Evaluation of Serum Zonulin Levels in Iraqi Patients Infected With the Emerging Coronavirus (CoV-19)
Keywords:
Coronavirus, Zonulin and respiratory syndrome
Abstract
CoV-19 is a novel infectious disease resulting from the SARS-CoV-2 coronavirus, which initially surfaced in Wuhan and swiftly expanded globally. Cross-species transmission of CoVs can be extremely deadly, as seen by the 2003 and more recent outbreaks of severe acute respiratory syndrome (SARS) and Middle-East respiratory disease. The globe has been threatened by the novel severe acute respiratory syndrome coronavirus 2 in a number of ways (SARS-CoV-2). Zonulin belongs to a family of proteins, the first of which was identified about a decade ago and is called pre-haptoglobin 2. Serum samples from 120 CoV-19 patients in total were gathered and apparently healthy group (n=60) with age range (20-70) years, admitted from AL-Hussien Teaching Hospital" in Al-muthana – Iraq. Zonulin levels were measured by enzyme-linked immunosorbent assay (kit. Metabolic parameters were measured by enzymatic spectrophotometer methods. The correlation coefficients between serum Zonulin levels and age, BMI, Elements and electrolytes were also evaluated. Serum Zonulin, CRP, D-dimer, and ferritin levels were substantially higher in CoV-19 patients (319.2±15.05) compared to control subjects (79.69±11.77), in CoV-19 patients (426.21±198.73) compared to control subjects (289.43±251), and in CoV-19 patients (738±20.09) compared to control subjects (130.66±9.2) (P <0.001). In COVID-19 patients, there was a significant negative correlation with iron, calcium, and sodium levels, but a positive correlation with age, CRP, D-dimer, and ferritin levels. When comparing the moderate COVID-19 patient group to the critical and severe patient group, the moderate patients' serum Zonulin levels were considerably higher. In CoV-19 patients, serum Zonulin levels were elevated, particularly in severe cases. As a result, Zonulin levels show promise in prognosticating CoV-19 severity. Throughout the trial period, Zonulin findings were consistently higher in the severe group than in the non-severe group.
References
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31. Sari ND, Serin I, Bakir A, Alacam S. Could serum thrombocyte/lymphocyte (TLR), neutrophil/lymphocyte (NLR) and neutro-phil/albumin (NAR) ratios be indicators of hospitalization and mortality in COVID-19?. Iranian Journal of Microbiology. 2022 Dec 6;14(6):913-20.
32. Sharma L, Riva A. Intestinal barrier function in health and disease—Any role of sars-cov-2?. Microorganisms. 2020 Nov 6;8(11):1744.
33. Slifer ZM, Krishnan BR, Madan J, Blikslager AT. Larazotide acetate: A pharmacological peptide approach to tight junction regulation. American Journal of Physiology-Gastrointestinal and Liver Physiology. 2021 Jun 1;320(6):G983-9.
34. Sun, J. T., Chen, Z., Nie, P., Ge, H., Shen, L., Yang, F., et al. (2020). Lipid profile features and their associations with disease severity and mortality in patients with COVID-19. Front. Cardiovasc. Med. 7:584987.
35. Theken KN, Tang SY, Sengupta S, FitzGerald GA. The roles of lipids in SARS-CoV-2 viral replication and the host immune response. Journal of lipid research. 2021 Jan 1;62.
36. Tripathi A, Lammers KM, Goldblum S, Shea-Donohue T, Netzel-Arnett S, Buzza MS, Antalis TM, Vogel SN, Zhao A, Yang S, Arrietta MC. Identification of human zonulin, a physiological modulator of tight junctions, as prehaptoglobin-2. Proceedings of the National Academy of Sciences. 2009 Sep 29;106(39):16799-804.
37. Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, et al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis. (2020) 20:669–77.
38. Wang D, Li R, Wang J, Jiang Q, Gao C, Yang J, Ge L, Hu Q. Correlation analysis between disease severity and clinical and biochemical characteristics of 143 cases of COVID-19 in Wuhan, China: a descriptive study. BMC infectious diseases. 2020 Dec; 20:1-9.
