Abstract
Sars Cov-2, the pathogen which belongs to the beta coronavirus family that is responsible for COVID-19, uses Angiotensin Converting Enzyme 2 (ACE2) as a receptor, which is responsible for controlling the actions of renin-angiotensin system (RAS). Sars Cov-2 – ACE2 binding leads to a RAS mediated immune response, which targets especially lungs to form ARDS, which in turn, is the most important cause of mortality in COVID-19. CD8+ T cell response dominates over CD4+ T cell response and natural killer cell dysfunction also leads to CD4+ cell dysfunction in COVID-19; this immune dysregulation leads to inappropriate (ARDS) and inadequate (low or quickly waning antibodies) responses to the disease and unfortunately, prepares the patients for re-infections. The peripheral anergy seen in chronic sarcoidosis has much resemblance to COVID-19; CD8+ T cell accumulation is also responsible for inadequate reaction to tuberculin and antigenic stimulus. This article, based on the similarity of COVID-19 and sarcoidosis, discusses a combination of the therapeutic strategy of the tetanus-diphtheria vaccine and dual RAS inhibition, alongside with hydroxychloroquine and antiviral agents, as a solution to overcome the problems described above.
【저자키워드】 COVID-19, SARS CoV-2, ACE2, RAS inhibition, Tetanus-diphtheria vaccine, 【초록키워드】 antibodies, ARDS, Vaccine, immune response, Mortality, Hydroxychloroquine, lung, Anergy, RAS, renin-angiotensin system, pathogen, response, Antiviral agents, target, receptor, sarcoidosis, therapeutic strategy, CD8+ T cell, CD4+ T cell, Combination, angiotensin, ACE2 binding, similarity, immune dysregulation, Re-infections, dysfunction, natural killer, antigenic, problem, CD4+, beta coronavirus, Cell, responsible, described, the patient, the disease, overcome, turn, 【제목키워드】 Vaccine, RAS, therapeutic option,