Abstract
The pathogenesis of SARS-CoV-2 infection is related to the direct cytopathic effect and associated hyper-inflammation due to exaggerated immune response. Different experimental and clinical studies revealed that many biomarkers could be used to determine the Covid-19 severity, such as Ddimer, procalcitonin, C-reaction protein (CRP), IL-6, and ferritin. Calprotectin (CP) is associated with intestinal inflammation, intestinal injury, and different respiratory diseases such as cystic fibrosis. Thus, CP might be a possible biomarker linking intestinal injury and acute lung injury (ALI) in Covid-19. Therefore, this study aimed to find a potential role of CP regarding GITI and ALI in Covid-19. CP is a complex protein consisting of S100A8 and S100A9, belonging to the Ca+2-binding proteins S100 family abundant in the cytosol of neutrophils and expressed on the monocyte membranes, macrophages, and intestinal epithelial cells. CP is a proinflammatory protein that acts through activation of the receptor for the advanced glycation end product (RAGE) and toll-like receptor 4 (TLR4). CP is a biomarker of neutrophil activation and is released following the turnover of neutrophils. CP could be controversial; it increases airway inflammation or protects lung and airway epithelium from an exaggerated immune response. Therefore, a high level of CP in different respiratory disorders might be protective and compensate against abnormal immune responses. CP level is high in Covid-19 and correlated with Covid-19 severity and oxygen demand due to activation of proinflammatory cytokines and inflammatory signaling pathways. Therefore, CP level is elevated in both ALI and intestinal inflammation so that it could be a potential biomarker that links the respiratory and intestinal injury in Covid-19.
Keywords: SARS-CoV-2, Covid-19, calprotectin, intestinal injury, acute lung injury, respiratory infection
Graphical Abstract
[http://dx.doi.org/10.4103/JMAU.JMAU_63_20] [PMID: 33623736]
[http://dx.doi.org/10.1016/j.pupt.2021.102008] [PMID: 33727066]
[http://dx.doi.org/10.3389/fnut.2021.649128] [PMID: 33816542]
[http://dx.doi.org/10.1016/j.bcp.2021.114431] [PMID: 33515531]
[http://dx.doi.org/10.1016/j.ijid.2020.04.027] [PMID: 32311451]
[http://dx.doi.org/10.1080/1744666X.2021.1905526] [PMID: 33750254]
[http://dx.doi.org/10.3109/00365521.2015.1066421] [PMID: 26200803]
[http://dx.doi.org/10.1186/1471-2431-14-133] [PMID: 24885444]
[PMID: 15209531]
[http://dx.doi.org/10.1016/j.jbspin.2019.01.003] [PMID: 30660804]
[http://dx.doi.org/10.1097/00054725-200606000-00013] [PMID: 16775498]
[http://dx.doi.org/10.1016/j.chom.2011.07.004] [PMID: 21843872]
[http://dx.doi.org/10.1038/nm.2150] [PMID: 20473308]
[http://dx.doi.org/10.1086/517816] [PMID: 9498472]
[http://dx.doi.org/10.1189/jlb.1008647] [PMID: 19451397]
[http://dx.doi.org/10.1007/s00281-013-0375-7]
