Article ; Online: Phosphatidylserine inside out: a possible underlying mechanism in the inflammation and coagulation abnormalities of COVID-19.
Cell communication and signaling : CCS
2020 Volume 18, Issue 1, Page(s) 190
Abstract: The rapid ability of SARS-CoV-2 to spread among humans, along with the clinical complications of coronavirus disease 2019-COVID-19, have represented a significant challenge to the health management systems worldwide. The acute inflammation and ... ...
| Abstract | The rapid ability of SARS-CoV-2 to spread among humans, along with the clinical complications of coronavirus disease 2019-COVID-19, have represented a significant challenge to the health management systems worldwide. The acute inflammation and coagulation abnormalities appear as the main causes for thousands of deaths worldwide. The intense inflammatory response could be involved with the formation of thrombi. For instance, the presence of uncleaved large multimers of von Willebrand (vWF), due to low ADAMTS13 activity in plasma could be explained by the inhibitory action of pro-inflammatory molecules such as IL-1β and C reactive protein. In addition, the damage to endothelial cells after viral infection and/or activation of endothelium by pro-inflammatory cytokines, such as IL-1β, IL-6, IFN-γ, IL-8, and TNF-α induces platelets and monocyte aggregation in the vascular wall and expression of tissue factor (TF). The TF expression may culminate in the formation of thrombi, and activation of cascade by the extrinsic pathway by association with factor VII. In this scenario, the phosphatidylserine-PtdSer exposure on the outer leaflet of the cell membrane as consequence of viral infection emerges as another possible underlying mechanism to acute immune inflammatory response and activation of coagulation cascade. The PtdSer exposure may be an important mechanism related to ADAM17-mediated ACE2, TNF-α, EGFR and IL-6R shedding, and the activation of TF on the surface of infected endothelial cells. In this review, we address the underlying mechanisms involved in the pathophysiology of inflammation and coagulation abnormalities. Moreover, we introduce key biochemical and pathophysiological concepts that support the possible participation of PtdSer exposure on the outer side of the SARS-CoV-2 infected cells membrane, in the pathophysiology of COVID-19. Video Abstract. |
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| MeSH term(s) | ADAM17 Protein/genetics ; ADAMTS13 Protein/genetics ; COVID-19/complications ; COVID-19/genetics ; COVID-19/pathology ; COVID-19/virology ; Endothelial Cells/virology ; Humans ; Inflammation/complications ; Inflammation/genetics ; Inflammation/virology ; Phosphatidylserines/genetics ; Phosphatidylserines/metabolism ; Receptors, Interleukin-6/genetics ; SARS-CoV-2/pathogenicity ; Thrombosis/genetics ; Thrombosis/pathology ; Thrombosis/virology ; von Willebrand Factor/genetics |
| Chemical Substances | IL6R protein, human ; Phosphatidylserines ; Receptors, Interleukin-6 ; von Willebrand Factor ; ADAM17 Protein (EC 3.4.24.86) ; ADAM17 protein, human (EC 3.4.24.86) ; ADAMTS13 Protein (EC 3.4.24.87) |
| Language | English |
| Publishing date | 2020-12-27 |
| Publishing country | England |
| Document type | Journal Article ; Review |
| ZDB-ID | 2126315-2 |
| ISSN | 1478-811X ; 1478-811X |
| ISSN (online) | 1478-811X |
| ISSN | 1478-811X |
| DOI | 10.1186/s12964-020-00687-7 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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