User:Ali Albasser

Coronavirus treatment depend on theory of AOPD

Coronavirus cause new disease AOPD(acute obstructive pulmonary disease)

Coronavirus family :

coronaviridae

SubFamily :Orthocoronavirinae

Structure:

The coronavirus RNA group of virus, spike protein is a multifunctional molecular machine that mediates coronavirus entry into host cells. It first binds to a receptor on the host cell surface through its S1 subunit and then fuses viral and host membranes through its S2 subunit. Two domains in S1 from different coronaviruses recognize a variety of host receptors, leading to viral attachment. The spike protein exists in two structurally distinct conformations, prefusion and postfusion. The transition from prefusion to postfusion conformation of the spike protein must be triggered, leading to membrane fusion. This article reviews current knowledge about the structures and functions of coronavirus spike proteins, illustrating how the two S1 domains recognize different receptors and how the spike proteins are regulated to undergo conformational transitions. I further discuss the evolution of these two critical functions of coronavirus spike proteins, receptor recognition and membrane fusion, in the context of the corresponding functions from other viruses and host cells.

Rout of transmission:airborne, direct contact.

Source of infectious:sick human.

Risk factor :

1-older people

2-people with immunodeficiency disease.

3- respiratory disease

4-poor hygienic conditions.

Pathogensis:

Coronavirus infection (regardless of the various types of corona virus) is primarily attacked by immune cells including mast cells (MCs), which are located in the submucosa of the respiratory tract and in the nasal cavity and represent a barrier of protection against microorganisms. Viral activate MCs release early inflammatory chemical copounds including histamine and protease.

while late activation provoke the generation of pro-inflammatory IL-1 family members including IL-1, IL-6 and IL-33. Here, we propose for the first time that inflammation by coronavirus maybe inhibited by anti-inflammatory cytokines belonging to the IL-1 family members.

role of proteases and their imbalance in AOPD ( acute obstructive pulmonary disease ) there are three classes (serine, mettalo, and cysteine) of proteases involved in COPD. In serine proteases, neutrophil elastase, cathepsin G, and proteinase-3 are involved in destruction of alveolar tissue. Matrix-mettaloproteinase-9, 12, 13, plays an influential role in severity of AOPD. Among cysteine proteases, caspase-3, caspases-8 and caspase-9 play an important role in controlling apoptosis. These proteases activities can be regulated by inhibitors like α-1-antitrypsin, neutrophil elastase inhibitor, and leukocyte protease inhibitor. Studies suggest that neutrophil elastase may be a therapeutic target for AOPD, and specific inhibitor against this enzyme has potential role to control the disease. Current study suggests that Dipeptidyl Peptidase IV is a potential marker for AOPD. Since the expression of proteases and its inhibitors play an important role in AOPD pathogenesis, therefore, it is worth investigating the role of proteases and their regulation.

Histamine plays a role in airway obstruction via smooth muscle contraction, bronchial secretion, and airway mucosal edema.

Histamine can cause :

1-sneezing due to histamine _associated sensory neural stimulation.

2-effect of enterochromaffin cell, located within gastric glands of stomach , release histamine which stimulates the parital cells which binding apical H2 receptor which cause stomach secretions which may cause diarrhea.

3-nasal congestion due to vascular engorgement associated with vasodilation and increase capillary permeability.

Activation of mast cells leads to interstitial lung disease and bronchial obstructive disease AOPD.

Clinical symptoms:

•fever

•cough

•shortness of breath or difficulty breathing

And may cause:

•Aches

•sore throat

•runny nose

•diarrhea

Complications:

•APOD (acute obstructive pulmonary disease)

•failure of many organ.

•death

Diagnosis:

•physical examination, clinical symptoms.

• laboratory test:

1-PCR detect coronavirus by RNA molecule.

2-Blood test, urine test check level histamine and another blood component.

3-Bacteriological text to detect secondary infection if it's present.

• instrumental examination

1-x-ray

2-spirometer

Prophylaxis:

•mask

•gloves

•isolation of sick people

•washing hands and use antiseptic

•keep distance between you and another people

•avoid smoking

Treatment:

During first and second week of infection:

•antiviral drug interferon with recommendations use of hydroxychloroquine.

•mast cell stabilizer chromone medication

•antihistamine drug

•supportive therapy vitamins

•antioxidant

•anti inflammatory drug

If develop AOPD use:

•oxygen therapy

•corticosteroids drunk prednisone 5-60mg orally

•short acting Bronchodilators albuterol sulfate 5 mg nebulizer

•antibiotic

•methylxanthine

•ventilation assistance

doctor:Ali MARE ALBASEER

email:Alialbassr1976@gmail.com