There is an under-recognized role of the aryl hydrocarbon receptor (AhR) in co-ordinating the entry and pathophysiology of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that underpins the COVID-19 pandemic. The rise in pro-inflammatory cytokines during the ‘cytokine storm’ induce indoleamine 2,3-dioxygenase (IDO), leading to an increase in kynurenine that activates the AhR, thereby heightening the initial pro-inflammatory cytokine phase and suppressing the endogenous anti-viral response. Such AhR-driven changes underpin the heightened severity and fatality associated with pre-existent high-risk medical conditions, such as type II diabetes, as well as to how racial discrimination stress contributes to the raised severity/fatality in people from the Black Asian and Minority Ethnic (BAME) communities. The AhR is pivotal in modulating mitochondrial metabolism and co-ordinating specialized, pro-resolving mediators (SPMs), the melatonergic pathways, acetyl-coenzyme A, and the cyclooxygenase (COX) 2-prostaglandin (PG) E2 pathway that underpin ‘exhaustion’ in the endogenous anti-viral cells, paralleling similar metabolic suppression in cytolytic immune cells that is evident across all cancers. The pro-inflammatory cytokine induced gut permeability/dysbiosis and suppression of pineal melatonin are aspects of the wider pathophysiological underpinnings regulated by the AhR. This has a number of prophylactic and treatment implications for SARS-CoV-2 infection and cancers and future research directions that better investigate the biological underpinnings of social processes and how these may drive health disparities.
【저자키워드】 COVID-19, Treatment, SARS-CoV-2, Mitochondria, melatonin, Cancer, immune, Aryl hydrocarbon receptor, racism, acetyl-CoA, 【초록키워드】 Bame, Stress, SARS-COV-2 infection, COVID-19 pandemic, severity, Prophylactic, Anti-viral, Health, pathophysiology, cells, cancers, Research, pathway, change, fatality, Indoleamine 2,3-dioxygenase, Immune cell, Pathways, Medical conditions, Gut, Asian, black, Type II Diabetes, Racial, anti-viral response, pro-inflammatory cytokine, implication, mitochondrial metabolism, initial, raised, contribute, increase in, induce, regulated, activate, COX, cytolytic, IDO, modulating, pathophysiological, 【제목키워드】 discrimination, change, hydrocarbon, aryl, role,