Prostaglandin D2 as a mediator of lymphopenia and a therapeutic target in COVID-19 disease.
Med Hypotheses
; 143: 110122, 2020 Oct.
Article
in English
| MEDLINE | ID: covidwho-663829
ABSTRACT
A characteristic feature of COVID-19 disease is lymphopenia. Lymphopenia occurs early in the clinical course and is a predictor of disease severity and outcomes. The mechanism of lymphopenia in COVID-19 is uncertain. It has been variously attributed to the release of inflammatory cytokines including IL-6 and TNF-α; direct infection of the lymphocytes by the virus; and rapid sequestration of lymphocytes in the tissues. Additionally, we postulate that prostaglandin D2 (PGD2) is a key meditator of lymphopenia in COVID-19. First, SARS-CoV infection is known to stimulate the production of PGD2 in the airways, which inhibits the host dendritic cell response via the DP1 receptor signaling. Second, PGD2 is known to upregulate monocytic myeloid-derived suppressor cells (MDSC) via the DP2 receptor signaling in group 2 innate lymphoid cells (ILC2). We propose targeting PGD2/DP2 signaling using a receptor antagonist such as ramatroban as an immunotherapy for immune dysfunction and lymphopenia in COVID-19 disease.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Respiratory System
/
Prostaglandin D2
/
Coronavirus Infections
/
Models, Immunological
/
Molecular Targeted Therapy
/
Pandemics
/
Betacoronavirus
/
Lymphopenia
Type of study:
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Child
/
Humans
Language:
English
Journal:
Med Hypotheses
Year:
2020
Document Type:
Article
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