[http://dx.doi.org/10.1074/jbc.272.14.9496] [PMID: 9083090]
[http://dx.doi.org/10.3109/00365519009104950] [PMID: 2128131]
[http://dx.doi.org/10.2147/JIR.S250675] [PMID: 32547154]
[http://dx.doi.org/10.1586/17474124.2014.869476] [PMID: 24345070]
[http://dx.doi.org/10.1016/S0140-6736(00)03224-4] [PMID: 11117904]
[http://dx.doi.org/10.1097/01.MPG.0000154657.08994.94] [PMID: 15795593]
[http://dx.doi.org/10.1016/S0009-8981(99)00206-5] [PMID: 10686275]
[http://dx.doi.org/10.1007/s10350-008-9310-8] [PMID: 18543035]
[http://dx.doi.org/10.5694/mja2.50384] [PMID: 31680263]
[http://dx.doi.org/10.1097/MEG.0000000000001509] [PMID: 31464777]
[http://dx.doi.org/10.3109/00365548.2014.974206] [PMID: 25522183]
[PMID: 29115397]
[http://dx.doi.org/10.1016/j.crohns.2013.06.008]
[http://dx.doi.org/10.1016/j.ajem.2015.07.007] [PMID: 26233616]
[http://dx.doi.org/10.1111/j.1651-2227.2010.01843.x] [PMID: 20412103]
[http://dx.doi.org/10.1097/MIB.0000000000000204] [PMID: 25222662]
[http://dx.doi.org/10.1016/j.cgh.2014.06.020] [PMID: 24993368]
[http://dx.doi.org/10.1038/srep27572] [PMID: 27264309]
[http://dx.doi.org/10.1002/jemt.10299] [PMID: 12645005]
[http://dx.doi.org/10.3390/antiox8090351] [PMID: 31480545]
[http://dx.doi.org/10.1096/fj.202002136R] [PMID: 33131091]
[http://dx.doi.org/10.4049/jimmunol.1302556] [PMID: 24532576]
[http://dx.doi.org/10.1111/j.1749-6632.2012.06526.x] [PMID: 22731713]
[http://dx.doi.org/10.1186/1471-2164-9-490] [PMID: 18928539]
[http://dx.doi.org/10.1038/s41598-020-61094-z] [PMID: 32144345]
[http://dx.doi.org/10.1097/MPG.0000000000002197] [PMID: 30640865]
[http://dx.doi.org/10.5114/aoms/130648]
[http://dx.doi.org/10.1183/09031936.00183814] [PMID: 25792636]
[http://dx.doi.org/10.1183/23120541.00014-2019] [PMID: 30863773]
[http://dx.doi.org/10.1002/pmic.201400366] [PMID: 25332062]
[http://dx.doi.org/10.1016/j.anai.2013.06.028] [PMID: 24054362]
[http://dx.doi.org/10.3346/jkms.2020.35.e362] [PMID: 33169556]
[http://dx.doi.org/10.3389/fimmu.2020.01932] [PMID: 32973796]
[http://dx.doi.org/10.1111/cea.12522] [PMID: 25758537]
[http://dx.doi.org/10.1186/s13075-016-1182-z] [PMID: 27894337]
[http://dx.doi.org/10.1097/BOR.0000000000000429] [PMID: 28719392]
[http://dx.doi.org/10.3906/biy-2005-102] [PMID: 32595361]
[http://dx.doi.org/10.1097/QAI.0000000000002538] [PMID: 33065582]
[http://dx.doi.org/10.1034/j.1399-302x.2001.016002119.x] [PMID: 11240866]
[http://dx.doi.org/10.1111/j.1348-0421.2001.tb01302.x] [PMID: 11762750]
[http://dx.doi.org/10.1155/2019/8028725] [PMID: 31612153]
[http://dx.doi.org/10.4103/2305-0500.282984]
[http://dx.doi.org/10.1016/j.ejphar.2021.174196] [PMID: 34004207]
[PMID: 32343593]
[http://dx.doi.org/10.1007/s11033-021-06770-7] [PMID: 34664162]
[http://dx.doi.org/10.1016/j.cell.2020.08.002] [PMID: 32810439]
[http://dx.doi.org/10.1016/j.intimp.2021.108516] [PMID: 35032828]
[http://dx.doi.org/10.1038/s41423-020-0492-x] [PMID: 32620787]
