Effects of β-Blockers on the Sympathetic and Cytokines Storms in Covid-19.
Effects of β-Blockers on the Sympathetic and Cytokines Storms in Covid-19.
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DOI：
10.3389/fimmu.2021.749291
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发表时间：
2021
影响因子：
7.3
通讯作者：
Batiha GE
中科院分区：
文献类型：
--
作者：
Al-Kuraishy HM;Al-Gareeb AI;Mostafa-Hedeab G;Kasozi KI;Zirintunda G;Aslam A;Allahyani M;Welburn SC;Batiha GE
严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）是导致2019冠状病毒病（Covid-19）大流行的一种致病病毒。SARS-CoV-2感染的呼吸道表现，如急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS），可导致缺氧、氧化应激和交感神经激活，严重者可导致交感神经风暴（SS）。另一方面，对SARS-CoV-2入侵的过度免疫反应可能导致细胞因子风暴（cytokine storm， CS）中促炎细胞因子的释放失控。在Covid-19中，CS和SS在多器官功能衰竭（MOF）的发展中存在相互作用。有趣的是，通过抗炎和抗肾上腺素能药物切断CS和SS之间的桥梁可能会减轻严重感染Covid-19患者由SARS-CoV-2感染引起的并发症。SS在Covid-19中的潜在机制是通过不同的途径，如缺氧通过颈动脉体化学感觉输入激活中央交感神经中枢，诱导促炎细胞因子穿过血脑屏障激活交感神经中枢。β2受体信号通路在促炎细胞因子的产生、巨噬细胞的活化和b细胞在炎症加重时产生抗体中起着至关重要的作用。β-阻滞剂通过抑制NF-κB，减少促炎细胞因子的释放，具有抗炎作用。总之，β受体阻滞剂通过抑制CS和SS的几种介质阻断这种相互作用，从而阻止SARS-CoV-2感染中神经-细胞因子环的发展。这项研究的证据为未来的前瞻性研究提供了思路，以确认β受体阻滞剂在Covid-19治疗中的潜在作用。
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a causative virus in the development of coronavirus disease 2019 (Covid-19) pandemic. Respiratory manifestations of SARS-CoV-2 infection such as acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) leads to hypoxia, oxidative stress, and sympatho-activation and in severe cases leads to sympathetic storm (SS). On the other hand, an exaggerated immune response to the SARS-CoV-2 invasion may lead to uncontrolled release of pro-inflammatory cytokine development of cytokine storm (CS). In Covid-19, there are interactive interactions between CS and SS in the development of multi-organ failure (MOF). Interestingly, cutting the bridge between CS and SS by anti-inflammatory and anti-adrenergic agents may mitigate complications that are induced by SARS-CoV-2 infection in severely affected Covid-19 patients. The potential mechanisms of SS in Covid-19 are through different pathways such as hypoxia, which activate the central sympathetic center through carotid bodies chemosensory input and induced pro-inflammatory cytokines, which cross the blood-brain barrier and activation of the sympathetic center. β2-receptors signaling pathway play a crucial role in the production of pro-inflammatory cytokines, macrophage activation, and B-cells for the production of antibodies with inflammation exacerbation. β-blockers have anti-inflammatory effects through reduction release of pro-inflammatory cytokines with inhibition of NF-κB. In conclusion, β-blockers interrupt this interaction through inhibition of several mediators of CS and SS with prevention development of neural-cytokine loop in SARS-CoV-2 infection. Evidence from this study triggers an idea for future prospective studies to confirm the potential role of β-blockers in the management of Covid-19.
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影响因子：
5
作者：
Al-Kuraishy HM;Al-Gareeb AI;Almulaiky YQ;Cruz-Martins N;El-Saber Batiha G
通讯作者：
El-Saber Batiha G
影响因子：
5.4
作者：
Changotra, Harish;Jia, Yali;Karst, Stephanie M.
通讯作者：
Karst, Stephanie M.
影响因子：
4.3
作者：
Al-Kuraishy HM;Al-Gareeb AI;Alzahrani KJ;Cruz-Martins N;Batiha GE
通讯作者：
Batiha GE
影响因子：
6.1
作者：
Evans AK;Ardestani PM;Yi B;Park HH;Lam RK;Shamloo M
通讯作者：
Shamloo M
影响因子：
1.2
作者：
Ammar MA;Hussein NS
通讯作者：
Hussein NS