic potential of SARS-CoV-2 has sparked interest in the role of the nervous system in respiratory failure in people with COVID-19. However, the neuroimmune interactions in the lung in the context of ARDS are poorly understood. In this Perspectives article, we propose the concept of the neuroimmune unit as a critical determinant of lung function in the context of COVID-19, inflammatory conditions and ageing, focusing particularly on the involvement of the vagus nerve. We discuss approaches such as neurostimulation and pharmacological neuromodulation to reduce tissue inflammation with the aim of preventing respiratory failure.
新型冠状病毒病（COVID-19）是由冠状病毒 SARS-CoV-2 引起的传染病，该病毒于 2019 年 12 月在中国武汉首次报告，并已造成全球大流行。急性呼吸窘迫综合征（ARDS）是 COVID-19 严重形式的常见特征，可导致呼吸衰竭，尤其是在老年人中。对 SARS-CoV-2 神经嗜性潜力的日益认识引发了人们对 COVID-19 患者呼吸衰竭中神经系统作用的兴趣。然而，ARDS 中肺的神经免疫相互作用仍知之甚少。在这篇观点文章中，我们提出了神经免疫单位的概念，认为它是 COVID-19、炎症和衰老背景下肺功能的关键决定因素，特别关注迷走神经的参与。我们讨论了神经刺激和药理学神经调节等方法，以减少组织炎症，从而预防呼吸衰竭。
