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open access

Vol 57, No 1 (2023)
Review Article
Submitted: 2023-01-30
Accepted: 2023-02-15
Published online: 2023-02-22
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Blood-brain barrier function in response to SARS-CoV-2 and its spike protein

Łukasz Suprewicz1, Krzysztof Fiedoruk1, Agata Czarnowska2, Marcin Sadowski3, Agnieszka Strzelecka4, Peter A. Galie5, Paul A. Janmey6, Alina Kułakowska2, Robert Bucki1
DOI: 10.5603/PJNNS.a2023.0014
·
Pubmed: 36810757
·
Neurol Neurochir Pol 2023;57(1):14-25.
Affiliations
  1. Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok, Poland
  2. Department of Neurology, Medical University of Bialystok, Bialystok, Poland
  3. Institute of Medical Sciences, Collegium Medicum, Jan Kochanowski University of Kielce, Kielce, Poland
  4. Institute of Health Science, Collegium Medicum, Jan Kochanowski University of Kielce, Kielce, Poland
  5. Department of Biomedical Engineering, Rowan University, Glassboro, NJ, United States
  6. Department of Physiology and Institute for Medicine and Engineering, University of Pennsylvania, Philadelphia, PA, United States

open access

Vol 57, No 1 (2023)
REVIEW ARTICLES — LEADING TOPIC
Submitted: 2023-01-30
Accepted: 2023-02-15
Published online: 2023-02-22

Abstract

The typical manifestation of coronavirus 2 (CoV-2) infection is a severe acute respiratory syndrome (SARS) accompanied by pneumonia (COVID-19). However, SARS-CoV-2 can also affect the brain, causing chronic neurological symptoms, variously known as long, post, post-acute, or persistent COVID-19 condition, and affecting up to 40% of patients. The symptoms (fatigue, dizziness, headache, sleep disorders, malaise, disturbances of memory and mood) usually are mild and resolve spontaneously. However, some patients develop acute and fatal complications, including stroke or encephalopathy. Damage to the brain vessels mediated by the coronavirus spike protein (S-protein) and overactive immune responses have been identified as leading causes of this condition. However, the molecular mechanism by which the virus affects the brain still needs to be fully delineated. In this review article, we focus on interactions between host molecules and S-protein as the mechanism allowing the transit of SARS-CoV-2 through the blood-brain barrier to reach the brain structures. In addition, we discuss the impact of S-protein mutations and the involvement of other cellular factors conditioning the pathophysiology of SARS-CoV-2 infection. Finally, we review current and future COVID-19 treatment options.

Abstract

The typical manifestation of coronavirus 2 (CoV-2) infection is a severe acute respiratory syndrome (SARS) accompanied by pneumonia (COVID-19). However, SARS-CoV-2 can also affect the brain, causing chronic neurological symptoms, variously known as long, post, post-acute, or persistent COVID-19 condition, and affecting up to 40% of patients. The symptoms (fatigue, dizziness, headache, sleep disorders, malaise, disturbances of memory and mood) usually are mild and resolve spontaneously. However, some patients develop acute and fatal complications, including stroke or encephalopathy. Damage to the brain vessels mediated by the coronavirus spike protein (S-protein) and overactive immune responses have been identified as leading causes of this condition. However, the molecular mechanism by which the virus affects the brain still needs to be fully delineated. In this review article, we focus on interactions between host molecules and S-protein as the mechanism allowing the transit of SARS-CoV-2 through the blood-brain barrier to reach the brain structures. In addition, we discuss the impact of S-protein mutations and the involvement of other cellular factors conditioning the pathophysiology of SARS-CoV-2 infection. Finally, we review current and future COVID-19 treatment options.

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Keywords

SARS-CoV-2, spike protein, blood-brain barrier, encephalopathy, stroke, cytokine storm, neuroinflammation

About this article
Title

Blood-brain barrier function in response to SARS-CoV-2 and its spike protein

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 57, No 1 (2023)

Article type

Review Article

Pages

14-25

Published online

2023-02-22

Page views

3476

Article views/downloads

1184

DOI

10.5603/PJNNS.a2023.0014

Pubmed

36810757

Bibliographic record

Neurol Neurochir Pol 2023;57(1):14-25.

Keywords

SARS-CoV-2
spike protein
blood-brain barrier
encephalopathy
stroke
cytokine storm
neuroinflammation

Authors

Łukasz Suprewicz
Krzysztof Fiedoruk
Agata Czarnowska
Marcin Sadowski
Agnieszka Strzelecka
Peter A. Galie
Paul A. Janmey
Alina Kułakowska
Robert Bucki

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