[http://dx.doi.org/10.3346/jkms.2020.35.e343] [PMID: 32989935]
[http://dx.doi.org/10.1073/pnas.2018030117] [PMID: 33082228]
[http://dx.doi.org/10.1016/j.cell.2020.08.001] [PMID: 32810438]
[http://dx.doi.org/10.1016/j.cell.2021.01.053] [PMID: 33657410]
[http://dx.doi.org/10.1016/j.dld.2020.05.039] [PMID: 32527653]
[http://dx.doi.org/10.1016/j.cmi.2020.05.032] [PMID: 32502643]
[http://dx.doi.org/10.1136/annrheumdis-2020-218214] [PMID: 32632035]
[http://dx.doi.org/10.1002/art.33493] [PMID: 22131101]
[http://dx.doi.org/10.1016/j.mehy.2020.110394] [PMID: 33239231]
[http://dx.doi.org/10.1177/1535370216681551] [PMID: 27895095]
[http://dx.doi.org/10.1136/gutjnl-2020-321388] [PMID: 32312790]
[http://dx.doi.org/10.1186/s10020-020-00230-x] [PMID: 33121429]
[http://dx.doi.org/10.1172/JCI62423] [PMID: 22850880]
[http://dx.doi.org/10.1101/2020.09.03.20183947]
[http://dx.doi.org/10.1016/j.dld.2020.09.015] [PMID: 33060042]
[http://dx.doi.org/10.1016/j.cgh.2020.07.036] [PMID: 32712394]
[http://dx.doi.org/10.1053/j.gastro.2020.05.045] [PMID: 32425230]
[http://dx.doi.org/10.1002/JLB.3COVCRA0720-359R] [PMID: 32869342]
[http://dx.doi.org/10.1155/2020/4641585] [PMID: 32410855]
[http://dx.doi.org/10.1136/mp.51.3.143] [PMID: 9850337]
[http://dx.doi.org/10.3390/cells10051109] [PMID: 34062964]
[http://dx.doi.org/10.1038/s41577-020-0320-7] [PMID: 32327719]
[http://dx.doi.org/10.3324/haematol.2019.225722] [PMID: 31699792]
[http://dx.doi.org/10.4084/mjhid.2021.016] [PMID: 33747397]
[http://dx.doi.org/10.1097/SHK.0000000000001057] [PMID: 29176404]
[http://dx.doi.org/10.1016/j.bcp.2006.05.017] [PMID: 16846592]
[http://dx.doi.org/10.4049/jimmunol.1402301] [PMID: 25911757]
[http://dx.doi.org/10.1016/j.clnesp.2021.12.030] [PMID: 35063236]
[http://dx.doi.org/10.1016/j.ijcrp.2021.200121] [PMID: 34806090]
[http://dx.doi.org/10.1016/j.lfs.2021.119251] [PMID: 33636175]
[http://dx.doi.org/10.1002/jcp.25724] [PMID: 27925202]
[PMID: 34919258]
[http://dx.doi.org/10.3389/fcvm.2021.644095] [PMID: 34124187]
[http://dx.doi.org/10.1101/gad.262642.115] [PMID: 26227964]
[http://dx.doi.org/10.3390/life11080734] [PMID: 34440478]
[http://dx.doi.org/10.1016/j.biopha.2021.112193] [PMID: 34543987]
[http://dx.doi.org/10.1371/journal.ppat.1003848] [PMID: 24391503]
[http://dx.doi.org/10.1159/000480340] [PMID: 28854431]
[http://dx.doi.org/10.1016/j.sciaf.2021.e01084] [PMID: 34957352]
[http://dx.doi.org/10.1007/s00210-021-02147-6] [PMID: 34480616]
[http://dx.doi.org/10.1016/j.hjc.2017.07.002] [PMID: 28712999]
[http://dx.doi.org/10.1016/j.bbadis.2009.10.003]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.108.814582] [PMID: 19620505]
[http://dx.doi.org/10.1007/s00011-018-1173-4] [PMID: 30083975]
[http://dx.doi.org/10.1080/14767058.2016.1220524] [PMID: 27491377]
[http://dx.doi.org/10.3389/fimmu.2020.01712] [PMID: 32754164]
[http://dx.doi.org/10.1016/j.ijid.2020.09.014] [PMID: 32920234]