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      Inflammatory cytokine storms severity may be fueled by interactions of Micronuclei and RNA viruses such as COVID-19 virus SARS-CoV-2. A hypothesis

      review-article
      a , ** , b , c , d , *
      Mutation Research. Reviews in Mutation Research
      Elsevier B.V.
      ACE2, angiotensin-converting enzyme 2, ARDS, acute respiratory distress syndrome, cGAS, cyclic GMP–AMP synthase, DDR, DNA damage response, IRF3, interferon regulatory factor 3, MAVS, mitochondrial anti-viral signaling protein, MN, micronuclei or micronucleus, PRR, pattern recognition receptors, RIG-1, retinoic acid-inducible gene I, RONS, reactive oxygen and nitrogen species, SASP, senescence associated secretory phenotype, STING, cyclic GMP–AMP receptor stimulator of interferon genes, TMPRSS2, transmembrane protease serine 2, Micronuclei, Aneuploidy, Viruses, COVID-19, cGAS-STING, Inflammation

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          Abstract

          In this review we bring together evidence that (i) RNA viruses are a cause of chromosomal instability and micronuclei (MN), (ii) those individuals with high levels of lymphocyte MN have a weakened immune response and are more susceptible to RNA virus infection and (iii) both RNA virus infection and MN formation can induce inflammatory cytokine production. Based on these observations we propose a hypothesis that those who harbor elevated frequencies of MN within their cells are more prone to RNA virus infection and are more likely, through combined effects of leakage of self-DNA from MN and RNA from viruses, to escalate pro-inflammatory cytokine production via the cyclic GMP–AMP synthase (cGAS), stimulator of interferon genes (STING) and the Senescence Associated Secretory Phenotype (SASP) mechanisms to an extent that is unresolvable and therefore confers high risk of causing tissue damage by an excessive and overtly toxic immune response. The corollaries from this hypothesis are (i) those with abnormally high MN frequency are more prone to infection by RNA viruses; (ii) the extent of cytokine production and pro-inflammatory response to infection by RNA viruses is enhanced and possibly exceeds threshold levels that may be unresolvable in those with elevated MN levels in affected organs; (iii) reduction of MN frequency by improving nutrition and life-style factors increases resistance to RNA virus infection and moderates inflammatory cytokine production to a level that is immunologically efficacious and survivable.

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          Most cited references222

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          The trinity of COVID-19: immunity, inflammation and intervention

          Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Alongside investigations into the virology of SARS-CoV-2, understanding the fundamental physiological and immunological processes underlying the clinical manifestations of COVID-19 is vital for the identification and rational design of effective therapies. Here, we provide an overview of the pathophysiology of SARS-CoV-2 infection. We describe the interaction of SARS-CoV-2 with the immune system and the subsequent contribution of dysfunctional immune responses to disease progression. From nascent reports describing SARS-CoV-2, we make inferences on the basis of the parallel pathophysiological and immunological features of the other human coronaviruses targeting the lower respiratory tract — severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Finally, we highlight the implications of these approaches for potential therapeutic interventions that target viral infection and/or immunoregulation.
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            Sex differences in immune responses

            Males and females differ in their immunological responses to foreign and self-antigens and show distinctions in innate and adaptive immune responses. Certain immunological sex differences are present throughout life, whereas others are only apparent after puberty and before reproductive senescence, suggesting that both genes and hormones are involved. Furthermore, early environmental exposures influence the microbiome and have sex-dependent effects on immune function. Importantly, these sex-based immunological differences contribute to variations in the incidence of autoimmune diseases and malignancies, susceptibility to infectious diseases and responses to vaccines in males and females. Here, we discuss these differences and emphasize that sex is a biological variable that should be considered in immunological studies.
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              The pathogenesis and treatment of the `Cytokine Storm' in COVID-19

              Summary Cytokine storm is an excessive immune response to external stimuli. The pathogenesis of the cytokine storm is complex. The disease progresses rapidly, and the mortality is high. Certain evidence shows that, during the coronavirus disease 2019 (COVID-19) epidemic, the severe deterioration of some patients has been closely related to the cytokine storm in their bodies. This article reviews the occurrence mechanism and treatment strategies of the COVID-19 virus-induced inflammatory storm in attempt to provide valuable medication guidance for clinical treatment.
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                Author and article information

                Journal
                Mutat Res Rev Mutat Res
                Mutat Res Rev Mutat Res
                Mutation Research. Reviews in Mutation Research
                Elsevier B.V.
                1383-5742
                1388-2139
                28 September 2021
                28 September 2021
                : 108395
                Affiliations
                [a ]Laboratory for Cell Genetics, Department Biology, Faculty of Sciences and Bio-engineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
                [b ]Genome Health Foundation, North Brighton, SA, 5048, Australia
                [c ]Clinical and Health Sciences, University of South Australia, SA, 5000, Australia
                [d ]Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
                Author notes
                [* ]Corresponding author at: Genome Health Foundation, North Brighton, SA, 5048, Australia.
                [** ]Corresponding author.
                Article
                S1383-5742(21)00032-6 108395
                10.1016/j.mrrev.2021.108395
                8479308
                34893160
                c8670a07-9a39-4f13-919d-2534c470d203
                © 2021 Elsevier B.V. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 3 March 2021
                : 23 September 2021
                : 23 September 2021
                Categories
                Review

                ace2, angiotensin-converting enzyme 2,ards, acute respiratory distress syndrome,cgas, cyclic gmp–amp synthase,ddr, dna damage response,irf3, interferon regulatory factor 3,mavs, mitochondrial anti-viral signaling protein,mn, micronuclei or micronucleus,prr, pattern recognition receptors,rig-1, retinoic acid-inducible gene i,rons, reactive oxygen and nitrogen species,sasp, senescence associated secretory phenotype,sting, cyclic gmp–amp receptor stimulator of interferon genes,tmprss2, transmembrane protease serine 2,micronuclei,aneuploidy,viruses,covid-19,cgas-sting,inflammation

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