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神经炎症与 COVID-19 缺血性脑卒中恢复:ACE2/血管紧张素-(1-7)/Mas 受体轴和 NLRP3 炎性小体的介导作用的新证据。

Neuroinflammation and COVID-19 Ischemic Stroke Recovery-Evolving Evidence for the Mediating Roles of the ACE2/Angiotensin-(1-7)/Mas Receptor Axis and NLRP3 Inflammasome.

机构信息

Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.

Faculty of Industrial Sciences and Technology, Universiti Malaysia Pahang, Lebuhraya Tun Razak, Gambang Kuantan 26300, Pahang, Malaysia.

出版信息

Int J Mol Sci. 2022 Mar 13;23(6):3085. doi: 10.3390/ijms23063085.

Abstract

Cerebrovascular events, notably acute ischemic strokes (AIS), have been reported in the setting of novel coronavirus disease (COVID-19) infection. Commonly regarded as cryptogenic, to date, the etiology is thought to be multifactorial and remains obscure; it is linked either to a direct viral invasion or to an indirect virus-induced prothrombotic state, with or without the presence of conventional cerebrovascular risk factors. In addition, patients are at a greater risk of developing long-term negative sequelae, i.e., long-COVID-related neurological problems, when compared to non-COVID-19 stroke patients. Central to the underlying neurobiology of stroke recovery in the context of COVID-19 infection is reduced angiotensin-converting enzyme 2 (ACE2) expression, which is known to lead to thrombo-inflammation and ACE2/angiotensin-(1-7)/mitochondrial assembly receptor (MasR) (ACE2/Ang-(1-7)/MasR) axis inhibition. Moreover, after AIS, the activated nucleotide-binding oligomerization domain (NOD)-like receptor (NLR) family pyrin domain-containing 3 (NLRP3) inflammasome may heighten the production of numerous proinflammatory cytokines, mediating neuro-glial cell dysfunction, ultimately leading to nerve-cell death. Therefore, potential neuroprotective therapies targeting the molecular mechanisms of the aforementioned mediators may help to inform rehabilitation strategies to improve brain reorganization (i.e., neuro-gliogenesis and synaptogenesis) and secondary prevention among AIS patients with or without COVID-19. Therefore, this narrative review aims to evaluate the mediating role of the ACE2/Ang- (1-7)/MasR axis and NLRP3 inflammasome in COVID-19-mediated AIS, as well as the prospects of these neuroinflammation mediators for brain repair and in secondary prevention strategies against AIS in stroke rehabilitation.

摘要

脑血管事件,特别是急性缺血性脑卒中(AIS),已在新型冠状病毒疾病(COVID-19)感染的背景下报告。通常被认为是隐源性的,迄今为止,病因被认为是多因素的,仍然不清楚;它与直接的病毒侵袭或间接的病毒诱导的血栓形成状态有关,无论是否存在常规的脑血管危险因素。此外,与非 COVID-19 脑卒中患者相比,患者发生长期负面后果(即与长 COVID 相关的神经问题)的风险更高。在 COVID-19 感染背景下,中风恢复的潜在神经生物学的核心是血管紧张素转换酶 2(ACE2)表达减少,这已知会导致血栓炎症和 ACE2/血管紧张素(1-7)/线粒体组装受体(MasR)(ACE2/Ang-(1-7)/MasR)轴抑制。此外,在 AIS 后,激活的核苷酸结合寡聚化结构域(NOD)样受体(NLR)家族吡喃结构域包含 3(NLRP3)炎症小体可能会增加许多促炎细胞因子的产生,介导神经胶质细胞功能障碍,最终导致神经细胞死亡。因此,针对上述介质的分子机制的潜在神经保护疗法可能有助于为 AIS 患者提供康复策略,以改善大脑重组(即神经发生和突触发生)和 COVID-19 与无 COVID-19 的 AIS 患者的二级预防。因此,本叙述性综述旨在评估 ACE2/Ang-(1-7)/MasR 轴和 NLRP3 炎症小体在 COVID-19 介导的 AIS 中的介导作用,以及这些神经炎症介质在中风康复中的大脑修复和二级预防策略中的前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a46/8949282/d18cabcf19aa/ijms-23-03085-g001.jpg

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