The emergence of coronavirus disease-2019 induced by a newly identified bcoronavirus, namely severe acute respiratory syndrome coronavirus 2(SARSCoV-2) has constituted a public health emergency. Even though it was con...The emergence of coronavirus disease-2019 induced by a newly identified bcoronavirus, namely severe acute respiratory syndrome coronavirus 2(SARSCoV-2) has constituted a public health emergency. Even though it was considered a zoonotic disease, the virus has also spread among humans via respiratory secretions. The expression and distribution of angiotensin converting enzyme type 2(ACE2) in various human organs might also show other possible infection routes. High ACE2 ribonucleic acid expression has been identified in the gastrointestinal tract(GI) indicating its importance as a possible infection pathway of SARS-CoV-2. ACE2 induces viral entry into the host and most importantly has been found to be associated with the function of the gut. Its deficiency has been implicated in several pathologies such as colorectal inflammation. The renin-angiotensin system(RAS) is an essential regulatory cascade operating both at a local tissue level and at the systemic or circulatory level. The RAS may be important in the pathogenesis of chronic liver disease and is associated with the up-regulation of ACE2. Thus, the aim of this review is firstly, the analysis of some important general and genome characteristics of SARS-CoV-2 and secondly, and most importantly, to focus on the utility of ACE2 receptors in both SARS-CoV-2 replication and pathogenesis, especially in the GI tract.展开更多
The survey aimed to explore the association of liver transaminases with the prevalence of type 2 diabetes mellitus（T2DM） and pre-diabetes（pre-DM） in the middle-aged rural population in China. A cross-sectional stu...The survey aimed to explore the association of liver transaminases with the prevalence of type 2 diabetes mellitus（T2DM） and pre-diabetes（pre-DM） in the middle-aged rural population in China. A cross-sectional study was conducted in 10 800 middle-aged subjects who lived in rural area of central China. The 75-g oral glucose-tolerance test（OGTT） was performed. Participants were asked to complete physical examination and standard questionnaire. The serum liver transaminases（ALT and GGT）, Hb A1 C and serum lipids were measured. In middle-aged rural population, the prevalence of impaired fasting glucose（IFG）, impaired glucose tolerance（IGT）, impaired fasting glucose combined with impaired glucose tolerance（IFG＋IGT） and DM was 4.0%, 11.8%, 2.6% and 10.0%, respectively. Some measurements were higher in males than in females, such as waist hip ratio（WHR）, blood pressure, fasting blood glucose（FBG）, high density lipoprotein-cholesterol（HDL-C）, and liver enzymes（ALT and GGT）. Further, we found that elevated serum GGT and ALT levels were significantly positively correlated with the prevalence of DM, independent of central obesity, serum lipid and insulin resistance（IR） in both genders. However, the correlation of GGT and ALT with pre-DM was determined by genders and characteristics of liver enzymes. Higher serum GGT was indicative of IGT in both genders. The association of serum ALT with pre-DM was significant only in female IGT group. In conclusion, our present survey shows both serum GGT and ALT are positively associated with DM, independent of the cardiovascular risk factors in both genders.展开更多
Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)recently emerged as a highly virulent respiratory pathogen that is known as the causative agent of coronavirus disease 2019(COVID-19).Diarrhea is a common ear...Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)recently emerged as a highly virulent respiratory pathogen that is known as the causative agent of coronavirus disease 2019(COVID-19).Diarrhea is a common early symptom in a significant proportion of patients with SARS-CoV-2 infection.SARS-CoV-2 can infect and replicate in esophageal cells and enterocytes,leading to direct damage to the intestinal epithelium.The infection decreases the level of angiotensinconverting enzyme 2 receptors,thereby altering the composition of the gut microbiota.SARS-CoV-2 elicits a cytokine storm,which contributes to gastrointestinal inflammation.The direct cytopathic effects of SARS-CoV-2,gut dysbiosis,and aberrant immune response result in increased intestinal permeability,which may exacerbate existing symptoms and worsen the prognosis.By exploring the elements of pathogenesis,several therapeutic options have emerged for the treatment of COVID-19 patients,such as biologics and biotherapeutic agents.However,the presence of SARS-CoV-2 in the feces may facilitate the spread of COVID-19 through fecal-oral transmission and contaminate the environment.Thus gastrointestinal SARS-CoV-2 infection has important epidemiological significance.The development of new therapeutic and preventive options is necessary to treat and restrict the spread of this severe and widespread infection more effectively.Therefore,we summarize the key elements involved in the pathogenesis and the epidemiology of COVID-19-associated diarrhea.展开更多
