Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, Rajasthan, India.
Rajasthan State Regional Forensic Science Laboratory, Kota, Rajasthan, India.
Biochem Pharmacol. 2023 Mar;209:115437. doi: 10.1016/j.bcp.2023.115437. Epub 2023 Jan 30.
Fatal "cytokine storms (CS)" observed in critically ill COVID-19 patients are consequences of dysregulated host immune system and over-exuberant inflammatory response. Acute respiratory distress syndrome (ARDS), multi-system organ failure, and eventual death are distinctive symptoms, attributed to higher morbidity and mortality rates among these patients. Consequent efforts to save critical COVID-19 patients via the usage of several novel therapeutic options are put in force. Strategically, drugs being used in such patients are dexamethasone, remdesivir, hydroxychloroquine, etc. along with the approved vaccines. Moreover, it is certain that activation of the resolution process is important for the prevention of chronic diseases. Until recently Inflammation resolution was considered a passive process, rather it's an active biochemical process that can be achieved by the use of specialized pro-resolving mediators (SPMs). These endogenous mediators are an array of atypical lipid metabolites that include Resolvins, lipoxins, maresins, protectins, considered as immunoresolvents, but their role in COVID-19 is ambiguous. Recent evidence from studies such as the randomized clinical trial, in which omega 3 fatty acid was used as supplement to resolve inflammation in COVID-19, suggests that direct supplementation of SPMs or the use of synthetic SPM mimetics (which are still being explored) could enhance the process of resolution by regulating the aberrant inflammatory process and can be useful in pain relief and tissue remodeling. Here we discussed the biosynthesis of SPMs, & their mechanistic pathways contributing to inflammation resolution along with sequence of events leading to CS in COVID-19, with a focus on therapeutic potential of SPMs.
在重症 COVID-19 患者中观察到的致命“细胞因子风暴 (CS)”是宿主免疫系统失调和过度炎症反应的结果。急性呼吸窘迫综合征 (ARDS)、多系统器官衰竭以及最终死亡是这些患者的独特症状,归因于这些患者的发病率和死亡率较高。因此,人们努力通过使用几种新型治疗选择来拯救重症 COVID-19 患者。从策略上讲,在这些患者中使用的药物是地塞米松、瑞德西韦、羟氯喹等,以及已批准的疫苗。此外,可以肯定的是,激活解决过程对于预防慢性病很重要。直到最近,炎症解决才被认为是一个被动过程,而它是一个可以通过使用专门的解决炎症介质 (SPM) 来实现的主动生化过程。这些内源性介质是一系列非典型脂质代谢物,包括 Resolvins、lipoxins、maresins、protectins,被认为是免疫调节剂,但它们在 COVID-19 中的作用尚不清楚。最近的研究证据表明,随机临床试验中使用 omega 3 脂肪酸作为补充剂来解决 COVID-19 中的炎症,直接补充 SPM 或使用合成 SPM 模拟物(仍在探索中)可以通过调节异常炎症过程来增强解决炎症的过程,并可用于缓解疼痛和组织重塑。在这里,我们讨论了 SPM 的生物合成及其参与炎症解决的机制途径,以及 COVID-19 中 CS 发生的事件顺序,并重点介绍了 SPM 的治疗潜力。
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