A comprehensive review on current understanding of bradykinin in COVID-19 and inflammatory diseases

Rex, Devasahayam Arokia Balaya; Vaid, Neelanchal; Deepak, K; Dagamajalu, Shobha; Prasad, T. S. Keshava

doi:10.1007/s11033-022-07539-2

Cited by 21 publications

(28 citation statements)

References 141 publications

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“…Hence, bradykinin and cytokine storms might be associated with worse outcomes in COVID-19. Therefore, mediating these pathways may lead to better symptom-relieving (Rex et al, 2022). Noscapine is considered a safe candidate with the potential benefits of modulating both pathways (Luo et al, 2020;Kumar et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of noscapine-licorice combination effects on cough relieving in COVID-19 outpatients: A randomized controlled trial

Barati

Feizabadi²,

Khalaj³

et al. 2023

Front. Pharmacol.

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Background: As February 2023, SARS-CoV-2 is still infecting people and children worldwide. Cough and dyspnea are annoying symptoms almost present in a large proportion of COVID-19 outpatients, and the duration of these symptoms might be long enough to affect the patients’ quality of life. Studies have shown positive effects for noscapine plus licorice in the previous COVID-19 trials. This study aimed to assess the effects of the combination of noscapine and licorice-for relieving cough in outpatients with COVID-19.Methods: This randomized controlled trial was conducted on 124 patients at the Dr. Masih Daneshvari Hospital. Participants over 18 years of age with confirmed COVID-19 and cough were allowed to enter the study if the onset of symptoms was less than 5 days. The primary outcome was to assess the response to treatment over 5 days using the visual analogue scale. Secondary outcomes included the assessment of cough severity after 5 days using Cough Symptom Score, as well as the cough-related quality of life and dyspnea relieving. Patients in the noscapine plus licorice group received Noscough® syrup 20 mL every 6 h for 5 days. The control group received diphenhydramine elixir 7 mL every 8 h.Results: By day five, 53 (85.48%) patients in the Noscough® group and 49 (79.03%) patients in the diphenhydramine group had response to treatment. This difference was not statistically significant (p-value = 0.34). The presence of dyspnea was significantly lower in the Noscough® group versus diphenhydramine at day five (1.61% in the Noscough® group vs. 12.9% in the diphenhydramine group; p-value = 0.03). The cough-related quality of life and severity also significantly favored Noscough® syrup (p-values <0.001).Conclusion: Noscapine plus licorice syrup was slightly superior to diphenhydramine in relieving cough symptoms and dyspnea in the COVID-19 outpatients. The severity of cough and cough-related quality of life were also significantly better in the noscapine plus licorice syrup. Noscapine plus licorice may be a valuable treatment in relieving cough in COVID-19 outpatients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of noscapine-licorice combination effects on cough relieving in COVID-19 outpatients: A randomized controlled trial

Barati

Feizabadi²,

Khalaj³

et al. 2023

Front. Pharmacol.

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“…Bradykinin, a member of the kallikrein-kinin system (KKS), acts as a vasodilator and inflammatory mediator in various signal cascades, mediating a variety of vascular permeability functions such as thrombosis and coagulation ( Costa-Neto et al., 2008 ). Signal transduction is induced by coupling the transmembrane receptors of kinetin B1 and B2 with different subunits of G protein ( Rex et al., 2022 ). The formation and regulation of bradykinin is initiated by the activation of coagulation factor XII ( Alfaro et al., 2022 ).…”

Section: Cytokine Storms—an Imbalance Of Proinflammatory Cytokines Af...mentioning

confidence: 99%

Immune response induced by novel coronavirus infection

Sun

Zou

et al. 2022

Front. Cell. Infect. Microbiol.

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The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus (SARS-CoV)-2 has been prominent around the world since it was first discovered, affecting more than 100 million people. Although the symptoms of most infected patients are not serious, there is still a considerable proportion of patients who need hospitalization and even develop fatal symptoms such as cytokine storms, acute respiratory distress syndrome and so on. Cytokine storm is usually described as a collection of clinical manifestations caused by overactivation of the immune system, which plays an important role in tissue injury and multiorgan failure. The immune system of healthy individuals is composed of two interrelated parts, the innate immune system and the adaptive immune system. Innate immunity is the body’s first line of defense against viruses; it can quickly perceive viruses through pattern recognition receptors and activate related inflammatory pathways to clear pathogens. The adaptive immune system is activated by specific antigens and is mainly composed of CD4+ T cells, CD8+ T cells and B cells, which play different roles in viral infection. Here, we discuss the immune response after SARS-CoV-2 infection. In-depth study of the recognition of and response of innate immunity and adaptive immunity to SARS-CoV-2 will help to prevent the development of critical cases and aid the exploration of more targeted treatments.

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“…SARS-CoV-2 disrupt the renin-angiotensin–aldosterone system (RAAS) and KKS, leading to the bradykinin storm, a response associated with increased expression of bradykinin and of its resulting downstream mediated effects. In such a condition, bradykinin is at the center of many important symptoms of COVID-19, such as leaky blood vessels, loss of sense of taste and smell, organs abnormal coagulation, and fluid accumulation in tissues ( Rex et al, 2022 ).…”

Section: Covid-19 Immune Function Diabetes and Obesitymentioning

confidence: 99%

Leukocyte metabolism in obese type 2 diabetic individuals associated with COVID-19 severity

et al. 2022

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Recent studies show that the metabolic characteristics of different leukocytes, such as, lymphocytes, neutrophils, and macrophages, undergo changes both in the face of infection with SARS-CoV-2 and in obesity and type 2 diabetes mellitus (DM2) condition. Thus, the objective of this review is to establish a correlation between the metabolic changes caused in leukocytes in DM2 and obesity that may favor a worse prognosis during SARS-Cov-2 infection. Chronic inflammation and hyperglycemia, specific and usual characteristics of obesity and DM2, contributes for the SARS-CoV-2 replication and metabolic disturbances in different leukocytes, favoring the proinflammatory response of these cells. Thus, obesity and DM2 are important risk factors for pro-inflammatory response and metabolic dysregulation that can favor the occurrence of the cytokine storm, implicated in the severity and high mortality risk of the COVID-19 in these patients.

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A comprehensive review on current understanding of bradykinin in COVID-19 and inflammatory diseases

Cited by 21 publications

References 141 publications

Evaluation of noscapine-licorice combination effects on cough relieving in COVID-19 outpatients: A randomized controlled trial

Evaluation of noscapine-licorice combination effects on cough relieving in COVID-19 outpatients: A randomized controlled trial

Immune response induced by novel coronavirus infection

Leukocyte metabolism in obese type 2 diabetic individuals associated with COVID-19 severity

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