Jia Feng-Ju, Han Jing
School of Nursing, Qingdao University, Qingdao 266071, Shandong Province, China.
World J Clin Cases. 2022 Dec 26;10(36):13148-13156. doi: 10.12998/wjcc.v10.i36.13148.
Even in patients without a history of liver disease, liver injury caused by coronavirus disease 2019 (COVID-19) is gradually becoming more common. However, the precise pathophysiological mechanisms behind COVID-19's liver pathogenicity are still not fully understood. We hypothesize that inflammation may become worse by cytokine storms caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Elevated ferritin levels can initiate ferritinophagy mediated by nuclear receptor coactivator 4 (NCOA4), which leads to iron elevation, and ferroptosis. In COVID-19 patients, ferroptosis can be restricted to reduce disease severity and liver damage by targeting NCOA4-mediated ferritinophagy. To confirm the role of ferritinophagy-mediated ferroptosis in SARS-CoV-2 infection, further research is required.
即使在没有肝脏疾病史的患者中,2019冠状病毒病(COVID-19)引起的肝损伤也逐渐变得更加常见。然而,COVID-19肝脏致病性背后的确切病理生理机制仍未完全明确。我们推测,严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染引起的细胞因子风暴可能会使炎症加重。铁蛋白水平升高可启动由核受体辅激活因子4(NCOA4)介导的铁蛋白自噬,导致铁含量升高和铁死亡。在COVID-19患者中,通过靶向NCOA4介导的铁蛋白自噬,可以限制铁死亡,从而降低疾病严重程度和肝损伤。为了证实铁蛋白自噬介导的铁死亡在SARS-CoV-2感染中的作用,还需要进一步的研究。