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Researchers at Radboud University Medical Center may have discovered an essential mechanism in the Covid-19 process. If true, it could have important implications for treating the disease. More research is now underway internationally to test the new vision.
The Radboud University Medical Center offers the following description: An infection with the COVID-19 coronavirus occurs differently than a flu or other infection. At first, patients are quickly out of breath due to fluid in the lungs. Then an inflammatory reaction is added to the lungs; The patient’s antibodies attack the virus in the lungs, which can further aggravate the situation in the lungs. Some of the patients who recover after an ICU stay develop thrombosis and scarring of the lungs from long-standing fluid, making recovery difficult.
Cleaning ACE2 receivers
Fluid problems in the lungs in the first stage are very characteristic. That leak causes problems for the lungs, because they partially fill up. Researchers at Radboud University Medical Center now present a hypothesis. Covid-19 enters the lungs through the ACE2 receptor. The virus binds to the receptor and the receptor withdraws it into the lung cell, where the virus can multiply. In a massive infection, those ACE2 receptors disappear from outside the cell. Its function will also disappear. “
Bradykinin makes blood vessels leak
ACE2 plays a role in maintaining blood pressure throughout the body. But ACE2 has another function. ACE2 controls the substance bradykinin. Bradykinin leaks in the blood vessels. And with this Covid-19 infection, ACE2 receptors disappear from lung cells by the introduction of the virus. As a result, bradykinin is unleashed and small blood vessels leak massively at the site of infection.
Also, some side effects of ACE inhibitors, which are used against high blood pressure, are very similar to the symptoms seen with COVID-19, such as dry cough.
Quick exchange and test of knowledge
Researchers at Radboud University Medical Center have published their ideas in an article that appeared in Preprints. Articles on Preprints have not been peer-reviewed and commented, but can therefore be published very quickly. The article on Preprints has been viewed about 1,500 times and has been downloaded more than 800 times. Based on this shared knowledge, Radboud University Medical Center is preparing the first treatments with Icatibant, a medicine that can inhibit the effects of bradykinin.
Publication in Preprints: Kinins and Cytokines at COVID-19: A Comprehensive Pathophysiological Approach – Frank van de Veerdonk, Mihai G. Netea, Marcel van Deuren, Jos W.M. van der Meer, Quirijn de Mast, Roger J. Bruggemann, Hans van der Hoeven
https://www.preprints.org/manuscript/202004.0023/v1
More information at Radboudumc
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