文摘The emergence of coronavirus disease-2019 induced by a newly identified bcoronavirus, namely severe acute respiratory syndrome coronavirus 2(SARSCoV-2) has constituted a public health emergency. Even though it was considered a zoonotic disease, the virus has also spread among humans via respiratory secretions. The expression and distribution of angiotensin converting enzyme type 2(ACE2) in various human organs might also show other possible infection routes. High ACE2 ribonucleic acid expression has been identified in the gastrointestinal tract(GI) indicating its importance as a possible infection pathway of SARS-CoV-2. ACE2 induces viral entry into the host and most importantly has been found to be associated with the function of the gut. Its deficiency has been implicated in several pathologies such as colorectal inflammation. The renin-angiotensin system(RAS) is an essential regulatory cascade operating both at a local tissue level and at the systemic or circulatory level. The RAS may be important in the pathogenesis of chronic liver disease and is associated with the up-regulation of ACE2. Thus, the aim of this review is firstly, the analysis of some important general and genome characteristics of SARS-CoV-2 and secondly, and most importantly, to focus on the utility of ACE2 receptors in both SARS-CoV-2 replication and pathogenesis, especially in the GI tract.
基金supported by Chinese Society of Endocrinology,the Key Laboratory for Endocrine and Metabolic Disease of Ministry of Healthy(No.1994DP131044)
文摘The survey aimed to explore the association of liver transaminases with the prevalence of type 2 diabetes mellitus（T2DM） and pre-diabetes（pre-DM） in the middle-aged rural population in China. A cross-sectional study was conducted in 10 800 middle-aged subjects who lived in rural area of central China. The 75-g oral glucose-tolerance test（OGTT） was performed. Participants were asked to complete physical examination and standard questionnaire. The serum liver transaminases（ALT and GGT）, Hb A1 C and serum lipids were measured. In middle-aged rural population, the prevalence of impaired fasting glucose（IFG）, impaired glucose tolerance（IGT）, impaired fasting glucose combined with impaired glucose tolerance（IFG＋IGT） and DM was 4.0%, 11.8%, 2.6% and 10.0%, respectively. Some measurements were higher in males than in females, such as waist hip ratio（WHR）, blood pressure, fasting blood glucose（FBG）, high density lipoprotein-cholesterol（HDL-C）, and liver enzymes（ALT and GGT）. Further, we found that elevated serum GGT and ALT levels were significantly positively correlated with the prevalence of DM, independent of central obesity, serum lipid and insulin resistance（IR） in both genders. However, the correlation of GGT and ALT with pre-DM was determined by genders and characteristics of liver enzymes. Higher serum GGT was indicative of IGT in both genders. The association of serum ALT with pre-DM was significant only in female IGT group. In conclusion, our present survey shows both serum GGT and ALT are positively associated with DM, independent of the cardiovascular risk factors in both genders.
文摘Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)recently emerged as a highly virulent respiratory pathogen that is known as the causative agent of coronavirus disease 2019(COVID-19).Diarrhea is a common early symptom in a significant proportion of patients with SARS-CoV-2 infection.SARS-CoV-2 can infect and replicate in esophageal cells and enterocytes,leading to direct damage to the intestinal epithelium.The infection decreases the level of angiotensinconverting enzyme 2 receptors,thereby altering the composition of the gut microbiota.SARS-CoV-2 elicits a cytokine storm,which contributes to gastrointestinal inflammation.The direct cytopathic effects of SARS-CoV-2,gut dysbiosis,and aberrant immune response result in increased intestinal permeability,which may exacerbate existing symptoms and worsen the prognosis.By exploring the elements of pathogenesis,several therapeutic options have emerged for the treatment of COVID-19 patients,such as biologics and biotherapeutic agents.However,the presence of SARS-CoV-2 in the feces may facilitate the spread of COVID-19 through fecal-oral transmission and contaminate the environment.Thus gastrointestinal SARS-CoV-2 infection has important epidemiological significance.The development of new therapeutic and preventive options is necessary to treat and restrict the spread of this severe and widespread infection more effectively.Therefore,we summarize the key elements involved in the pathogenesis and the epidemiology of COVID-19-associated diarrhea.
