Implications of Complement Imbalance in COVID-19: A Molecular Mechanistic Discussion on the Importance of Complement Balance
Two central questions in COVID-19 treatment which should be considered are: “How does the imbalance of the complement system affect the therapeutic approaches?” and “Do we consider complement inhibitors in therapeutic protocols?”. The complement system is a double-edged sword since it may either pro...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Shiraz University of Medical Sciences
2023-09-01
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| Series: | Iranian Journal of Immunology |
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| Online Access: | https://iji.sums.ac.ir/article_49464_4efa6a3990432cbf63d161a8d619b284.pdf |
| _version_ | 1797680471915626496 |
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| author | Mehdi Torabizadeh Helia Modaresi Asfeh Zeinab Deris Zayeri Cerdan Dominique Hashem Kazemi Najmaldin Saki |
| author_facet | Mehdi Torabizadeh Helia Modaresi Asfeh Zeinab Deris Zayeri Cerdan Dominique Hashem Kazemi Najmaldin Saki |
| author_sort | Mehdi Torabizadeh |
| collection | DOAJ |
| description | Two central questions in COVID-19 treatment which should be considered are: “How does the imbalance of the complement system affect the therapeutic approaches?” and “Do we consider complement inhibitors in therapeutic protocols?”. The complement system is a double-edged sword since it may either promote immune responses against COVID-19 or contribute to destructive inflammation in the host. Therefore, it is crucial to regulate this system with complement inhibitors. In this manuscript, we discuss the molecular mechanisms of complement and complement inhibitors in COVID-19 patients. We searched the terms “COVID-19”, “Complement”, “Complement inhibitor”, “SARS-CoV-2”, and all complement fragments and inhibitors from 2000 to 2022 in PubMed and google scholar and checked the pathways in “KEGG pathway database”. Complement is not well-appreciated in the treatment protocols despite its multiple roles in the disease, and most of the preventive anti-inflammatory therapeutic approaches did not include a complement inhibitor in COVID-19 therapeutic protocols. In this review article, we discussed the most recent studies regarding complement components mediated interventions and the mechanism of these interventions in COVID-19 patients. Since the control of the complement system overactivation is associated with a better prognosis in the initial stages of COVID-19, heparin, anti-thrombin, C1-inhibitor, montelukast, and hydralazine can be effective in the initial stages of this viral infection. Recombinant complement activation (RCA) proteins are more effective in regulating complement compared to terminal pathway therapeutic approaches such as the C3a and C5a inhibitors. |
| first_indexed | 2024-03-11T23:30:30Z |
| format | Article |
| id | doaj.art-1d433445c6e847ab91f989ebf0afbdbf |
| institution | Directory Open Access Journal |
| issn | 1735-1383 1735-367X |
| language | English |
| last_indexed | 2024-03-11T23:30:30Z |
| publishDate | 2023-09-01 |
| publisher | Shiraz University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Immunology |
| spelling | doaj.art-1d433445c6e847ab91f989ebf0afbdbf2023-09-20T09:13:41ZengShiraz University of Medical SciencesIranian Journal of Immunology1735-13831735-367X2023-09-0120324726110.22034/iji.2023.97585.252249464Implications of Complement Imbalance in COVID-19: A Molecular Mechanistic Discussion on the Importance of Complement BalanceMehdi Torabizadeh0Helia Modaresi Asfeh1Zeinab Deris Zayeri2Cerdan Dominique3Hashem Kazemi4Najmaldin Saki5Golestan Hospital Clinical Research Development Unit, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.Department of Microbiology, Sciences, and Research Branch, Islamic Azad University, Fars, Iran.Golestan Hospital Clinical Research Development Unit, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.Université Victor Segalen Bordeaux 2, France.Department of Biology, Dezful Branch, Islamic Azad University, Dezful, Iran.Health Research Institute, Research Center of Thalassemia & Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.Two central questions in COVID-19 treatment which should be considered are: “How does the imbalance of the complement system affect the therapeutic approaches?” and “Do we consider complement inhibitors in therapeutic protocols?”. The complement system is a double-edged sword since it may either promote immune responses against COVID-19 or contribute to destructive inflammation in the host. Therefore, it is crucial to regulate this system with complement inhibitors. In this manuscript, we discuss the molecular mechanisms of complement and complement inhibitors in COVID-19 patients. We searched the terms “COVID-19”, “Complement”, “Complement inhibitor”, “SARS-CoV-2”, and all complement fragments and inhibitors from 2000 to 2022 in PubMed and google scholar and checked the pathways in “KEGG pathway database”. Complement is not well-appreciated in the treatment protocols despite its multiple roles in the disease, and most of the preventive anti-inflammatory therapeutic approaches did not include a complement inhibitor in COVID-19 therapeutic protocols. In this review article, we discussed the most recent studies regarding complement components mediated interventions and the mechanism of these interventions in COVID-19 patients. Since the control of the complement system overactivation is associated with a better prognosis in the initial stages of COVID-19, heparin, anti-thrombin, C1-inhibitor, montelukast, and hydralazine can be effective in the initial stages of this viral infection. Recombinant complement activation (RCA) proteins are more effective in regulating complement compared to terminal pathway therapeutic approaches such as the C3a and C5a inhibitors.https://iji.sums.ac.ir/article_49464_4efa6a3990432cbf63d161a8d619b284.pdfcomplement system proteinscomplement inactivating agentssevere acute respiratory syndrome coronavirus 2 |
| spellingShingle | Mehdi Torabizadeh Helia Modaresi Asfeh Zeinab Deris Zayeri Cerdan Dominique Hashem Kazemi Najmaldin Saki Implications of Complement Imbalance in COVID-19: A Molecular Mechanistic Discussion on the Importance of Complement Balance Iranian Journal of Immunology complement system proteins complement inactivating agents severe acute respiratory syndrome coronavirus 2 |
| title | Implications of Complement Imbalance in COVID-19: A Molecular Mechanistic Discussion on the Importance of Complement Balance |
| title_full | Implications of Complement Imbalance in COVID-19: A Molecular Mechanistic Discussion on the Importance of Complement Balance |
| title_fullStr | Implications of Complement Imbalance in COVID-19: A Molecular Mechanistic Discussion on the Importance of Complement Balance |
| title_full_unstemmed | Implications of Complement Imbalance in COVID-19: A Molecular Mechanistic Discussion on the Importance of Complement Balance |
| title_short | Implications of Complement Imbalance in COVID-19: A Molecular Mechanistic Discussion on the Importance of Complement Balance |
| title_sort | implications of complement imbalance in covid 19 a molecular mechanistic discussion on the importance of complement balance |
| topic | complement system proteins complement inactivating agents severe acute respiratory syndrome coronavirus 2 |
| url | https://iji.sums.ac.ir/article_49464_4efa6a3990432cbf63d161a8d619b284.pdf |
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