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Cytokine storm in aged people with CoV-2: possible role of vitamins as therapy or preventive strategy.
Aging Clin Exp Res. 2020 Oct; 32(10):2115-2131.AC

Abstract

BACKGROUND

In December 2019, a novel human-infecting coronavirus, SARS-CoV-2, had emerged. The WHO has classified the epidemic as a "public health emergency of international concern". A dramatic situation has unfolded with thousands of deaths, occurring mainly in the aged and very ill people. Epidemiological studies suggest that immune system function is impaired in elderly individuals and these subjects often present a deficiency in fat-soluble and hydrosoluble vitamins.

METHODS

We searched for reviews describing the characteristics of autoimmune diseases and the available therapeutic protocols for their treatment. We set them as a paradigm with the purpose to uncover common pathogenetic mechanisms between these pathological conditions and SARS-CoV-2 infection. Furthermore, we searched for studies describing the possible efficacy of vitamins A, D, E, and C in improving the immune system function.

RESULTS

SARS-CoV-2 infection induces strong immune system dysfunction characterized by the development of an intense proinflammatory response in the host, and the development of a life-threatening condition defined as cytokine release syndrome (CRS). This leads to acute respiratory syndrome (ARDS), mainly in aged people. High mortality and lethality rates have been observed in elderly subjects with CoV-2-related infection.

CONCLUSIONS

Vitamins may shift the proinflammatory Th17-mediated immune response arising in autoimmune diseases towards a T-cell regulatory phenotype. This review discusses the possible activity of vitamins A, D, E, and C in restoring normal antiviral immune system function and the potential therapeutic role of these micronutrients as part of a therapeutic strategy against SARS-CoV-2 infection.

Authors+Show Affiliations

UO of Internal Medicine Unit, Hospital of Budrio, Via Benni 44, 40065, Budrio, Bologna, Italy. sirio.fiorino@ausl.bologna.it. Internal Medicine Unit, Maggiore Hospital of Bologna, Bologna, Italy. sirio.fiorino@ausl.bologna.it.Physician Specialist in Infectious Diseases, AUSL Bologna, Bologna, Italy.Unit of Gastroenterology and Digestive Endoscopy, Sandro Petrini Hospital, Rome, Italy.Infective Disease Unit, University of Bologna, Bologna, Italy.Infective Disease Unit, University of Bologna, Bologna, Italy.UO of Internal Medicine Unit, Hospital of Budrio, Via Benni 44, 40065, Budrio, Bologna, Italy.UO of Internal Medicine Unit, Hospital of Budrio, Via Benni 44, 40065, Budrio, Bologna, Italy.UO of Internal Medicine Unit, Hospital of Budrio, Via Benni 44, 40065, Budrio, Bologna, Italy.UO of Internal Medicine Unit, Hospital of Budrio, Via Benni 44, 40065, Budrio, Bologna, Italy.Experimental, Diagnostic and Specialty Medicine Department, University of Bologna, Bologna, Italy.Experimental, Diagnostic and Specialty Medicine Department, University of Bologna, Bologna, Italy.UO of Internal Medicine Unit, Hospital of Budrio, Via Benni 44, 40065, Budrio, Bologna, Italy.UO of Internal Medicine Unit, Hospital of Budrio, Via Benni 44, 40065, Budrio, Bologna, Italy.UO of Internal Medicine Unit, Hospital of Budrio, Via Benni 44, 40065, Budrio, Bologna, Italy.UO of Internal Medicine Unit, Hospital of Budrio, Via Benni 44, 40065, Budrio, Bologna, Italy.Unit of Radiology, Maggiore Hospital of Bologna, Bologna, Italy.Internal Medicine Unit, Maggiore Hospital of Bologna, Bologna, Italy.UO Farmacia Centralizzata OM, Farmacia Ospedale Di Budrio, Budrio, Bologna, Italy.Department of Pharmacy and Biotechnology (FABIT), University of Bologna, Bologna, Italy. Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale), Molecular Diagnostic Unit, University of Bologna, Azienda USL di Bologna, Bologna, Italy.Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale), Molecular Diagnostic Unit, University of Bologna, Azienda USL di Bologna, Bologna, Italy.Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale), Molecular Diagnostic Unit, University of Bologna, Azienda USL di Bologna, Bologna, Italy.Internal Medicine Unit, Maggiore Hospital of Bologna, Bologna, Italy.Department of Gastroenterology and Hepatology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, The People's Republic of China.Regenerative Medicine Center Utrecht, University of Utrecht, Utrecht, Netherlands.Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale), Molecular Diagnostic Unit, University of Bologna, Azienda USL di Bologna, Bologna, Italy.Surgery Unit, Maggiore Hospital, Bologna, Italy.Physical Medicine and Rehabilitation Unit, Maggiore Hospital, Bologna, Italy.Department of Pharmacy and Biotechnology (FABIT), University of Bologna, Bologna, Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32865757

