Destekleyici bir tedavi olarak mast hücre stabilizatörleri COVID-19 enfeksiyonunda ölümcül inflamatuar yanıtları ve pulmoner komplikasyonların şiddetini hafifletmeye katkıda bulunabilir

Year 2020, Issue: Special Issue on COVID 19, 111 - 118, 20.03.2020

Erkan Kılınç , Yasemin Baranoğlu

https://doi.org/10.21673/anadoluklin.720116

Cited By: 11

Abstract

SARS-CoV-2 (COVID-19) 
pulmoner sisteme yerleşerek ciddi akut solunum yetmezliği sendromuna yol
açmaktadır. Mast hücreleri vücutta yaygın dağılım gösteren ve pulmoner sistemde
bol miktarda bulunan çok fonksiyonlu bağışıklık hücreleridir. Mast hücreleri
doğal ve kazanılmış bağışıklıkta ve vücudun bağışıklık homeostazının
sürdürülmesinde sitoplazmik granüllerindeki çeşitli mediyatörler aracılığıyla
hayati bir rol oynamaktadır. COVID-19 enfeksiyonu sırasında pro-inflamatuar
sitokin salınımı ve pnömoni ile karakterize ağır akut solunum yetmezliği
özellikle zayıf veya ilişkili kronik hastalıklardan muzdarip bireylerde ölümle
sonuçlanabilmektedir. Bu derlemede COVID-19 semptomları ve mast hücreleri
arasındaki potansiyel ilişkiyi ve destekleyici bir terapötik seçenek olarak
mast hücre stabilizatörlerinin COVID-19 enfeksiyonunda potansiyel kullanımını
tartışmaya çalıştık.

Mast hücreleri, COVID-19 enfeksiyonu sırasında ölümcül
inflamatuar yanıtları ve pulmoner komplikasyonları tetikleyebilen IL-1, IL-6 ve
TNF-α gibi pro-inflamatuar sitokinlerin ve histamin, prostaglandin-D2 ve
lökotrien-C4 gibi bronkokonstriktör mediyatörlerin ana kaynağıdır. SARS-CoV-2,
mast hücrelerini toll-like reseptörleri aracılığıyla veya  IgE-FcεRI’nın çapraz bağlanmasını
tetikleyerek aktive edebilir ve böylece mast hücrelerinden bu mediyatörlerin
salınımına yol açar.

Mast hücrelerinden bu mediyatörlerin SARS-CoV-2 ile
tetiklenmiş anormal üretimi ve salınımı solunum sisteminde inflamasyonu ve
sonuçta pulmoner komplikasyonları daha fazla kötüleştirebilir. Böylece
destekleyici bir tedavi olarak mast hücre stabilizatörlerinin kullanılması
SARS-CoV-2 enfeksiyonundan ölümleri azaltmak amacıyla inflamatuar yanıtları ve
pulmoner komplikasyonları hafifletmek/iyileştirmek için faydalı olabilir.

Keywords

SARS-CoV-2, COVID-19, mast hücreleri, inflamatuar mediyatörler, mast hücre stabilizatörleri

Mast cell stabilizers as a supportive therapy can contribute to alleviate fatal inflammatory responses and severity of pulmonary complications in COVID-19 infection

Abstract

SARS-CoV-2(COVID-19) leads to severe acute
respiratory syndrome by settling the pulmonary system. Mast cells (MCs) are
multifunctional immune cells that are extensively distributed throughout the
body and mostly present in pulmonary system.

MCs play a vital role in acquired and innate
immunity,  and to maintain immune
homeostasis of the body through a wide range of mediators in their cytoplasmic
granules. Severe acute respiratory syndrome with proinflammatory cytokine
release and pneumonia during COVID-19 infection can result in the death, in
particular in debilitated individuals or those suffering from related chronic
disorders. In this review, we attempt to discuss potential relationship between
COVID-19 symptoms and mast cells as well as potential use of mast cell
stabilizers as a supportive therapeutic option in COVID-19 infection.

MCs are main source of pro-inflammatory
cytokines such as IL-1, IL-6 and TNF-α as well as bronchoconstrictor mediators
such as histamine, prostaglandin-D2 and leukotriene-C4 that can lead to fatal
inflammatory responses and pulmonary complications during COVID-19 infection.
SARS-CoV-2 may activate MCs through toll-like receptors or by inducing the
cross-linking of the IgE-FcεRI, thus leading to release of those mediators.
SARS-CoV-2-induced abnormal production and release of these mediators from MCs
can further exacerbate inflammation in respiratory system, consequently
pulmonary complications.

Therefore administration of MC stabilizers as a
supportive therapy may be useful to alleviate inflammatory responses and
pulmonary complications in order to reduce deaths from SARS-CoV-2 infection.

 

Keywords

SARS-CoV-2, COVID-19, mast cells, inflammatory mediators, mast cell stabilizers

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