Clinical Features and Pathogenic Mechanisms of Gastrointestinal Injury in COVID-19

Mitsuyama, Keiichi; Tsuruta, Kozo; Takedatsu, Hidetoshi; Yoshioka, Shinichiro; Morita, Masaru; Niwa, Masao; Matsumoto, Satoshi

doi:10.3390/jcm9113630

Cited by 19 publications

(21 citation statements)

References 107 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings that SP is distributed to the salivary glands, may support suggestions that these glands are a potential reservoir of SAR-CoV-2, which may lead to parotitislike syndrome [105,106]. Interestingly, within the gastro-intestinal tract, blood-borne SP-NIRF was mostly located at the duodenum [27,28,56,107,108]. The intestine expresses ACE2 and this has been suggested to contribute to COVID-19-related gastrointestinal tract effects [27,28,56,108].…”

Section: Sp Biodistribution From Blood To Peripheral Organssupporting

confidence: 82%

See 1 more Smart Citation

Spike protein multiorgan tropism suppressed by antibodies targeting SARS-CoV-2

Brady

Combs

Venkatraman

et al. 2021

Preprint

View full text Add to dashboard Cite

While there is clinical evidence of severe acute respiratory syndrome coronavirus 2 multiorgan tropism in severely infected coronavirus 19 patients, it is unclear if there is differential multiorgan biodistribution and organ uptake in healthy young individuals, a group that usually has asymptomatic to moderate coronavirus 19 symptoms. In addition, for antibody therapies and vaccines that target the spike protein, it is unclear if these reduce severe acute respiratory syndrome coronavirus 2 or spike protein multiorgan tropism equally. We used fluorescently labeled spike protein near infrared fluorescence to study viral behavior, using an in vivo dynamic imaging system, in young mice. We found a spike protein body-wide biodistribution followed by a slow regional elimination, except for the liver, which showed an accumulation. Spike protein uptake was highest for the lungs, and this was followed by kidney, heart and liver, but, unlike the choroid plexus, it was not detected in the brain parenchyma or cerebrospinal fluid. Thus, the brain vascular barriers were effective in restricting the entry of spike protein into brain parenchyma in young healthy mice. While both anti-angiotensin converting enzyme 2 and anti-spike protein antibodies suppressed spike protein biodistribution and organ uptake, anti-spike protein antibody was more effective. By extension, our data support the efficacy of these antibodies on severe acute respiratory syndrome coronavirus 2 biodistribution kinetics and multiorgan tropism that could determine coronavirus 19 organ-specific outcomes.

show abstract

Section: Sp Biodistribution From Blood To Peripheral Organssupporting

confidence: 82%

“…Interestingly, within the gastro-intestinal tract, blood-borne SP-NIRF was mostly located at the duodenum [27,28,56,107,108]. The intestine expresses ACE2 and this has been suggested to contribute to COVID-19-related gastrointestinal tract effects [27,28,56,108].…”

Section: Sp Biodistribution From Blood To Peripheral Organsmentioning

confidence: 99%

Spike protein multiorgan tropism suppressed by antibodies targeting SARS-CoV-2

Brady

Combs

Venkatraman

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…As described previously, the absorption of tryptophan is associated with neurological abnormities, as it is the precursor for the synthesis of 5-hydroxytryptophan in the brain[ 103 ]. It also regulates the levels of antimicrobial peptides that affect the composition of the gut microbiota, leading to increased sensitivity to intestinal inflammation and epithelial dysfunction[ 106 ]. Thus, this viral infection might affect the homeostasis of the gut-brain axis through the intestinal microbiota[ 103 , 107 ].…”