Citation

Fiorino, Sirio, et al. "Cytokine Storm in Aged People With CoV-2: Possible Role of Vitamins as Therapy or Preventive Strategy." Aging Clinical and Experimental Research, vol. 32, no. 10, 2020, pp. 2115-2131.
Fiorino S, Gallo C, Zippi M, et al. Cytokine storm in aged people with CoV-2: possible role of vitamins as therapy or preventive strategy. Aging Clin Exp Res. 2020;32(10):2115-2131.
Fiorino, S., Gallo, C., Zippi, M., Sabbatani, S., Manfredi, R., Moretti, R., Fogacci, E., Maggioli, C., Travasoni Loffredo, F., Giampieri, E., Corazza, I., Dickmans, C., Denitto, C., Cammarosano, M., Battilana, M., Orlandi, P. E., Del Forno, F., Miceli, F., Visani, M., ... de Biase, D. (2020). Cytokine storm in aged people with CoV-2: possible role of vitamins as therapy or preventive strategy. Aging Clinical and Experimental Research, 32(10), 2115-2131. https://doi.org/10.1007/s40520-020-01669-y
Fiorino S, et al. Cytokine Storm in Aged People With CoV-2: Possible Role of Vitamins as Therapy or Preventive Strategy. Aging Clin Exp Res. 2020;32(10):2115-2131. PubMed PMID: 32865757.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cytokine storm in aged people with CoV-2: possible role of vitamins as therapy or preventive strategy. AU - Fiorino,Sirio, AU - Gallo,Claudio, AU - Zippi,Maddalena, AU - Sabbatani,Sergio, AU - Manfredi,Roberto, AU - Moretti,Renzo, AU - Fogacci,Elisa, AU - Maggioli,Caterina, AU - Travasoni Loffredo,Francesca, AU - Giampieri,Enrico, AU - Corazza,Ivan, AU - Dickmans,Christoph, AU - Denitto,Claudio, AU - Cammarosano,Michele, AU - Battilana,Michele, AU - Orlandi,Paolo Emilio, AU - Del Forno,Francesco, AU - Miceli,Francesco, AU - Visani,Michela, AU - Acquaviva,Giorgia, AU - De Leo,Antonio, AU - Leandri,Paolo, AU - Hong,Wandong, AU - Brand,Thomas, AU - Tallini,Giovanni, AU - Jovine,Elio, AU - Jovine,Roberto, AU - de Biase,Dario, Y1 - 2020/08/31/ PY - 2020/06/18/received PY - 2020/07/21/accepted PY - 2020/9/1/pubmed PY - 2020/10/21/medline PY - 2020/9/1/entrez KW - COVID-19 KW - CoV-2 KW - SARS KW - Therapeutic strategy KW - Vitamins SP - 2115 EP - 2131 JF - Aging clinical and experimental research JO - Aging Clin Exp Res VL - 32 IS - 10 N2 - BACKGROUND: In December 2019, a novel human-infecting coronavirus, SARS-CoV-2, had emerged. The WHO has classified the epidemic as a "public health emergency of international concern". A dramatic situation has unfolded with thousands of deaths, occurring mainly in the aged and very ill people. Epidemiological studies suggest that immune system function is impaired in elderly individuals and these subjects often present a deficiency in fat-soluble and hydrosoluble vitamins. METHODS: We searched for reviews describing the characteristics of autoimmune diseases and the available therapeutic protocols for their treatment. We set them as a paradigm with the purpose to uncover common pathogenetic mechanisms between these pathological conditions and SARS-CoV-2 infection. Furthermore, we searched for studies describing the possible efficacy of vitamins A, D, E, and C in improving the immune system function. RESULTS: SARS-CoV-2 infection induces strong immune system dysfunction characterized by the development of an intense proinflammatory response in the host, and the development of a life-threatening condition defined as cytokine release syndrome (CRS). This leads to acute respiratory syndrome (ARDS), mainly in aged people. High mortality and lethality rates have been observed in elderly subjects with CoV-2-related infection. CONCLUSIONS: Vitamins may shift the proinflammatory Th17-mediated immune response arising in autoimmune diseases towards a T-cell regulatory phenotype. This review discusses the possible activity of vitamins A, D, E, and C in restoring normal antiviral immune system function and the potential therapeutic role of these micronutrients as part of a therapeutic strategy against SARS-CoV-2 infection. SN - 1720-8319 UR - https://www.unboundmedicine.com/medline/citation/32865757/Cytokine_storm_in_aged_people_with_CoV_2:_possible_role_of_vitamins_as_therapy_or_preventive_strategy_ DB - PRIME DP - Unbound Medicine ER -