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Medicinal nicotine in COVID-19 acute respiratory distress syndrome, the new corticosteroid

The cholinergic anti-inflammatory pathway (CAP) refers to the anti-inflammatory effects mediated by the parasympathetic nervous system. Existence of this pathway was first demonstrated when acetylcholinesterase inhibitors showed benefits in animal models of sepsis. CAP functions via the vagus nerve....

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Autor principal: Ahmad, Farrukh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9305679/
https://www.ncbi.nlm.nih.gov/pubmed/36051943
http://dx.doi.org/10.5492/wjccm.v11.i4.228
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author Ahmad, Farrukh
author_facet Ahmad, Farrukh
author_sort Ahmad, Farrukh
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description The cholinergic anti-inflammatory pathway (CAP) refers to the anti-inflammatory effects mediated by the parasympathetic nervous system. Existence of this pathway was first demonstrated when acetylcholinesterase inhibitors showed benefits in animal models of sepsis. CAP functions via the vagus nerve. The systemic anti-inflammatory effects of CAP converges on the α7 nicotinic acetylcholine receptor on splenic macrophages, leading to suppression of pro-inflammatory cytokines and simultaneous stimulation of anti-inflammatory cytokines, including interleukin 10. CAP offers a novel mechanism to mitigate inflammation. Electrical vagal nerve stimulation has shown benefits in patients suffering from rheumatoid arthritis. Direct agonists like nicotine and GTS-1 have also demonstrated anti-inflammatory properties in models of sepsis and acute respiratory distress syndrome, as have acetylcholinesterase inhibitors like Galantamine and Physostigmine. Experience with coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome indicates that immunomodulators have a protective role in patient outcomes. Dexamethasone is the only medication currently in use that has shown to improve clinical outcomes. This is likely due to the suppression of what is referred to as a cytokine storm, which is implicated in the lethality of viral pneumonia. Nicotine transdermal patch activates CAP and harvests its anti-inflammatory potential by means of an easily administered depot delivery mechanism. It could prove to be a promising, safe and inexpensive additional tool in the currently limited armamentarium at our disposal for management of COVID-19 induced acute hypoxic respiratory failure.
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spelling pubmed-93056792022-08-31 Medicinal nicotine in COVID-19 acute respiratory distress syndrome, the new corticosteroid Ahmad, Farrukh World J Crit Care Med Minireviews The cholinergic anti-inflammatory pathway (CAP) refers to the anti-inflammatory effects mediated by the parasympathetic nervous system. Existence of this pathway was first demonstrated when acetylcholinesterase inhibitors showed benefits in animal models of sepsis. CAP functions via the vagus nerve. The systemic anti-inflammatory effects of CAP converges on the α7 nicotinic acetylcholine receptor on splenic macrophages, leading to suppression of pro-inflammatory cytokines and simultaneous stimulation of anti-inflammatory cytokines, including interleukin 10. CAP offers a novel mechanism to mitigate inflammation. Electrical vagal nerve stimulation has shown benefits in patients suffering from rheumatoid arthritis. Direct agonists like nicotine and GTS-1 have also demonstrated anti-inflammatory properties in models of sepsis and acute respiratory distress syndrome, as have acetylcholinesterase inhibitors like Galantamine and Physostigmine. Experience with coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome indicates that immunomodulators have a protective role in patient outcomes. Dexamethasone is the only medication currently in use that has shown to improve clinical outcomes. This is likely due to the suppression of what is referred to as a cytokine storm, which is implicated in the lethality of viral pneumonia. Nicotine transdermal patch activates CAP and harvests its anti-inflammatory potential by means of an easily administered depot delivery mechanism. It could prove to be a promising, safe and inexpensive additional tool in the currently limited armamentarium at our disposal for management of COVID-19 induced acute hypoxic respiratory failure. Baishideng Publishing Group Inc 2022-07-09 /pmc/articles/PMC9305679/ /pubmed/36051943 http://dx.doi.org/10.5492/wjccm.v11.i4.228 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Minireviews
Ahmad, Farrukh
Medicinal nicotine in COVID-19 acute respiratory distress syndrome, the new corticosteroid
title Medicinal nicotine in COVID-19 acute respiratory distress syndrome, the new corticosteroid
title_full Medicinal nicotine in COVID-19 acute respiratory distress syndrome, the new corticosteroid
title_fullStr Medicinal nicotine in COVID-19 acute respiratory distress syndrome, the new corticosteroid
title_full_unstemmed Medicinal nicotine in COVID-19 acute respiratory distress syndrome, the new corticosteroid
title_short Medicinal nicotine in COVID-19 acute respiratory distress syndrome, the new corticosteroid
title_sort medicinal nicotine in covid-19 acute respiratory distress syndrome, the new corticosteroid
topic Minireviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9305679/
https://www.ncbi.nlm.nih.gov/pubmed/36051943
http://dx.doi.org/10.5492/wjccm.v11.i4.228
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