Relação da patogênese de COVID-19 para pesquisa de medicina periodontal. Parte I: Patogênese da COVID-19
DOI:
https://doi.org/10.33448/rsd-v10i5.13729Palavras-chave:
Infecção por Coronavírus; Patogênese; Periodontia.Resumo
A invasão celular mediada pela enzima conversora de angiotensina 2 (ACE2) ectoenzima e proteases celulares, tem como alvo diferentes tecidos e órgãos. A perda da homeostase do sistema renina-angiotensina desorganiza diferentes eixos, comprometendo o controle metabólico, cardiorrespiratório, renal e hepático. A célula infectada com SARS-CoV-2 sofre piroptose e libera padrões moleculares associados a danos: interleucina pró-inflamatória (IL) -1β, IL-6, IL-8, IL-10, IL-17, induzida por proteína-10, interferon gama, proteína induzida por interferon gama-10, fator estimulador de colônia de granulócitos, fator estimulador de colônia de granulócitos-macrófagos, proteína inflamatória de macrófagos 1α e 1β, proteína de ativação de quimioterapia de monócitos 1, células inflamatórias de proteína de macrófagos 1, necrose tumoral-α e mediadores de doenças inflamatórias mediadas. A tempestade de citocinas e os anticorpos não neutralizantes produzidos pelas células B circulam, exacerbando os danos a vários órgãos. Durante a replicação viral e a baixa saturação de oxigênio, a perda da homeostase celular mediada pelo HIF pode levar à morte/lise celular e danos aos tecidos, relacionados à resposta hiperinflamatória. O SARS-CoV-2-ACE2 pode aumentar a permeabilidade, inflamação e transmissão microbiana por bacteremia ou endotoxemia, além da disbiose. O potencial trombótico e o desequilíbrio imunoinflamatório comprometem a função ou levam a lesões e falência de múltiplos órgãos. A infecção por SARS-CoV-2 tem o potencial de modificar a história natural das doenças, as relações ou interações entre diferentes sistemas e patologias e os efeitos de seus tratamentos, como na abordagem da medicina periodontal.
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