Why is SARS-CoV-2 infection more severe in obese men? The gut lymphatics - Lung axis hypothesis.
COVID-19
/ complications
Critical Care
Cytokines
/ metabolism
Gastrointestinal Microbiome
Humans
Immune System
Inflammation
Intensive Care Units
Intra-Abdominal Fat
/ pathology
Ischemia
/ pathology
Lung
/ physiopathology
Lymphatic System
/ physiopathology
Male
Metabolic Syndrome
/ immunology
Models, Theoretical
Obesity
/ complications
Overweight
/ complications
Permeability
Risk Factors
Systemic Inflammatory Response Syndrome
/ immunology
Journal
Medical hypotheses
ISSN: 1532-2777
Titre abrégé: Med Hypotheses
Pays: United States
ID NLM: 7505668
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
05
06
2020
accepted:
19
06
2020
pubmed:
1
7
2020
medline:
6
1
2021
entrez:
29
6
2020
Statut:
ppublish
Résumé
Consistent observations report increased severity of SARS-CoV-2 infection in overweight men with cardiovascular factors. As the visceral fat possesses an intense immune activity, is involved in metabolic syndrome and is at the crossroad between the intestines, the systemic circulation and the lung, we hypothesized that it plays a major role in severe forms of SARS-CoV-2 infection. SARS-CoV2 presents the ability to infect epithelial cells of the respiratory tract as well as the intestinal tract. Several factors may increase intestinal permeability including direct enterocyte damage by SARS-CoV2, systemic inflammatory response syndrome (SIRS) and epithelial ischemia secondary to SARS-CoV2- associated endothelial dysfunction. This increase permeability further leads to translocation of microbial components such as MAMPs (microbial-associated molecular pattern), triggering an inflammatory immune response by TLR-expressing cells of the mesentery fat (mostly macrophages and adipocytes). The pro-inflammatory cytokines produced by the mesentery fat mediates systemic inflammation and aggravate acute respiratory distress syndrome (ARDS) through the mesenteric lymph drainage.
Identifiants
pubmed: 32593832
pii: S0306-9877(20)31666-2
doi: 10.1016/j.mehy.2020.110023
pmc: PMC7308746
pii:
doi:
Substances chimiques
Cytokines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
110023Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
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