Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, SP, Brazil.
Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, SP, Brazil.
Nitric Oxide. 2021 Jun 1;111-112:64-71. doi: 10.1016/j.niox.2021.04.003. Epub 2021 Apr 6.
Symptoms of COVID-19 range from asymptomatic/mild symptoms to severe illness and death, consequence of an excessive inflammatory process triggered by SARS-CoV-2 infection. The diffuse inflammation leads to endothelium dysfunction in pulmonary blood vessels, uncoupling eNOS activity, lowering NO production, causing pulmonary physiological alterations and coagulopathy. On the other hand, iNOS activity is increased, which may be advantageous for host defense, once NO plays antiviral effects. However, overproduction of NO may be deleterious, generating a pro-inflammatory effect. In this review, we discussed the role of endogenous NO as a protective or deleterious agent of the respiratory and vascular systems, the most affected in COVID-19 patients, focusing on eNOS and iNOS roles. We also reviewed the currently available NO therapies and pointed out possible alternative treatments targeting NO metabolism, which could help mitigate health crises in the present and future CoV's spillovers.
COVID-19 的症状从无症状/轻度症状到严重疾病和死亡不等，这是由 SARS-CoV-2 感染引发的过度炎症反应的结果。弥漫性炎症导致肺血管内皮功能障碍，eNOS 活性解偶联，NO 生成减少，导致肺生理改变和凝血功能障碍。另一方面，iNOS 活性增加，这可能对宿主防御有利，因为 NO 具有抗病毒作用。然而，NO 的过度产生可能是有害的，产生促炎作用。在这篇综述中，我们讨论了内源性 NO 作为 COVID-19 患者受影响最严重的呼吸系统和血管系统的保护或有害剂的作用，重点讨论了 eNOS 和 iNOS 的作用。我们还回顾了目前可用的 NO 治疗方法，并指出了针对 NO 代谢的可能替代治疗方法，这可能有助于减轻当前和未来 CoV 溢出的健康危机。
