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Các Dấu Hiệu Bệnh Sinh Học Cho Thấy SARS-CoV-2 Mới Nổi Có Thể Tăng Cường Độ Nhạy Cảm Đối Với Sự Thoái Hóa Thần Kinh
Tóm tắt
Cùng với sự xuất hiện của virus corona gây hội chứng hô hấp cấp tính nghiêm trọng 2 (SARS-CoV-2) vào cuối năm 2019, nhiều triệu chứng thần kinh, có liên quan đến sự thay đổi cấu trúc não, đã được báo cáo. Trong bài báo này, chúng tôi cung cấp bằng chứng để thảo luận một cách phê phán về tuyên bố rằng những bệnh nhân sống sót có thể gặp nguy cơ cao hơn mắc các bệnh thoái hóa thần kinh thông qua nhiều cơ chế khác nhau. Virus này có thể xâm nhập trực tiếp vào não thông qua củ khứu giác, vận chuyển trục ngược từ các đầu dây thần kinh ngoại vi hoặc thông qua các con đường huyết học hoặc bạch huyết. Sự lây nhiễm của các tế bào thần kinh cùng với sự kích hoạt tế bào bạch cầu ngoại vi dẫn đến sự gia tăng cytokine pro-inflammatory, khiến cho não bị tổn thương thoái hóa thần kinh. Thêm vào đó, việc virus chiếm giữ enzym chuyển đổi angiotensin 2 (ACE-2) có thể dẫn đến sự giảm hoạt động của ACE-2, yếu tố có tác dụng bảo vệ thần kinh. Hơn nữa, hội chứng suy hô hấp cấp tính (ARDS) và nhiễm trùng huyết tạo ra chứng thiếu oxy và thiếu tưới máu, mà tình trạng này trở nên trầm trọng hơn do trạng thái đông máu thuận lợi và thrombosis vi mạch trong các mạch máu não, dẫn đến căng thẳng oxy hóa và sự thoái hóa thần kinh. Các yếu tố nguy cơ chung cho COVID-19 và các bệnh thoái hóa thần kinh, chẳng hạn như các yếu tố nguy cơ chuyển hóa, thiên hướng di truyền, và ngay cả sự rối loạn hệ vi sinh vật đường ruột, có thể góp phần vào sự gia tăng tần suất của các bệnh thoái hóa thần kinh ở những người sống sót sau COVID-19. Tuy nhiên, cũng cần cân nhắc rằng mức độ nghiêm trọng của nhiễm trùng, mức độ triệu chứng thần kinh và sự tồn tại hậu quả của nhiễm trùng virus là những yếu tố quyết định chính của mối liên hệ này. Quan trọng là, việc đại dịch này có làm tăng tổng thể tần suất mắc bệnh thoái hóa thần kinh hay không vẫn chưa rõ ràng, vì tỷ lệ cao các bệnh nhân bị COVID-19 nặng có thể không sống sót đủ lâu để phát triển các bệnh thoái hóa thần kinh.
Từ khóa
#SARS-CoV-2 #thoái hóa thần kinh #virus #cytokine #hội chứng suy hô hấp cấp tính #di truyền #hệ vi sinh vậtTài liệu tham khảo
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