39. Weitz JI, Fredenburgh JC, Eikelboom JW. A test in context: D-dimer. Journal of the American College of Cardiology. 2017 Nov 7;70(19):2411-20.
40. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. Jama. 2020 Aug 25;324(8):782-93.
41. Zhao T, Wang C, Duan B, Yang P, Wu J, Zhang Q. Altered lipid profile in COVID-19 patients and metabolic reprogramming. Frontiers in Microbiology. 2022;13.
42. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet. 2020 Mar 28;395(10229):1054-62.
43. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus From Patients With Pneumonia in China, 2019. N Engl J Med (2020) 382 (8):727–33.
44. Zinellu A, Paliogiannis P, Fois AG, Solidoro P, Carru C, Mangoni AA. Cholesterol and triglyceride concentrations, COVID-19 severity, and mortality: a systematic review and meta-analysis with meta-regression. Frontiers in public health. 2021 Aug 18;9:705916.
2. Ajamian M, Steer D, Rosella G, Gibson PR. Serum zonulin as a marker of intestinal mucosal barrier function: May not be what it seems. PloS one. 2019 Jan 14;14 (1):e0210728.
3. Bande F, Arshad SS, Hair Bejo M, Moeini H, Omar AR. Progress and challenges toward the development of vaccines against avian infectious bronchitis. Journal of immunology research. 2015 Oct;2015.
4. Barbara G, Barbaro MR, Fuschi D, Palombo M, Falangone F, Cremon C, Marasco G, Stanghellini V. Corrigendum: inflammatory and microbiota-related regulation of the intestinal epithelial barrier. Frontiers in Nutrition. 2021 Nov 1;8:790387.
5. Cenac N, Chin AC, Garcia-Villar R, Salvador-Cartier C, Ferrier L, Vergnolle N, et al. PAR2 activation alters colonic paracellular permeability in mice via IFN-gamma-dependent and -independent pathways.The Journal of physiology. 2004; 558(Pt 3):913–25. https://doi.org/10.1113/jphysiol.2004.061721 PMID: 15194744;
6. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Yu T. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The lancet. 2020 Feb 15;395(10223):507-13.
7. Chidambaram V, Geetha HS, Kumar A, Majella MG, Sivakumar RK, Voruganti D, Mehta JL, Karakousis PC. Association of lipid levels with COVID-19 infection, disease severity and mortality: a systematic review and meta-analysis. Frontiers in Cardiovascular Medicine. 2022;9.
8. cholesterol level is an early prognostic marker for organ dysfunction and death in patients with suspected sepsis. Journal of critical care. 2017 Apr 1;38:289-94.
9. de Lemos JA, McGuire DK, Drazner MH. B-type natriuretic peptide in cardiovascular disease. The Lancet. 2003 Jul 26;362 (9380):316-22.
10. Di Micco S, Musella S, Scala MC, Sala M, Campiglia P, Bifulco G, Fasano A. In silico analysis revealed potential anti-SARS-CoV-2 main protease activity by the zonulin inhibitor larazotide acetate. Frontiers in Chemistry. 2021 Jan 15;8:628609.
11. Fan H, Tang X, Song Y, Liu P, Chen Y. Influence of COVID-19 on cerebrovascular disease and its possible mechanism. Neuropsychiatric Disease and Treatment. 2020 May 28:1359-67.
12. Fantini J, Di Scala C, Chahinian H, Yahi N. Structural and molecular modelling studies reveal a new mechanism of action of chloroquine and hydroxychloroquine against SARS-CoV-2 infection. International journal of antimicrobial agents. 2020 May 1;55(5):105960.
13. Fasano A. Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer. Physiological reviews. 2011; 91(1):151–75. https://doi.org/10.1152/physrev. 00003.2008 PMID: 21248165.
14. Fauquet CM, Mayo MA, Maniloff J, Desselberger U, Ball LA, editors. Virus taxonomy: VIIIth report of the International Committee on Taxonomy of Viruses. Academic Press; 2005 Jul 15.
15. Feingold KR, Grunfeld C. Effect of inflammation on HDL structure and function. Current opinion in lipidology. 2016 Oct 1;27(5):521-30.
