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SARS-CoV-2 感染与中枢及外周神经系统相关的并发症及其潜在发病机制。

SARS-CoV-2 Infection in the Central and Peripheral Nervous System-Associated Morbidities and Their Potential Mechanism.

机构信息

Department of Immunology and Nano-Medicine, Alzheimer's Disease Research Unit, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.

出版信息

Mol Neurobiol. 2021 Jun;58(6):2465-2480. doi: 10.1007/s12035-020-02245-1. Epub 2021 Jan 13.

Abstract

The recent outbreak of SARS-CoV-2 infections that causes coronavirus-induced disease of 2019 (COVID-19) is the defining and unprecedented global health crisis of our time in both the scale and magnitude. Although the respiratory tract is the primary target of SARS-CoV-2, accumulating evidence suggests that the virus may also invade both the central nervous system (CNS) and the peripheral nervous system (PNS) leading to numerous neurological issues including some serious complications such as seizures, encephalitis, and loss of consciousness. Here, we present a comprehensive review of the currently known role of SARS-CoV-2 and identify all the neurological problems reported among the COVID-19 case reports throughout the world. The virus might gain entry into the CNS either through the trans-synaptic route via the olfactory neurons or through the damaged endothelium in the brain microvasculature using the ACE2 receptor potentiated by neuropilin-1 (NRP-1). The most critical of all symptoms appear to be the spontaneous loss of breathing in some COVID-19 patients. This might be indicative of a dysfunction within the cardiopulmonary regulatory centers in the brainstem. These pioneering studies, thus, lay a strong foundation for more in-depth basic and clinical research required to confirm the role of SARS-CoV-2 infection in neurodegeneration of critical brain regulatory centers.

摘要

最近爆发的严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)感染导致的 2019 年冠状病毒病(COVID-19)是当前全球范围内规模和程度都前所未有的重大卫生危机。尽管呼吸道是 SARS-CoV-2 的主要靶标,但越来越多的证据表明,该病毒也可能侵犯中枢神经系统(CNS)和周围神经系统(PNS),导致许多神经系统问题,包括一些严重并发症,如癫痫发作、脑炎和意识丧失。在这里,我们全面回顾了目前已知的 SARS-CoV-2 作用,并确定了世界各地 COVID-19 病例报告中报告的所有神经问题。病毒可能通过嗅神经元的跨突触途径,或通过大脑微血管中 ACE2 受体增强的神经纤毛蛋白 1(NRP-1),通过受损的内皮细胞进入 CNS。所有症状中最关键的似乎是一些 COVID-19 患者的自发性呼吸丧失。这可能表明脑干心肺调节中心功能障碍。这些开拓性研究为更深入的基础和临床研究奠定了坚实的基础,以证实 SARS-CoV-2 感染在关键大脑调节中心的神经退行性变中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1da4/7805264/d104185ed097/12035_2020_2245_Fig1_HTML.jpg

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