tetano
Editor, Senior Moderator
Cells
. 2021 Nov 24;10(12):3291.
doi: 10.3390/cells10123291.
COVID-19 and Rheumatoid Arthritis Crosstalk: Emerging Association, Therapeutic Options and Challenges
Saikat Dewanjee[SUP] 1 [/SUP], Ramesh Kandimalla[SUP] 2 3 [/SUP], Rajkumar Singh Kalra[SUP] 4 [/SUP], Chandrasekhar Valupadas[SUP] 5 6 [/SUP], Jayalakshmi Vallamkondu[SUP] 7 [/SUP], Viswakalyan Kolli[SUP] 8 [/SUP], Sarbani Dey Ray[SUP] 9 [/SUP], Arubala P Reddy[SUP] 10 [/SUP], P Hemachandra Reddy[SUP] 11 12 13 14 [/SUP]
Affiliations
Abstract
Hyperactivation of immune responses resulting in excessive release of pro-inflammatory mediators in alveoli/lung structures is the principal pathological feature of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The cytokine hyperactivation in COVID-19 appears to be similar to those seen in rheumatoid arthritis (RA), an autoimmune disease. Emerging evidence conferred the severity and risk of COVID-19 to RA patients. Amid the evidence of musculoskeletal manifestations involving immune-inflammation-dependent mechanisms and cases of arthralgia and/or myalgia in COVID-19, crosstalk between COVID-19 and RA is often debated. The present article sheds light on the pathological crosstalk between COVID-19 and RA, the risk of RA patients in acquiring SARS-CoV-2 infection, and the aspects of SARS-CoV-2 infection in RA development. We also conferred whether RA can exacerbate COVID-19 outcomes based on available clinical readouts. The mechanistic overlapping in immune-inflammatory features in both COVID-19 and RA was discussed. We showed the emerging links of angiotensin-converting enzyme (ACE)-dependent and macrophage-mediated pathways in both diseases. Moreover, a detailed review of immediate challenges and key recommendations for anti-rheumatic drugs in the COVID-19 setting was presented for better clinical monitoring and management of RA patients. Taken together, the present article summarizes available knowledge on the emerging COVID-19 and RA crosstalk and their mechanistic overlaps, challenges, and therapeutic options.
Keywords: ACE; ACE2; COVID-19; SARS-CoV-2; anti-rheumatic drugs; cytokine storm; immune response; inflammation; rheumatoid arthritis; therapeutic options.
. 2021 Nov 24;10(12):3291.
doi: 10.3390/cells10123291.
COVID-19 and Rheumatoid Arthritis Crosstalk: Emerging Association, Therapeutic Options and Challenges
Saikat Dewanjee[SUP] 1 [/SUP], Ramesh Kandimalla[SUP] 2 3 [/SUP], Rajkumar Singh Kalra[SUP] 4 [/SUP], Chandrasekhar Valupadas[SUP] 5 6 [/SUP], Jayalakshmi Vallamkondu[SUP] 7 [/SUP], Viswakalyan Kolli[SUP] 8 [/SUP], Sarbani Dey Ray[SUP] 9 [/SUP], Arubala P Reddy[SUP] 10 [/SUP], P Hemachandra Reddy[SUP] 11 12 13 14 [/SUP]
Affiliations
- PMID: 34943795
- DOI: 10.3390/cells10123291
Abstract
Hyperactivation of immune responses resulting in excessive release of pro-inflammatory mediators in alveoli/lung structures is the principal pathological feature of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The cytokine hyperactivation in COVID-19 appears to be similar to those seen in rheumatoid arthritis (RA), an autoimmune disease. Emerging evidence conferred the severity and risk of COVID-19 to RA patients. Amid the evidence of musculoskeletal manifestations involving immune-inflammation-dependent mechanisms and cases of arthralgia and/or myalgia in COVID-19, crosstalk between COVID-19 and RA is often debated. The present article sheds light on the pathological crosstalk between COVID-19 and RA, the risk of RA patients in acquiring SARS-CoV-2 infection, and the aspects of SARS-CoV-2 infection in RA development. We also conferred whether RA can exacerbate COVID-19 outcomes based on available clinical readouts. The mechanistic overlapping in immune-inflammatory features in both COVID-19 and RA was discussed. We showed the emerging links of angiotensin-converting enzyme (ACE)-dependent and macrophage-mediated pathways in both diseases. Moreover, a detailed review of immediate challenges and key recommendations for anti-rheumatic drugs in the COVID-19 setting was presented for better clinical monitoring and management of RA patients. Taken together, the present article summarizes available knowledge on the emerging COVID-19 and RA crosstalk and their mechanistic overlaps, challenges, and therapeutic options.
Keywords: ACE; ACE2; COVID-19; SARS-CoV-2; anti-rheumatic drugs; cytokine storm; immune response; inflammation; rheumatoid arthritis; therapeutic options.