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长新冠:当前的发病机制观点和治疗展望。

Long Neuro-COVID-19: Current Mechanistic Views and Therapeutic Perspectives.

机构信息

Sorbonne Université, INSERM U938, Biology and Cancer Therapeutics, Centre de Recherche Saint Antoine, Saint Antoine Hospital, 75231 Paris, France.

Sorbonne Université, CNRS UMR 7238, Laboratoire de Biologie Computationnelle et Quantitative, Institut de Biologie Paris-Seine, 75005 Paris, France.

出版信息

Biomolecules. 2024 Aug 28;14(9):1081. doi: 10.3390/biom14091081.


DOI:10.3390/biom14091081
PMID:39334847
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11429791/
Abstract

Long-lasting COVID-19 (long COVID) diseases constitute a real life-changing burden for many patients around the globe and, overall, can be considered societal and economic issues. They include a variety of symptoms, such as fatigue, loss of smell (anosmia), and neurological-cognitive sequelae, such as memory loss, anxiety, brain fog, acute encephalitis, and stroke, collectively called long neuro-COVID-19 (long neuro-COVID). They also include cardiopulmonary sequelae, such as myocardial infarction, pulmonary damage, fibrosis, gastrointestinal dysregulation, renal failure, and vascular endothelial dysregulation, and the onset of new diabetes, with each symptom usually being treated individually. The main unmet challenge is to understand the mechanisms of the pathophysiologic sequelae, in particular the neurological symptoms. This mini-review presents the main mechanistic hypotheses considered to explain the multiple long neuro-COVID symptoms, namely immune dysregulation and prolonged inflammation, persistent viral reservoirs, vascular and endothelial dysfunction, and the disruption of the neurotransmitter signaling along various paths. We suggest that the nucleoprotein N of SARS-CoV-2 constitutes a "hub" between the virus and the host inflammation, immunity, and neurotransmission.

摘要

长期 COVID-19(长新冠)疾病给全球许多患者带来了真正改变生活的负担,总体而言,可被视为社会和经济问题。它们包括各种症状,如疲劳、嗅觉丧失(嗅觉障碍)和神经认知后遗症,如记忆力减退、焦虑、脑雾、急性脑炎和中风,统称为长新冠神经后遗症(long neuro-COVID)。它们还包括心肺后遗症,如心肌梗死、肺部损伤、纤维化、胃肠道失调、肾衰竭和血管内皮失调,以及新发糖尿病的发作,每种症状通常都需要单独治疗。主要的未满足的挑战是了解病理生理后遗症的机制,特别是神经症状。这篇迷你综述提出了被认为可以解释多种长新冠神经症状的主要机制假说,即免疫失调和持续炎症、持续存在的病毒储库、血管和内皮功能障碍以及沿着各种途径破坏神经递质信号传递。我们认为,SARS-CoV-2 的核蛋白 N 构成了病毒与其宿主炎症、免疫和神经传递之间的“枢纽”。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a62/11429791/5d4deeae9920/biomolecules-14-01081-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a62/11429791/ede2c789e556/biomolecules-14-01081-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a62/11429791/5d4deeae9920/biomolecules-14-01081-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a62/11429791/ede2c789e556/biomolecules-14-01081-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a62/11429791/5d4deeae9920/biomolecules-14-01081-g002.jpg

相似文献

[1]
Long Neuro-COVID-19: Current Mechanistic Views and Therapeutic Perspectives.

Biomolecules. 2024-8-28

[2]
Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC).

Elife. 2023-3-22

[3]
Neurological Sequelae of COVID-19.

J Integr Neurosci. 2022-4-6

[4]
Plasma proteomics show altered inflammatory and mitochondrial proteins in patients with neurologic symptoms of post-acute sequelae of SARS-CoV-2 infection.

Brain Behav Immun. 2023-11

[5]
The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 infection.

Curr Neurol Neurosci Rep. 2021-6-28

[6]
Neuro-molecular perspectives on long COVID-19 impacted cerebrovascular diseases - a role for dipeptidyl peptidase IV.

Exp Neurol. 2024-10

[7]
Long COVID brain fog and muscle pain are associated with longer time to clearance of SARS-CoV-2 RNA from the upper respiratory tract during acute infection.

Front Immunol. 2023

[8]
Mid and long-term neurological and neuropsychiatric manifestations of post-COVID-19 syndrome: A meta-analysis.

J Neurol Sci. 2022-3-15

[9]
EuCARE-POSTCOVID Study: a multicentre cohort study on long-term post-COVID-19 manifestations.

BMC Infect Dis. 2023-10-13

[10]
SARS CoV-2 related microvascular damage and symptoms during and after COVID-19: Consequences of capillary transit-time changes, tissue hypoxia and inflammation.

Physiol Rep. 2021-2

引用本文的文献

[1]
Validity of the test for attentional performance in neurological post-COVID condition.

Sci Rep. 2025-7-7

[2]
The Molecular Mechanisms of Cognitive Dysfunction in Long COVID: A Narrative Review.

Int J Mol Sci. 2025-5-26

[3]
Hyperthermia and targeting heat shock proteins: innovative approaches for neurodegenerative disorders and Long COVID.

Front Neurosci. 2025-2-4

本文引用的文献

[1]
Identification of risk factors of Long COVID and predictive modeling in the RECOVER EHR cohorts.

Commun Med (Lond). 2024-7-11

[2]
Delta opioid peptide [D-ala2, D-leu5]-Enkephalin's ability to enhance mitophagy via TRPV4 to relieve ischemia/reperfusion injury in brain microvascular endothelial cells.

Stroke Vasc Neurol. 2025-2-25

[3]
A Cholecystokinin Analogue Ameliorates Cognitive Deficits and Regulates Mitochondrial Dynamics via the AMPK/Drp1 Pathway in APP/PS1 Mice.

J Prev Alzheimers Dis. 2024

[4]
SARS-CoV-2 nucleocapsid protein, rather than spike protein, triggers a cytokine storm originating from lung epithelial cells in patients with COVID-19.

Infection. 2024-6

[5]
SARS-CoV-2 nucleocapsid protein enhances the level of mitochondrial reactive oxygen species.

J Med Virol. 2023-12

[6]
SARS-CoV-2 N protein induced acute kidney injury in diabetic db/db mice is associated with a Mincle-dependent M1 macrophage activation.

Front Immunol. 2023

[7]
The SARS-CoV-2 spike glycoprotein interacts with MAO-B and impairs mitochondrial energetics.

Curr Res Neurobiol. 2023-10-6

[8]
Substance P, NPY, CCK and their receptors in five brain regions in major depressive disorder with transcriptomic analysis of locus coeruleus neurons.

Eur Neuropsychopharmacol. 2024-1

[9]
Serotonin reduction in post-acute sequelae of viral infection.

Cell. 2023-10-26

[10]
SARS-CoV-2 reservoir in post-acute sequelae of COVID-19 (PASC).

Nat Immunol. 2023-10

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