SARS-CoV-2 is causing a pandemic resulting in high morbidity and mortality. COVID-19 patients suffering from acute respiratory distress syndrome (ARDS) are often critically ill and show lung injury and hemolysis. Heme is a prosthetic moiety crucial for the function of a wide variety of heme-proteins, including hemoglobin and cytochromes. However, injury-derived free heme promotes adhesion molecule expression, leukocyte recruitment, vascular permeabilization, platelet activation, complement activation, thrombosis, and fibrosis. Heme can be degraded by the anti-inflammatory enzyme heme oxygenase (HO) generating biliverdin/bilirubin, iron/ferritin, and carbon monoxide. We therefore postulate that free heme contributes to many of the inflammatory phenomena witnessed in critically ill COVID-19 patients, whilst induction of HO-1 or harnessing heme may provide protection. HO-activity not only degrades injurious heme, but its effector molecules possess also potent salutary anti-oxidative and anti-inflammatory properties. Until a vaccine against SARS-CoV-2 becomes available, we need to explore novel strategies to attenuate the pro-inflammatory, pro-thrombotic, and pro-fibrotic consequences of SARS-CoV-2 leading to morbidity and mortality. The heme-HO system represents an interesting target for novel “proof of concept” studies in the context of COVID-19.
【저자키워드】 COVID-19, SARS-CoV-2, Inflammation, heme, heme oxygenase, 【초록키워드】 platelet activation, ARDS, Vaccine, pandemic, thrombosis, Anti-inflammatory, fibrosis, complement, Lung injury, Hemolysis, Critically ill, morbidity and mortality, hemoglobin, recruitment, expression, COVID-19 patients, acute respiratory distress, Inflammatory, COVID-19 patient, leukocyte, Activation, Vascular, enzyme, syndrome, anti-inflammatory properties, pro-inflammatory, consequence, resulting, contribute, variety, promote, effector molecule, attenuate, anti-oxidative, degrade, pro-fibrotic, pro-thrombotic, prosthetic, 【제목키워드】 Complication, targeting, System, Oxygenase,