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CS triggered by excessive inflammatory response drives the pathogenesis of COVID-19.
ASX inhibits TNFα, IL1β, IL6 via regulation of NF-kB & JAK/STAT; prevents CS & ALI/ARDS.
ASX suppresses plasma CRP, iNOS, COX2, PGE2 & ICAM-1; prevents oxidative damages.
ASX inhibits NLRP3, HIF1α, activates Nrf2, Sirtuin pathways; exerts antioxidant effect.
ASX enhances immune responses, NK cell activity, T- & B- cell population.
Host excessive inflammatory immune response to SARS-CoV-2 infection is thought to underpin the pathogenesis of COVID-19 associated severe pneumonitis and acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Once an immunological complication like cytokine storm occurs, anti-viral based monotherapy alone is not enough. Additional anti-inflammatory treatment is recommended. It must be noted that anti-inflammatory drugs such as JAK inhibitors, IL-6 inhibitors, TNF-α inhibitors, colchicine, etc., have been either suggested or are under trials for managing cytokine storm in COVID-19 infections. Natural astaxanthin (ASX) has a clinically proven safety profile and has antioxidant, anti-inflammatory, and immunomodulatory properties. There is evidence from preclinical studies that supports its preventive actions against ALI/ARDS. Moreover, ASX has a potent PPARs activity. Therefore, it is plausible to speculate that ASX could be considered as a potential adjunctive supplement. Here, we summarize the mounting evidence where ASX is shown to exert protective effect by regulating the expression of pro-inflammatory factors IL-1β, IL-6, IL-8 and TNF-α. We present reports where ASX is shown to prevent against oxidative damage and attenuate exacerbation of the inflammatory responses by regulating signaling pathways like NF-ĸB, NLRP3 and JAK/STAT. These evidences provide a rationale for considering natural astaxanthin as a therapeutic agent against inflammatory cytokine storm and associated risks in COVID-19 infection and this suggestion requires further validation with clinical studies.Le texte complet de cet article est disponible en PDF.
Abbreviations : ALT, AST, CCL-3, COX-2, CRP, dsRNA, FOXO3, G-CSF, GM-CSF, GSH, HCFs, HDAC4, HGF, HIF-1α, ICAM-1, IkB, IL-1ra, LDH, LFA-1, LPS, MAPK, MCP, M-CSF, MDA, MIP, MMPs, MPO, MSCs, NO, NT, PDGF, PGE2, PPARs, SOD, TGF, TNF, VEGF
Keywords : COVID-19, Cytokine storm, Acute respiratory distress syndrome, Astaxanthin, Antioxidant, Anti-inflammatory