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10.3389/fimmu.2021.641295

http://scihub22266oqcxt.onion/10.3389/fimmu.2021.641295
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suck abstract from ncbi


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pmid34025650      Front+Immunol 2021 ; 12 (ä): 641295
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  • Anti-TNF-alpha agents Modulate SARS-CoV-2 Receptors and Increase the Risk of Infection Through Notch-1 Signaling #MMPMID34025650
  • Keewan E; Beg S; Naser SA
  • Front Immunol 2021[]; 12 (ä): 641295 PMID34025650show ga
  • Although millions of patients with underlining conditions are treated primarily with anti-TNF-alpha agents, little is known about the safety of this standard therapy during the coronavirus disease-2019 (COVID-19) pandemic. In this study, we investigated the effect of anti-TNF-alpha monoclonal antibodies on the cellular entry mechanism of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and increasing the risk of COVID-19 development. We focused on the expression of angiotensin-converting enzyme II (ACE2), type II transmembrane serine proteases (TMPRSS2)/TNF-alpha converting enzyme (TACE) ratio. We also investigated the involvement of Notch-1 signaling and its downstream influence on IL-6, myeloid cell leukemia sequence-1(MCL-1) in the anti-TNF-alpha mode of action and increased the susceptibility to Mycobacterium avium subspecies paratuberculosis (MAP) infection. Surprisingly, anti-TNF-alpha downregulated ACE2 expression by 0.46-fold and increased TMPRSS2/TACE ratio by 44% in THP-1 macrophages. Treatment of macrophages with rIL-6 also downregulated ACE2 and increased TMPRSS2/TACE ratio by 54%. Interestingly, anti-TNF-alpha treatment upregulated Notch-1, IL-6, and MCL-1 by 1.3, 1.2, and 1.9-fold, respectively, and increased viability and burden of MAP infection in macrophages. Blocking Notch signaling doubled ACE2 expression, decreased TMPRSS2/TACE ratio by 38%, and reduced MAP viability by 56%. In a small group of patients, ACE2 level was significantly lower in the plasma from rheumatoid arthritis (RA) patients on anti-TNF-alpha treatment compared to healthy control. The data in this critical study demonstrated that through Notch-1/IL-6 signaling, anti-TNF-alpha agents decreased ACE2 expression and shedding through TMPRSS2/TACE modulation and increased the susceptibility to infection. Overall, this study warns against anti-TNF-alpha therapy in some patients with underlining inflammatory conditions during the COVID-19 pandemic. The findings should impact current guidelines regarding treatment decisions of patients on anti-TNF-alpha during the COVID-19 pandemic.
  • |ADAM17 Protein/metabolism[MESH]
  • |Angiotensin-Converting Enzyme 2/*metabolism[MESH]
  • |Animals[MESH]
  • |COVID-19/*immunology/transmission/virology[MESH]
  • |Disease Susceptibility[MESH]
  • |Disease Transmission, Infectious[MESH]
  • |Humans[MESH]
  • |Interleukin-6/metabolism[MESH]
  • |Macrophages/*immunology[MESH]
  • |Mycobacterium avium/*physiology[MESH]
  • |Receptor, Notch1/*metabolism[MESH]
  • |Risk[MESH]
  • |SARS-CoV-2/*physiology[MESH]
  • |Serine Endopeptidases/metabolism[MESH]
  • |Signal Transduction[MESH]
  • |THP-1 Cells[MESH]
  • |Tuberculosis, Avian/*immunology[MESH]


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