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Pathways in the Pathophysiology of Coronavirus 19 Lung Disease Accessible to Prevention and Treatment

DC FieldValueLanguage
dc.contributor.author신재일-
dc.date.accessioned2020-12-01T17:44:29Z-
dc.date.available2020-12-01T17:44:29Z-
dc.date.issued2020-08-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/180420-
dc.description.abstractBackground: In COVID 19 related lung disease, which is a leading cause of death from this disease, cytokines like tumor necrosis factor-alpha (TNF alpha) may be pivotal in the pathogenesis. TNF alpha reduces fluid absorption due to impairment of sodium and chloride transport required for building an osmotic gradient across epithelial cells, which in the airways maintains airway surface liquid helping to keep airways open and enabling bacterial clearance and aids water absorption from the alveolar spaces. TNF alpha can, through Rho-kinase, disintegrate the endothelial and epithelial cytoskeleton, and thus break up intercellular tight junctional proteins, breaching the intercellular barrier, which prevents flooding of the interstitial and alveolar spaces with fluid. Hypotheses: (1) Preservation and restoration of airway and alveolar epithelial sodium and chloride transport and the cytoskeleton dependent integrity of the cell barriers within the lung can prevent and treat COVID 19 lung disease. (2) TNF alpha is the key mediator of pulmonary edema in COVID 19 lung disease. Confirmation of hypothesis and implications: The role of a reduction in the function of epithelial sodium and chloride transport could with regards to chloride transport be tested by analysis of chloride levels in exhaled breath condensate and levels correlated with TNF alpha concentrations. Reduced levels would indicate a reduction of the function of the cystic fibrosis transmembrane conductance regulator (CFTR) chloride channel and a correlation with TNF alpha levels indicative of its involvement. Anti-TNF alpha treatment with antibodies is already available and needs to be tested in randomized controlled trials of COVID 19 lung disease. TNF alpha levels could also be reduced by statins, aspirin, and curcumin. Chloride transport could be facilitated by CFTR activators, including curcumin and phosphodiesterase-5 inhibitors. Sodium and chloride transport could be further regulated to prevent accumulation of alveolar fluid by use of Na(+)/K(+)/2Cl(-) cotransporter type 1 inhibitors, which have been associated with improved outcome in adults ventilated for acute respiratory distress syndrome (ARDS) in randomized controlled trials. Primary prevention of coronavirus infection and TNF alpha release in response to it could be improved by induction of antimicrobial peptides LL-37 and human beta defensin-2 and reduction of TNF alpha production by vitamin D prophylaxis for the population as a whole.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherFrontiers Research Foundation-
dc.relation.isPartOfFRONTIERS IN PHYSIOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titlePathways in the Pathophysiology of Coronavirus 19 Lung Disease Accessible to Prevention and Treatment-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Pediatrics (소아청소년과학교실)-
dc.contributor.googleauthorMichael Eisenhut-
dc.contributor.googleauthorJae Il Shin-
dc.identifier.doi10.3389/fphys.2020.00872-
dc.contributor.localIdA02142-
dc.relation.journalcodeJ02868-
dc.identifier.eissn1664-042X-
dc.identifier.pmid32922301-
dc.subject.keywordNa(+)/K(+)/2Cl(−) cotransporter type 1 cystic fibrosis transmembrane-
dc.subject.keywordacute lung injury-
dc.subject.keywordacute respiratory distress syndrome-
dc.subject.keywordconductance regulator chloride channel-
dc.subject.keywordepithelial sodium channel-
dc.subject.keywordfurosemide-
dc.subject.keywordpulmonary edema-
dc.subject.keywordtumor necrosis factor-
dc.contributor.alternativeNameShin, Jae Il-
dc.contributor.affiliatedAuthor신재일-
dc.citation.volume11-
dc.citation.startPage872-
dc.identifier.bibliographicCitationFRONTIERS IN PHYSIOLOGY, Vol.11 : 872, 2020-08-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers

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