Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, USA.
Paediatric Critical Care, Western University and Lawson Health Research Institute, London, ON, Canada.
Lancet Microbe. 2023 Aug;4(8):e642-e650. doi: 10.1016/S2666-5247(23)00111-8. Epub 2023 Jun 13.
The most prevalent symptoms of post-COVID-19 condition are pulmonary dysfunction, fatigue and muscle weakness, anxiety, anosmia, dysgeusia, headaches, difficulty in concentrating, sexual dysfunction, and digestive disturbances. Hence, neurological dysfunction and autonomic impairments predominate in post-COVID-19 condition. Tachykinins including the most studied substance P are neuropeptides expressed throughout the nervous and immune systems, and contribute to many physiopathological processes in the nervous, immune, gastrointestinal, respiratory, urogenital, and dermal systems and participate in inflammation, nociception, and cell proliferation. Substance P is a key molecule in neuroimmune crosstalk; immune cells near the peripheral nerve endings can send signals to the brain with cytokines, which highlights the important role of tachykinins in neuroimmune communication. We reviewed the evidence that relates the symptoms of post-COVID-19 condition to the functions of tachykinins and propose a putative pathogenic mechanism. The antagonism of tachykinins receptors can be a potential treatment target.
新冠后症状最常见的是肺功能障碍、疲劳和肌肉无力、焦虑、嗅觉丧失、味觉障碍、头痛、注意力不集中、性功能障碍和消化紊乱。因此,新冠后以神经功能障碍和自主神经损伤为主。速激肽包括研究最多的物质 P 是一种在神经系统和免疫系统中表达的神经肽,有助于神经系统、免疫系统、胃肠道、呼吸系统、泌尿生殖系统和皮肤系统的许多生理病理过程,并参与炎症、痛觉过敏和细胞增殖。物质 P 是神经免疫相互作用的关键分子;外周神经末梢附近的免疫细胞可以用细胞因子向大脑发送信号,这突出了速激肽在神经免疫通讯中的重要作用。我们回顾了与新冠后症状相关的速激肽功能的证据,并提出了一个假设的发病机制。速激肽受体的拮抗作用可能是一个潜在的治疗靶点。