Pi Peng, Zeng Zhipeng, Zeng Liqing, Han Bing, Bai Xizhe, Xu Shousheng
School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China.
College of Physical Education and Health, East China Normal University, Shanghai, China.
Front Pharmacol. 2023 Aug 3;14:1218059. doi: 10.3389/fphar.2023.1218059. eCollection 2023.
As the outbreak of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first broke out in Hubei Province, China, at the end of 2019. It has brought great challenges and harms to global public health. SARS-CoV-2 mainly affects the lungs and is mainly manifested as pulmonary disease. However, one of the biggest crises arises from the emergence of COVID-19-induced fibrosis. At present, there are still many questions about how COVID-19 induced pulmonary fibrosis (PF) occurs and how to treat and regulate its long-term effects. In addition, as an important process of fibrosis, the effect of COVID-19 on epithelial-mesenchymal transition (EMT) may be an important factor driving PF. This review summarizes the main pathogenesis and treatment mechanisms of COVID-19 related to PF. Starting with the basic mechanisms of PF, such as EMT, transforming growth factor-β (TGF-β), fibroblasts and myofibroblasts, inflammation, macrophages, innate lymphoid cells, matrix metalloproteinases and tissue inhibitors of metalloproteinases, hedgehog pathway as well as Notch signaling. Further, we highlight the importance of COVID-19-induced EMT in the process of PF and provide an overview of the related molecular mechanisms, which will facilitate future research to propose new clinical therapeutic solutions for the treatment of COVID-19-induced PF.
2019年底，由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）疫情首先在中国湖北省爆发。它给全球公共卫生带来了巨大挑战和危害。SARS-CoV-2主要影响肺部，主要表现为肺部疾病。然而，最大的危机之一来自COVID-19诱导的纤维化的出现。目前，关于COVID-19如何诱导肺纤维化（PF）以及如何治疗和调节其长期影响仍有许多问题。此外，作为纤维化的一个重要过程，COVID-19对上皮-间质转化（EMT）的影响可能是驱动PF的一个重要因素。本综述总结了与PF相关的COVID-19的主要发病机制和治疗机制。从PF的基本机制入手，如EMT、转化生长因子-β（TGF-β）、成纤维细胞和平滑肌成纤维细胞、炎症、巨噬细胞、固有淋巴细胞、基质金属蛋白酶和金属蛋白酶组织抑制剂、刺猬通路以及Notch信号。此外，我们强调了COVID-19诱导的EMT在PF过程中的重要性，并概述了相关分子机制，这将有助于未来的研究为治疗COVID-19诱导的PF提出新的临床治疗方案。
