Yang Chun-Pai, Chang Ching-Mao, Yang Cheng-Chia, Pariante Carmine M, Su Kuan-Pin
Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan; Department of Nutrition, HungKuang University, Taichung, Taiwan.
Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Brain Behav Immun. 2022 Jul;103:19-27. doi: 10.1016/j.bbi.2022.04.001. Epub 2022 Apr 4.
The global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the lasting pandemic of coronavirus disease 2019 (COVID-19) and the post-acute phase sequelae of heterogeneous negative impacts in multiple systems known as the "long COVID." The mechanisms of neuropsychiatric complications of long COVID are multifactorial, including long-term tissue damages from direct CNS viral involvement, unresolved systemic inflammation and oxidative stress, maladaptation of the renin-angiotensin-aldosterone system and coagulation system, dysregulated immunity, the dysfunction of neurotransmitters and hypothalamus-pituitaryadrenal (HPA) axis, and the psychosocial stress imposed by societal changes in response to this pandemic. The strength of safety, well-acceptance, and accumulating scientific evidence has now afforded nutritional medicine a place in the mainstream of neuropsychiatric intervention and prophylaxis. Long chain omega-3 polyunsaturated fatty acids (omega-3 or n-3 PUFAs) might have favorable effects on immunity, inflammation, oxidative stress and psychoneuroimmunity at different stages of SARS-CoV-2 infection. Omega-3 PUFAs, particularly EPA, have shown effects in treating mood and neurocognitive disorders by reducing pro-inflammatory cytokines, altering the HPA axis, and modulating neurotransmission via lipid rafts. In addition, omega-3 PUFAs and their metabolites, including specialized pro-resolvin mediators, accelerate the process of cleansing chronic inflammation and restoring tissue homeostasis, and therefore offer a promising strategy for Long COVID. In this article, we explore in a systematic review the putative molecular mechanisms by which omega-3 PUFAs and their metabolites counteract the negative effects of long COVID on the brain, behavior, and immunity.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的全球传播导致了2019冠状病毒病（COVID-19）的持续大流行以及被称为“长新冠”的多系统异质性负面影响的急性期后后遗症。长新冠神经精神并发症的机制是多因素的，包括中枢神经系统病毒直接感染导致的长期组织损伤、未解决的全身炎症和氧化应激、肾素-血管紧张素-醛固酮系统和凝血系统的适应性不良、免疫失调、神经递质和下丘脑-垂体-肾上腺（HPA）轴功能障碍，以及社会应对这一流行病变化所带来的心理社会压力。营养医学的安全性、良好的接受度以及不断积累的科学证据，使其在神经精神干预和预防的主流领域中占据了一席之地。长链ω-3多不饱和脂肪酸（ω-3或n-3多不饱和脂肪酸）可能在SARS-CoV-2感染的不同阶段对免疫、炎症、氧化应激和心理神经免疫产生有利影响。ω-3多不饱和脂肪酸，特别是二十碳五烯酸（EPA），已显示出通过减少促炎细胞因子、改变HPA轴以及通过脂筏调节神经传递来治疗情绪和神经认知障碍的作用。此外，ω-3多不饱和脂肪酸及其代谢产物，包括特殊的促消退介质，加速了清除慢性炎症和恢复组织稳态的过程，因此为长新冠提供了一种有前景的策略。在本文中，我们通过系统综述探讨了ω-3多不饱和脂肪酸及其代谢产物抵消长新冠对大脑、行为和免疫负面影响的假定分子机制。
