4.8 Article

Neurological Symptoms of COVID-19: The Zonulin Hypothesis

Journal

FRONTIERS IN IMMUNOLOGY
Volume 12, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2021.665300

Keywords

zonulin; Toll-like receptor4; tight junctions; blood-brain barrier; neurological symptoms; gastrointestinal symptoms; haematogenous route; SARS-CoV-2

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The COVID-19 pandemic caused by SARS-CoV-2 in 2020 has led to global outbreak, with patients experiencing respiratory, digestive, and neurological symptoms, including anosmia suggesting potential neurotropism. Research proposes an alternative pathway from gut infection involving Toll-like receptor 4 (TLR4), protease-activated receptor 2 (PAR2), and zonulin, and suggests investigation into the use of zonulin antagonists to mitigate neurological manifestations caused by SARS-CoV-19 infection.
The irruption of SARS-CoV-2 during 2020 has been of pandemic proportions due to its rapid spread and virulence. COVID-19 patients experience respiratory, digestive and neurological symptoms. Distinctive symptom as anosmia, suggests a potential neurotropism of this virus. Amongst the several pathways of entry to the nervous system, we propose an alternative pathway from the infection of the gut, involving Toll-like receptor 4 (TLR4), zonulin, protease-activated receptor 2 (PAR2) and zonulin brain receptor. Possible use of zonulin antagonists could be investigated to attenuate neurological manifestations caused by SARS-CoV-19 infection.

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