Chakravarty Debanjana, Das Sarma Jayasri
Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, Haringhata, 741246, Mohanpur, India.
Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
J Neurovirol. 2021 Apr;27(2):197-216. doi: 10.1007/s13365-021-00945-5. Epub 2021 Feb 5.
The pandemic caused by SARS-CoV-2 has caused widespread infection and significant mortality across the globe. Combined virology perspective of SARS-CoV-2 with a deep-rooted understanding of pathophysiological and immunological processes underlying the clinical manifestations of COVID-19 is of prime importance. The characteristic symptom of COVID-19 is respiratory distress with diffused alveolar damage, but emerging evidence suggests COVID-19 might also have neurologic consequences. Dysregulated homeostasis in the lungs has proven to be fatal, but one cannot ignore that the inability to breathe might be due to defects in the respiratory control center of the brainstem. While the mechanism of pulmonary distress has been documented in the literature, awareness of neurological features and their pathophysiology is still in the nascent state. This review makes references to the neuro-immune axis and neuro-invasive potential of SARS-CoV and SARS-CoV2, as well as the prototypic H-CoV strains in human brains. Simultaneously, considerable discussion on relevant experimental evidence of mild to severe neurological manifestations of fellow neurotropic murine-β-CoVs (m-CoVs) in the mouse model will help understand the underpinning mechanisms of Neuro-COVID. In this review, we have highlighted the neuroimmunopathological processes in murine CoVs. While MHV infection in mice and SARS-CoV-2 infection in humans share numerous parallels, there are critical differences in viral recognition and viral entry. These similarities are highlighted in this review, while differences have also been emphasized. Though CoV-2 Spike does not favorably interact with murine ACE2 receptor, modification of murine SARS-CoV2 binding domain or development of transgenic ACE-2 knock-in mice might help in mediating consequential infection and understanding human CoV2 pathogenesis in murine models. While a global animal model that can replicate all aspects of the human disease remains elusive, prior insights and further experiments with fellow m-β-CoV-induced cause-effect experimental models and current human COVID-19 patients data may help to mitigate the SARS-CoV-2-induced multifactorial multi-organ failure.
由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的大流行在全球范围内造成了广泛感染和重大死亡。将SARS-CoV-2的病毒学视角与对2019冠状病毒病(COVID-19)临床表现背后的病理生理和免疫过程的深入理解相结合至关重要。COVID-19的特征性症状是伴有弥漫性肺泡损伤的呼吸窘迫,但新出现的证据表明COVID-19可能也有神经系统后果。肺部内稳态失调已被证明是致命的,但不能忽视的是,呼吸功能丧失可能是由于脑干呼吸控制中心的缺陷。虽然肺部窘迫的机制已在文献中有所记载,但对神经系统特征及其病理生理学的认识仍处于初期阶段。本综述参考了SARS-CoV和SARS-CoV-2的神经免疫轴和神经侵袭潜力,以及人类大脑中的原型人冠状病毒(H-CoV)毒株。同时,对嗜神经小鼠β冠状病毒(m-CoV)在小鼠模型中从轻度到重度神经系统表现的相关实验证据进行大量讨论,将有助于理解神经型COVID-19的潜在机制。在本综述中,我们强调了鼠冠状病毒中的神经免疫病理过程。虽然小鼠的小鼠肝炎病毒(MHV)感染和人类的SARS-CoV-2感染有许多相似之处,但在病毒识别和病毒进入方面存在关键差异。本综述突出了这些相似之处,同时也强调了差异。尽管冠状病毒2(CoV-2)刺突蛋白不能与小鼠血管紧张素转换酶2(ACE2)受体良好相互作用,但对小鼠SARS-CoV-2结合域进行修饰或培育转基因ACE-2基因敲入小鼠可能有助于介导后续感染,并在小鼠模型中理解人类CoV-2发病机制。虽然能够复制人类疾病所有方面的全球动物模型仍然难以实现,但先前的见解以及对其他m-β-CoV诱导的因果实验模型和当前人类COVID-19患者数据的进一步实验,可能有助于减轻SARS-CoV-2引起的多因素多器官衰竭。