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新冠后急性神经认知症状的肠-脑发病机制

Gut-brain pathogenesis of post-acute COVID-19 neurocognitive symptoms.

作者信息

Plummer Allison M, Matos Yvette L, Lin Henry C, Ryman Sephira G, Birg Aleksandr, Quinn Davin K, Parada Alisha N, Vakhtin Andrei A

机构信息

School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States.

The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States.

出版信息

Front Neurosci. 2023 Sep 28;17:1232480. doi: 10.3389/fnins.2023.1232480. eCollection 2023.


DOI:10.3389/fnins.2023.1232480
PMID:37841680
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10568482/
Abstract

Approximately one third of non-hospitalized coronavirus disease of 2019 (COVID-19) patients report chronic symptoms after recovering from the acute stage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Some of the most persistent and common complaints of this post-acute COVID-19 syndrome (PACS) are cognitive in nature, described subjectively as "brain fog" and also objectively measured as deficits in executive function, working memory, attention, and processing speed. The mechanisms of these chronic cognitive sequelae are currently not understood. SARS-CoV-2 inflicts damage to cerebral blood vessels and the intestinal wall by binding to angiotensin-converting enzyme 2 (ACE2) receptors and also by evoking production of high levels of systemic cytokines, compromising the brain's neurovascular unit, degrading the intestinal barrier, and potentially increasing the permeability of both to harmful substances. Such substances are hypothesized to be produced in the gut by pathogenic microbiota that, given the profound effects COVID-19 has on the gastrointestinal system, may fourish as a result of intestinal post-COVID-19 dysbiosis. COVID-19 may therefore create a scenario in which neurotoxic and neuroinflammatory substances readily proliferate from the gut lumen and encounter a weakened neurovascular unit, gaining access to the brain and subsequently producing cognitive deficits. Here, we review this proposed PACS pathogenesis along the gut-brain axis, while also identifying specific methodologies that are currently available to experimentally measure each individual component of the model.

摘要

约三分之一的非住院2019冠状病毒病(COVID-19)患者在从严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的急性期康复后报告有慢性症状。这种急性后COVID-19综合征(PACS)最持久和常见的一些症状本质上是认知性的,主观上被描述为“脑雾”,客观上也被测量为执行功能、工作记忆、注意力和处理速度方面的缺陷。目前尚不清楚这些慢性认知后遗症的机制。SARS-CoV-2通过与血管紧张素转换酶2(ACE2)受体结合以及引发高水平的全身细胞因子产生,对脑血管和肠壁造成损害,损害大脑的神经血管单元,破坏肠道屏障,并可能增加两者对有害物质的通透性。据推测,这些物质是由致病微生物群在肠道中产生的,鉴于COVID-19对胃肠道系统有深远影响,肠道COVID-19后生态失调可能会导致这些微生物群大量繁殖。因此,COVID-19可能会造成一种情况,即神经毒性和神经炎性物质很容易从肠腔中扩散出来,遇到减弱的神经血管单元,进入大脑并随后导致认知缺陷。在此,我们回顾了这种沿着肠-脑轴提出的PACS发病机制,同时也确定了目前可用于通过实验测量该模型各个单独组成部分的具体方法。

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引用本文的文献

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Gut Microbial Signatures in Long COVID: Potential Biomarkers and Therapeutic Targets.

Infect Dis Ther. 2025-6-1

[2]
SARS-CoV-2 Spike Protein and Long COVID-Part 1: Impact of Spike Protein in Pathophysiological Mechanisms of Long COVID Syndrome.

Viruses. 2025-4-25

[3]
Pediatric SARS-CoV-2 infection and development of anxiety and depression.

Front Pediatr. 2025-3-17

[4]
Acute gastrointestinal and post-acute COVID-19 gastrointestinal syndrome assessment on the Gastrointestinal Symptom Rating Scale scoring system: A questionnaire-based survey.

J Family Med Prim Care. 2024-12

[5]
Pathophysiological, Neuropsychological, and Psychosocial Influences on Neurological and Neuropsychiatric Symptoms of Post-Acute COVID-19 Syndrome: Impacts on Recovery and Symptom Persistence.

Biomedicines. 2024-12-13

[6]
Human microbiome in post-acute COVID-19 syndrome (PACS).

Curr Res Microb Sci. 2024-11-28

[7]
Gut microbe-host interactions in post-COVID syndrome: a debilitating or restorative partnership?

Gut Microbes. 2024

[8]
Mechanisms of Gut-Related Viral Persistence in Long COVID.

Viruses. 2024-8-7

[9]
Diffusion magnetic resonance spectroscopy captures microglial reactivity related to gut-derived systemic lipopolysaccharide: A preliminary study.

Brain Behav Immun. 2024-11

[10]
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本文引用的文献

[1]
Interferon-lambda: New role in intestinal symptoms of COVID-19.

World J Gastroenterol. 2023-4-7

[2]
Severe COVID-19 is associated with molecular signatures of aging in the human brain.

Nat Aging. 2022-12

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Front Neurosci. 2023-3-2

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Role of the microbiota-gut-brain axis in postacute COVID syndrome.

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Cell Host Microbe. 2023-2-8

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Nat Immunol. 2023-2

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