Section: Mechanisms Of Gi Tract Involvementmentioning

confidence: 99%

COVID-19 and the digestive system: A comprehensive review

Wang¹,

Yue²,

Cai³

et al. 2021

WJCC

View full text Add to dashboard Cite

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is spreading at an alarming rate, and it has created an unprecedented health emergency threatening tens of millions of people worldwide. Previous studies have indicated that SARS-CoV-2 ribonucleic acid could be detected in the feces of patients even after smear-negative respiratory samples. However, demonstration of confirmed fecal-oral transmission has been difficult. Clinical studies have shown an incidence rate of gastrointestinal (GI) symptoms ranging from 2% to 79.1% in patients with COVID-19. They may precede or accompany respiratory symptoms. The most common GI symptoms included nausea, diarrhea, and abdominal pain. In addition, some patients also had liver injury, pancreatic damage, and even acute mesenteric ischemia/thrombosis. Although the incidence rates reported in different centers were quite different, the digestive system was the clinical component of the COVID-19 section. Studies have shown that angiotensin-converting enzyme 2, the receptor of SARS-CoV-2, was not only expressed in the lungs, but also in the upper esophagus, small intestine, liver, and colon. The possible mechanism of GI symptoms in COVID-19 patients may include direct viral invasion into target cells, dysregulation of angiotensin-converting enzyme 2, immune-mediated tissue injury, and gut dysbiosis caused by microbiota. Additionally, numerous experiences, guidelines, recommendations, and position statements were published or released by different organizations and societies worldwide to optimize the management practice of outpatients, inpatients, and endoscopy in the era of COVID-19. In this review, based on our previous work and relevant literature, we mainly discuss potential fecal-oral transmission, GI manifestations, abdominal imaging findings, relevant pathophysiological mechanisms, and infection control and prevention measures in the time of COVID-19.

show abstract

“… 56 As a consequence, the conversion of Ang II to Ang-(1–7) is decreased, reducing the anti-inflammatory effects mediated by the Mas receptor. 57 , 58 In addition, the binding of Ang II to AT1R is increased relative to its binding to AT2R, thereby leading to a higher production of pro-inflammatory cytokines. 57 After endocytosis, SARS-CoV-2 per se triggers the production of pro-inflammatory cytokines via PAK-1 and AP-1.…”

Section: Introductionmentioning

confidence: 99%

“… 57 , 58 In addition, the binding of Ang II to AT1R is increased relative to its binding to AT2R, thereby leading to a higher production of pro-inflammatory cytokines. 57 After endocytosis, SARS-CoV-2 per se triggers the production of pro-inflammatory cytokines via PAK-1 and AP-1. 59 , 60 Zinc deficiency, in turn, affects the tight junction, while reducing the maintenance of Paneth cells via an impaired action of zinc transporters (eg, ZIP4 and ZIP7).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic supplementation with zinc in the management of COVID-19–related diarrhea and ageusia/dysgeusia: mechanisms and clues for a personalized dosage regimen

Santos

2021

Nutrition Reviews

View full text Add to dashboard Cite

Zinc supplementation is indicated for diarrhea and taste disorders, which are both features of COVID-19. Nevertheless, this strategy has not been tested for the treatment of these secondary complications in the current pandemic. Through an updated review, a practical appraisal was considered as a means of providing a medical nexus of therapeutic zinc regimens as an adjunct in the management of COVID-19–related diarrhea and ageusia/dysgeusia. While diarrhea and taste disorders are consequences of COVID-19, zinc supplementation is useful for non–COVID-19 patients with these clinical problems. The overwhelming evidence for supplementing with zinc in diarrhea and pneumonia is associated with the treatment of children, while for taste disorders the use of supplementing with zinc is more examined in adults. Whereas COVID-19 is more prevalent in adults, precautions should be exercised not to translate the zinc dosage used for children with diarrhea and taste disorders into the current pandemic. Therapeutic doses of zinc used for adults (∼50–150 mg/day of elemental zinc) could be included in the treatment strategies for COVID-19, but this proposal should be examined through randomized studies.

show abstract

Clinical Features and Pathogenic Mechanisms of Gastrointestinal Injury in COVID-19

Cited by 19 publications

References 107 publications

Spike protein multiorgan tropism suppressed by antibodies targeting SARS-CoV-2

Spike protein multiorgan tropism suppressed by antibodies targeting SARS-CoV-2

COVID-19 and the digestive system: A comprehensive review

Therapeutic supplementation with zinc in the management of COVID-19–related diarrhea and ageusia/dysgeusia: mechanisms and clues for a personalized dosage regimen

Contact Info

Product

Resources

About