SRM Medical College Hospital and Research Centre, Chennai, Tamilnadu, India.
The Institute of Liver Disease and Transplantation, Dr. Rela Institute and Medical Centre, Bharath Institute of Higher Education and Research, Chennai, Tamilnadu, India.
Inflammopharmacology. 2021 Feb;29(1):91-100. doi: 10.1007/s10787-020-00773-9. Epub 2020 Nov 7.
Coronavirus disease 2019 (COVID-19) pandemic has affected health care systems worldwide. Severe presentations of COVID-19 such as severe pneumonia and acute respiratory distress syndrome (ARDS) have been associated with the post-viral activation and release of cytokine/chemokines which leads to a "cytokine storm" causing inflammatory response and destruction, mainly affecting the lungs. COVID-19 activation of transcription factor, NF-kappa B (NF-κB) in various cells such as macrophages of lung, liver, kidney, central nervous system, gastrointestinal system and cardiovascular system leads to production of IL-1, IL-2, IL-6, IL-12, TNF-α, LT-α, LT-β, GM-CSF, and various chemokines. The sensitised NF-κB in elderly and in patients with metabolic syndrome makes this set of population susceptible to COVID-19 and their worse complications, including higher mortality. Immunomodulation at the level of NF-κB activation and inhibitors of NF-κB (IκB) degradation along with TNF-α inhibition will potentially result in a reduction in the cytokine storm and alleviate the severity of COVID-19. Inhibition of NF-κB pathway has a potential therapeutic role in alleviating the severe form of COVID-19.
2019 年冠状病毒病（COVID-19）大流行已影响全球卫生保健系统。COVID-19 的严重表现，如严重肺炎和急性呼吸窘迫综合征（ARDS），与病毒后激活和细胞因子/趋化因子的释放有关，这导致了“细胞因子风暴”，从而引发炎症反应和破坏，主要影响肺部。COVID-19 在各种细胞（如肺、肝、肾、中枢神经系统、胃肠道和心血管系统中的巨噬细胞）中的转录因子 NF-κB（NF-κB）的激活导致 IL-1、IL-2、IL-6、IL-12、TNF-α、LT-α、LT-β、GM-CSF 和各种趋化因子的产生。老年人群和代谢综合征患者中致敏的 NF-κB 使这组人群易感染 COVID-19 及其更严重的并发症，包括更高的死亡率。NF-κB 激活的免疫调节和 NF-κB（IκB）降解抑制剂以及 TNF-α 抑制剂可能会减少细胞因子风暴并减轻 COVID-19 的严重程度。NF-κB 通路的抑制在缓解 COVID-19 的严重形式方面具有潜在的治疗作用。
