Obesity and the metabolic syndrome (MetS), which have reached pandemic proportions significantly increase the risk for type 2 diabetes, cardiovascular disease, and other serious conditions. Recent data with COVID-19 patients indicate that obesity also is a significant risk factor for this novel viral disease and poor outcome of associated critical illness. These findings considerably change the view of obesity as a driver of serious, but slowly-progressing chronic diseases, and emphasize the urgency to explore new therapeutic approaches. Inflammation is a recognized driver of metabolic derangements in obesity and MetS, and a core feature of COVID-19 pathobiology. Recent advances in our understanding of inflammatory regulation have highlighted the role of the nervous system and the vagus nerve-based inflammatory reflex. Current bioelectronic and pharmacological therapeutic explorations centered on the inflammatory reflex offer new approaches for conditions characterized by immune and metabolic dysregulation and for ameliorating the escalating burden of obesity, MetS, and COVID-19.
【저자키워드】 COVID-19, Inflammation, obesity, COVID-19, Coronavirus disease 2019, metabolic syndrome, ARDS, acute respiratory distress syndrome, IL, interleukin, BMI, Body mass index, ICU, Intensive care unit, ACh, Acetylcholine, TNF, Tumor Necrosis Factor, GI, gastrointestinal, SARS-COV-2, severe acute respiratory syndrome coronavirus-2, MERS-CoV, Middle East Respiratory Syndrome Corona Virus, IBD, Inflammatory bowel disease, NF-κB, Nuclear Factor kappa B, LPS, lipopolysaccharide, MetS, metabolic syndrome, TLR, toll-like receptors, HRV, heart rate variability, The inflammatory reflex, Bioelectronic medicine, AChE, acetylcholinesterase, α7nAChR, alpha 7 nicotinic acetylcholine receptor, DMN, dorsal motor nucleus of the vagus, ChAT, choline acetyltransferase, HDL-C, high density lipoprotein-cholesterol, JAK2/STAT3, Janus kinase 2/signal transducer and activator of transcription 3, mAChR, muscarinic acetylcholine receptor, NA, nucleus ambiguus, NAFLD, non-alcoholic fatty liver disease, NASH, non-alcoholic steatohepatitis, NLRP3, NLRs nucleotide-binding oligomerization domain (NOD)-like receptors nucleotide-binding oligomerization domain-like receptor family pyrin domain containing-3, NTS, nucleus tractus solitarius, SARS-CoV, severe acute respiratory syndrome CoV, VNS, vagus nerve stimulation,