Understanding COVID-19 Pandemic: Molecular Mechanisms and Potential Therapeutic Strategies. An Evidence-Based Review

Hanna, Reem; Dalvi, Snehal; Sălăgean, Tudor; Pop, Ioana; Bordea, Ioana Roxana; Benedicenti, Stefano

doi:10.2147/jir.s282213

Cited by 37 publications

(38 citation statements)

References 160 publications

(293 reference statements)

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“…To counteract the detrimental effects of various proinflammatory cytokines, biological therapy is used in selected patient groups. IL-6 and IL-6 receptor inhibitors, such as tocilizumab, sarilumab and siltuximab, represent another class of drugs that often cause diarrhea[ 107 ]. Although enteral feeding has well- established, clear advantages over parenteral nutrition[ 108 ], adverse events, like diarrhea, may develop.…”

Section: Virus-independent Causes Of Covid-19-associated Diarrheamentioning

confidence: 99%

COVID-19-associated diarrhea

Megyeri

Dernovics

Al-Luhaibi

et al. 2021

WJG

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recently emerged as a highly virulent respiratory pathogen that is known as the causative agent of coronavirus disease 2019 (COVID-19). Diarrhea is a common early symptom in a significant proportion of patients with SARS-CoV-2 infection. SARS-CoV-2 can infect and replicate in esophageal cells and enterocytes, leading to direct damage to the intestinal epithelium. The infection decreases the level of angiotensin-converting enzyme 2 receptors, thereby altering the composition of the gut microbiota. SARS-CoV-2 elicits a cytokine storm, which contributes to gastrointestinal inflammation. The direct cytopathic effects of SARS-CoV-2, gut dysbiosis, and aberrant immune response result in increased intestinal permeability, which may exacerbate existing symptoms and worsen the prognosis. By exploring the elements of pathogenesis, several therapeutic options have emerged for the treatment of COVID-19 patients, such as biologics and biotherapeutic agents. However, the presence of SARS-CoV-2 in the feces may facilitate the spread of COVID-19 through fecal-oral transmission and contaminate the environment. Thus gastrointestinal SARS-CoV-2 infection has important epidemiological significance. The development of new therapeutic and preventive options is necessary to treat and restrict the spread of this severe and widespread infection more effectively. Therefore, we summarize the key elements involved in the pathogenesis and the epidemiology of COVID-19-associated diarrhea.

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Section: Virus-independent Causes Of Covid-19-associated Diarrheamentioning

confidence: 99%

COVID-19-associated diarrhea

Megyeri

Dernovics

Al-Luhaibi

et al. 2021

WJG

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“…EVs are playing significant role in spread and viral infection through delivering biomolecules to the recipient cells. Therefore it is necessary to develop technologies for exosome biogenesis and uptake, exosome-therapy, exosome-based drug delivery system, and exosome- based vaccine ( 217 ). Several studies are documented that EVs can reduce the inflammatory response in the lung, regenerate and repair the damaged alveolar epithelium and endothelium, and prevent pulmonary fibrosis.…”

Section: Role Mechanism and Management Of Exosomes In Treatment Of Sars-cov-2 Infected Patientsmentioning

confidence: 99%

Diverse Effects of Exosomes on COVID-19: A Perspective of Progress From Transmission to Therapeutic Developments

2021

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new strain of coronavirus and the causative agent of the current global pandemic of coronavirus disease 2019 (COVID-19). There are currently no FDA-approved antiviral drugs for COVID-19 and there is an urgent need to develop treatment strategies that can effectively suppress SARS-CoV-2 infection. Numerous approaches have been researched so far, with one of them being the emerging exosome-based therapies. Exosomes are nano-sized, lipid bilayer-enclosed structures, share structural similarities with viruses secreted from all types of cells, including those lining the respiratory tract. Importantly, the interplay between exosomes and viruses could be potentially exploited for antiviral drug and vaccine development. Exosomes are produced by virus-infected cells and play crucial roles in mediating communication between infected and uninfected cells. SARS-CoV-2 modulates the production and composition of exosomes, and can exploit exosome formation, secretion, and release pathways to promote infection, transmission, and intercellular spread. Exosomes have been exploited for therapeutic benefits in patients afflicted with various diseases including COVID-19. Furthermore, the administration of exosomes loaded with immunomodulatory cargo in combination with antiviral drugs represents a novel intervention for the treatment of diseases such as COVID-19. In particular, exosomes derived from mesenchymal stem cells (MSCs) are used as cell-free therapeutic agents. Mesenchymal stem cell derived exosomes reduces the cytokine storm and reverse the inhibition of host anti-viral defenses associated with COVID-19 and also enhances mitochondrial function repair lung injuries. We discuss the role of exosomes in relation to transmission, infection, diagnosis, treatment, therapeutics, drug delivery, and vaccines, and present some future perspectives regarding their use for combating COVID-19.

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“…True multi-target activity is thought to be the foundation for pharmacological polypharmacology, which is induced by simultaneous in vivo interactions with numerous targets [ 289 , 290 , 291 ]. Due to the presence of many channels of viral transmission, various mechanisms of virus impact on immune regulation and antiviral protection, and the multifactorial nature of COVID-19 disease pathogenesis, polypharmacology may be effective in the treatment of COVID-19 [ 292 ].…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

Problems of Pathogenesis and Pathogenetic Therapy of COVID-19 from the Perspective of the General Theory of Pathological Systems (General Pathological Processes)

Гусев

Sarapultsev

et al. 2021

IJMS

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The COVID-19 pandemic examines not only the state of actual health care but also the state of fundamental medicine in various countries. Pro-inflammatory processes extend far beyond the classical concepts of inflammation. They manifest themselves in a variety of ways, beginning with extreme physiology, then allostasis at low-grade inflammation, and finally the shockogenic phenomenon of “inflammatory systemic microcirculation”. The pathogenetic core of critical situations, including COVID-19, is this phenomenon. Microcirculatory abnormalities, on the other hand, lie at the heart of a specific type of general pathological process known as systemic inflammation (SI). Systemic inflammatory response, cytokine release, cytokine storm, and thrombo-inflammatory syndrome are all terms that refer to different aspects of SI. As a result, the metabolic syndrome model does not adequately reflect the pathophysiology of persistent low-grade systemic inflammation (ChSLGI). Diseases associated with ChSLGI, on the other hand, are risk factors for a severe COVID-19 course. The review examines the role of hypoxia, metabolic dysfunction, scavenger receptors, and pattern-recognition receptors, as well as the processes of the hemophagocytic syndrome, in the systemic alteration and development of SI in COVID-19.

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Understanding COVID-19 Pandemic: Molecular Mechanisms and Potential Therapeutic Strategies. An Evidence-Based Review

Cited by 37 publications

References 160 publications

COVID-19-associated diarrhea

COVID-19-associated diarrhea

Diverse Effects of Exosomes on COVID-19: A Perspective of Progress From Transmission to Therapeutic Developments

Problems of Pathogenesis and Pathogenetic Therapy of COVID-19 from the Perspective of the General Theory of Pathological Systems (General Pathological Processes)

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