Postgraduate Medical School, University of Chieti, 66013 Chieti, Italy.
School of Pharmacy, University of Camerino, Camerino, Italy.
J Biol Regul Homeost Agents. 2020 Nov-Dec;34(6):1971-1975. doi: 10.23812/20-1-E.
SARS-Cov-2 infection causes local and systemic inflammation mediated by pro-inflammatory cytokines and COX-2 eicosanoid products with metabolic dysfunction and tissue damage that can lead to patient death. These effects are primarily induced by IL-1 cytokines, which are involved in the elevation of hepatic acute phase proteins and fever. IL-1 has a broad spectrum of biological activities and participates in both innate and acquired immunity. In infections, IL-1 induces gene expression and synthesis of several cytokines/chemokines in both macrophages and mast cells (MCs). The activation of MCs triggers the secretion of mediators stored in the granules, and the de novo synthesis of pro-inflammatory cytokines. In microorganism infections, the release of IL-1 macrophage acts on adhesion molecules and endothelial cells leading to hypotension and septic shock syndrome. IL-1 activated by SARS-CoV-2 stimulates the secretion of TNF, IL-6 and other cytokines, a pro-inflammatory complex that can lead to cytokine storm and be deleterious in both lung and systemically. In SARS-CoV-2 septic shock, severe metabolic cellular abnormalities occur which can lead to death. Here, we report that SARS-CoV-2 induces IL-1 in macrophages and MCs causing the induction of gene expression and activation of other pro-inflammatory cytokines. Since IL-1 is toxic, its production from ubiquitous MCs and macrophages activated by SARS-CoV-2 can also provokes both gastrointestinal and brain disorders. Furthermore, in these immune cells, IL-1 also elevates nitric oxide, and the release of inflammatory arachidonic acid products such as prostaglndins and thromboxane A2. All together these effects can generate cytokine storm and be the primary cause of severe inflammation with respiratory distress and death. Although, IL-1 administered in low doses may be protective; when it is produced in high doses in infectious diseases can be detrimental, therefore, IL-1 blockade has been studied in many human diseases including sepsis, resulting that blocking it is absolutely necessary. This definitely nurtures hope for a new effective therapeutic treatment. Recently, two interesting anti-IL-1 cytokines have been widely described: IL-37 and IL-1Ra. IL-37, by blocking IL-1, has been observed to have anti-inflammatory action in rodents in vivo and in transfected cells. It has been reported that IL-37 is a very powerful protein which inhibits inflammation and its inhibition can be a valid therapeutic strategy. IL-37 is a natural suppressor of inflammation that is generated through a caspase-1 that cleaves pro-IL-37 into mature IL-37 which translocates to the nucleus and inhibits the transcription of pro-inflammatory genes; while IL-1Ra inhibits inflammation by binding IL-1 to its IL-1R (receptor). We firmly believe that blocking IL-1 with an anti-inflammatory cytokine such as IL-37 and/or IL-1Ra is an effective valid therapy in a wide spectrum of inflammatory disorders including SARS-CoV-2-induced COVID-19. Here, we propose for the first time that IL-37, by blocking IL-1, may have an important role in the therapy of COVID-19.
SARS-CoV-2 感染通过促炎细胞因子和 COX-2 类花生酸产物引起局部和全身炎症,导致代谢功能障碍和组织损伤,从而导致患者死亡。这些影响主要是由白细胞介素-1(IL-1)细胞因子引起的,它参与肝脏急性期蛋白和发热的升高。IL-1 具有广泛的生物学活性,参与固有免疫和获得性免疫。在感染中,IL-1 在巨噬细胞和肥大细胞(MCs)中诱导几种细胞因子/趋化因子的基因表达和合成。MCs 的激活触发储存在颗粒中的介质和新合成的促炎细胞因子的释放。在微生物感染中,IL-1 激活的巨噬细胞作用于粘附分子和内皮细胞,导致低血压和败血症休克综合征。由 SARS-CoV-2 激活的 IL-1 刺激 TNF、IL-6 和其他细胞因子的分泌,形成促炎复合物,可导致细胞因子风暴,并在肺部和全身系统中产生有害影响。在 SARS-CoV-2 败血性休克中,会发生严重的代谢细胞异常,可能导致死亡。在这里,我们报告 SARS-CoV-2 在巨噬细胞和 MCs 中诱导 IL-1 的产生,导致其他促炎细胞因子的基因表达和激活。由于 IL-1 具有毒性,因此由 SARS-CoV-2 激活的无处不在的 MCs 和巨噬细胞产生的 IL-1 也会引发胃肠道和大脑紊乱。此外,在这些免疫细胞中,IL-1 还会升高一氧化氮,并释放炎症性花生四烯酸产物,如前列腺素和血栓素 A2。所有这些作用都会产生细胞因子风暴,是导致呼吸窘迫和死亡的严重炎症的主要原因。尽管低剂量的 IL-1 可能具有保护作用,但在感染性疾病中高剂量产生时可能会产生有害影响,因此已在许多人类疾病中研究了 IL-1 阻断,包括败血症,结果表明阻断它是绝对必要的。这无疑为新的有效治疗方法带来了希望。最近,两种有趣的抗 IL-1 细胞因子已被广泛描述:IL-37 和 IL-1Ra。IL-37 通过阻断 IL-1,在体内和转染细胞中观察到具有抗炎作用。据报道,IL-37 是一种非常强大的蛋白质,具有抗炎作用,其抑制作用可能是一种有效的治疗策略。IL-37 是一种天然的炎症抑制剂,它通过半胱天冬酶-1将前体 IL-37 切割成成熟的 IL-37,然后转运到细胞核并抑制促炎基因的转录而产生。而 IL-1Ra 通过与 IL-1 结合到其 IL-1R(受体)来抑制炎症。我们坚信,使用抗炎细胞因子(如 IL-37 和/或 IL-1Ra)阻断 IL-1 是治疗包括 SARS-CoV-2 引起的 COVID-19 在内的广泛炎症性疾病的有效方法。在这里,我们首次提出,IL-37 通过阻断 IL-1,可能在 COVID-19 的治疗中发挥重要作用。
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