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10.1177/0271678X20985666

http://scihub22266oqcxt.onion/10.1177/0271678X20985666
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33530831!8142132!33530831
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suck abstract from ncbi


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pmid33530831      J+Cereb+Blood+Flow+Metab 2021 ; 41 (6): 1179-1192
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  • Pathophysiologic mechanisms of cerebral endotheliopathy and stroke due to Sars-CoV-2 #MMPMID33530831
  • Kakarla V; Kaneko N; Nour M; Khatibi K; Elahi F; Liebeskind DS; Hinman JD
  • J Cereb Blood Flow Metab 2021[Jun]; 41 (6): 1179-1192 PMID33530831show ga
  • Cerebrovascular events have emerged as a central feature of the clinical syndrome associated with Sars-CoV-2 infection. This increase in infection-related strokes is marked by atypical presentations including stroke in younger patients and a high rate of hemorrhagic transformation after ischemia. A variety of pathogenic mechanisms may underlie this connection. Efforts to identify synergism in the pathophysiology underlying stroke and Sars-CoV-2 infection can inform the understanding of both conditions in novel ways. In this review, the molecular cascades connected to Sars-CoV-2 infection are placed in the context of the cerebral vasculature and in relationship to pathways known to be associated with stroke. Cytokine-mediated promotion of systemic hypercoagulability is suggested while direct Sars-CoV-2 infection of cerebral endothelial cells may also contribute. Endotheliopathy resulting from direct Sars-CoV-2 infection of the cerebral vasculature can modulate ACE2/AT(1)R/MasR signaling pathways, trigger direct viral activation of the complement cascade, and activate feed-forward cytokine cascades that impact the blood-brain barrier. All of these pathways are already implicated as independent mechanisms driving stroke and cerebrovascular injury irrespective of Sars-CoV-2. Recognizing the overlap of molecular pathways triggered by Sars-CoV-2 infection with those implicated in the pathogenesis of stroke provides an opportunity to identify future therapeutics targeting both Sars-CoV-2 and stroke thereby reducing the impact of the global pandemic.
  • |Angiotensin-Converting Enzyme 2/metabolism[MESH]
  • |Blood-Brain Barrier/metabolism[MESH]
  • |COVID-19/complications/*pathology/virology[MESH]
  • |Cerebrovascular Disorders/*etiology/metabolism[MESH]
  • |Complement Activation[MESH]
  • |Humans[MESH]
  • |Proto-Oncogene Mas[MESH]
  • |Renin-Angiotensin System[MESH]
  • |Spike Glycoprotein, Coronavirus/metabolism[MESH]
  • |Stroke/*etiology/metabolism[MESH]


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