Department of Surgery, Kansas City VA Medical Center, University of Missouri Kansas City, 4801 E Linwood Blvd., Kansas City , MO, 64128, USA.
Inflamm Res. 2022 Jan;71(1):13-26. doi: 10.1007/s00011-021-01510-w. Epub 2021 Nov 5.
The SARS-CoV-2 pandemic continues to spread sporadically in the Unites States and worldwide. The severity and mortality excessively affected the frail elderly with co-existing medical diseases. There is growing evidence that cross-talk between the gut microbiome, Vitamin D and RAS/ACE2 system is essential for a balanced functioning of the elderly immune system and in regulating inflammation. In this review, we hypothesize that the state of gut microbiome, prior to infection determines the outcome associated with COVID-19 sepsis and may also be a critical factor in success to vaccination.
Articles from PubMed/Medline searches were reviewed using a combination of terms "SARS-CoV-2, COVID-19, Inflammaging, Immune-senescence, Gut microbiome, Vitamin D, RAS/ACE2, Vaccination".
Evidence indicates a complex association between gut microbiota, ACE-2 expression and Vitamin D in COVID-19 severity. Status of gut microbiome is highly predictive of the blood molecular signatures and inflammatory markers and host responses to infection. Vitamin D has immunomodulatory function in innate and adaptive immune responses to viral infection. Anti-inflammatory functions of Vit D include regulation of gut microbiome and maintaining microbial diversity. It promotes growth of gut-friendly commensal strains of Bifida and Fermicutus species. In addition, Vitamin D is a negative regulator for expression of renin and interacts with the RAS/ ACE/ACE-2 signaling axis. Collectively, this triad may be the critical, link in determination of outcomes in SARS-CoV-2 infection. The presented data are empirical and informative. Further research using advanced systems biology techniques and artificial intelligence-assisted integration could assist with correlation of the gut microbiome with sepsis and vaccine responses. Modulating these factors may impact in guiding the success of vaccines and clinical outcomes in COVID-19 infections.
SARS-CoV-2 病毒持续在美国和全球零星传播。其严重程度和死亡率对患有合并症的体弱老年人造成了极大的影响。越来越多的证据表明，肠道微生物群、维生素 D 和 RAS/ACE2 系统之间的串扰对于老年人免疫系统的平衡功能和炎症调节至关重要。在这篇综述中，我们假设感染前的肠道微生物群状态决定了与 COVID-19 败血症相关的结果，并且可能也是疫苗接种成功的关键因素。
使用“SARS-CoV-2、COVID-19、Inflammaging、Immune-senescence、Gut microbiome、Vitamin D、RAS/ACE2、Vaccination”等组合术语对 PubMed/Medline 搜索的文章进行了回顾。
有证据表明肠道微生物群、ACE-2 表达和维生素 D 与 COVID-19 严重程度之间存在复杂的关联。肠道微生物群的状态高度预测了血液分子特征和炎症标志物以及宿主对感染的反应。维生素 D 在病毒感染的固有和适应性免疫反应中具有免疫调节功能。维生素 D 的抗炎功能包括调节肠道微生物群和维持微生物多样性。它促进双歧杆菌和梭菌等肠道友好共生菌株的生长。此外，维生素 D 是肾素表达的负调节剂，并与 RAS/ACE/ACE-2 信号轴相互作用。总的来说，这三联体可能是决定 SARS-CoV-2 感染结局的关键环节。所呈现的数据是经验性和信息性的。使用先进的系统生物学技术和人工智能辅助集成的进一步研究可以帮助将肠道微生物群与败血症和疫苗反应相关联。调节这些因素可能会影响指导 COVID-19 感染中疫苗和临床结果的成功。
