ABSTRACT
Extensive extrapulmonary damages in a dozen of organs/systems, including the central nervous system (CNS), are reported in patients of the coronavirus disease 2019 (COVID-19). Three cases of Parkinson's disease (PD) have been reported as a direct consequence of COVID-19. In spite of the scarce data for establishing a definitive link between COVID-19 and PD, some hypotheses have been proposed to explain the cases reported. They, however, do not fit well with the clinical findings reported for COVID-19 patients, in general, and for the PD cases reported, in particular. Given the importance of this potential connection, we present here a molecular-level mechanistic hypothesis that explains well these findings and will serve to explore the potential CNS damage in COVID-19 patients. The model explaining the cascade effects from COVID-19 to CNS is developed by using bioinformatic tools. It includes the post-translational modification of host proteins in the lungs by viral proteins, the transport of modified host proteins via exosomes out the lungs, and the disruption of protein-protein interaction in the CNS by these modified host proteins. Our hypothesis is supported by finding 44 proteins significantly expressed in the CNS which are associated with PD and whose interactions can be perturbed by 24 host proteins significantly expressed in the lungs. These 24 perturbators are found to interact with viral proteins and to form part of the cargoes of exosomes in human tissues. The joint set of perturbators and PD-vulnerable proteins form a tightly connected network with significantly more connections than expected by selecting a random cluster of proteins of similar size from the human proteome. The molecular-level mechanistic hypothesis presented here provides several routes for the cascading of effects from the lungs of COVID-19 patients to PD. In particular, the disruption of autophagy/ubiquitination processes appears as an important mechanism that triggers the generation of large amounts of exosomes containing perturbators in their cargo, which would insult several PD-vulnerable proteins, potentially triggering Parkinsonism in COVID-19 patients.
Subject(s)
COVID-19/complications , Parkinson Disease, Secondary/etiology , COVID-19/metabolism , Central Nervous System/virology , Exosomes/metabolism , Humans , Lung/metabolism , Models, Theoretical , Parkinson Disease/etiology , Parkinson Disease/metabolism , Parkinson Disease/virology , Parkinson Disease, Secondary/metabolism , Parkinson Disease, Secondary/virology , Protein Interaction Maps , SARS-CoV-2/pathogenicity , Viral Proteins/metabolismSubject(s)
AIDS Dementia Complex/complications , Brain/pathology , HIV-1/isolation & purification , Parkinson Disease, Secondary/virology , AIDS Dementia Complex/diagnosis , Basal Ganglia Diseases/virology , Brain/virology , Fatal Outcome , Humans , Japan , Magnetic Resonance Imaging , Male , Middle Aged , Polymerase Chain ReactionABSTRACT
We report a boy with subacute sclerosing panencephalitis (SSPE) who exhibited parkinsonian symptoms four months after onset. The symptoms improved after administration of levodopa. One year after onset, bilateral symmetric lesions appeared in the substantia nigra and the putamen, as observed using magnetic resonance imaging. After a one-year interval, the lesions migrated to the bilateral caudate and the cerebellar dentate nuclei. The series of migratory legions, each of which was connected by axonal pathways originating from the substantia nigra, suggests axonal spread of the SSPE virus.
Subject(s)
Axons/virology , Basal Ganglia/pathology , Basal Ganglia/virology , Subacute Sclerosing Panencephalitis/virology , Adolescent , Disease Progression , Humans , Levodopa/therapeutic use , Magnetic Resonance Imaging , Male , Parkinson Disease, Secondary/diagnosis , Parkinson Disease, Secondary/drug therapy , Parkinson Disease, Secondary/virology , Subacute Sclerosing Panencephalitis/complications , Subacute Sclerosing Panencephalitis/diagnosis , Subacute Sclerosing Panencephalitis/drug therapy , Treatment FailureABSTRACT
Thyrotropin-releasing hormone (TRH) has been reported to have some possibilities toward the treatment of affective CNS disorders. However, long term treatments with daily injections are often required. Effects of TRH-SR (sustained release microspheres of TRH) which is encapsulated in copoly (dl-lactic/glycolic acid) using an in-water drying method were investigated in experimental Japanese encephalitis virus (JEV)-induced post-encephalitic parkinsonism rats by a pole test and high performance liquid chromatography (HPLC) with an electrochemical detector (ECD). We have already reported that in adult Fischer rats killed 12 weeks after infection with JEV at the age of 13 days a marked decrease of tyrosine hydroxylase-positive neurons was found in the bilateral substantia nigra. TRH-SR (3 mg/kg per 2 weeks, 4 times injections, subcutaneous [s.c.]) improved bradykinesia observed in the JEV-induced parkinsonism rats. Dopamine (DA) concentrations in the JEV-infected rats were profoundly reduced in the striatum as compared with controls. TRH-SR (3 mg/kg, once, s.c.) increased DA in the striatum 7 days after the injection. Although the pathomechanism of post-encephalitic parkinsonism is different from that of Parkinson's disease and TRH possesses a variety of CNS effects as well, these results suggest that TRH-SR play a possible role in the treatment of Parkinson's disease in addition to post-encephalitic parkinsonism as a supportive drug of L-DOPA.