16. Femlak M, Gluba-Brzózka A, Ciałkowska-Rysz A, Rysz J. The role and function of HDL in patients with diabetes mellitus and the related cardiovascular risk. Lipids in health and disease. 2017 Dec;16 (1):1-9.
17. Han Y, Du J, Su H, Zhang J, Zhu G, Zhang S, Wu Z, Jin Q. Identification of diverse bat alphacoronaviruses and betacoronaviruses in China provides new insights into the evolution and origin of coronavirus-related diseases. Frontiers in microbiology. 2019 Aug 14;10:1900.
18. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet. 2020 Feb 15;395 (10223):497-506.
19. Idris F, Muharram SH, Zaini Z, Alonso S, Diah S. Invasion of a murine in vitro blood-brain barrier co-culture model by dengue virus serotypes 1 to 4. Archives of virology. 2019 Apr 3;164:1069-83.
20. Koch V, Biener M, Müller-Hennessen M, Vafaie M, Staudacher I, Katus HA, Giannitsis E. Diagnostic performance of D-dimer in predicting venous thromboembolism and acute aortic dissection. European Heart Journal Acute Cardiovascular Care. 2021 May;10(5):559-66.
21. Lee C. Porcine epidemic diarrhea virus: an emerging and re-emerging epizootic swine virus. Virology journal. 2015 Dec;12:1-6.
22. Li G, Zhou CL, Ba YM, Wang YM, Song B, Cheng XB, Dong QF, Wang LL, You SS. Nutritional risk and therapy for severe and critical COVID-19 patients: a multicenter retrospective observational study. Clinical Nutrition. 2021 Apr 1;40(4):2154-61.
23. Li X, Sun JT, Chen Z, Nie P, Ge H, Shen L, Yang F, Qu XL, Ying XY, Zhou Y, Wang W, Zhang M. Lipid profile features and their associations with disease severity and mortality in patients with COVID-19. Frontiers in cardiovascular medicine. 2020 Dec 4;7:584987.
24. Lippi G, Favaloro EJ. D-dimer is associated with severity of coronavirus disease 2019: a pooled analysis. Thrombosis and haemostasis. 2020 May;120(05):876-8.
25. Losy J. SARS-CoV-2 infection: symptoms of the nervous system and implications for therapy in neurological disorders. Neurology and therapy. 2021 Jun;10:31-42.
26. Lu J, Hu S, Fan R, Liu Z, Yin X, Wang Q, Lv Q, Cai Z, Li H, Hu Y, Han Y. ACP risk grade: a simple mortality index for patients with confirmed or suspected severe acute respiratory syndrome coronavirus 2 disease (COVID-19) during the early stage of outbreak in Wuhan, China. MedRxiv. 2020 Feb 23:2020-02.
27. Odenwald MA, Turner JR. Intestinal permeability defects: is it time to treat?. Clinical gastroenterology and hepatology. 2013 Sep 1;11(9):1075-83.
28. Pradesh U, E'andit Deen Dayal Upadhayay P, Vigyan C. Coronavirus Infection in Equines: A Review" K. Dhama," RVS Pawaiya," S. Chakraborty,“R. Tiwari," M. Saminathan and. Asian Journal of Animal and Veterinary Advances. 2014;9(3):164-76.
29. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, Xie C, Ma K, Shang K, Wang W, Tian DS. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clinical infectious diseases. 2020 Jul 28;71(15):762-8.
30. Robinson CP, Busl KM. Neurologic manifestations of severe respiratory viral contagions. Critical care explorations. 2020 Apr;2(4).
31. Sari ND, Serin I, Bakir A, Alacam S. Could serum thrombocyte/lymphocyte (TLR), neutrophil/lymphocyte (NLR) and neutro-phil/albumin (NAR) ratios be indicators of hospitalization and mortality in COVID-19?. Iranian Journal of Microbiology. 2022 Dec 6;14(6):913-20.
32. Sharma L, Riva A. Intestinal barrier function in health and disease—Any role of sars-cov-2?. Microorganisms. 2020 Nov 6;8(11):1744.
33. Slifer ZM, Krishnan BR, Madan J, Blikslager AT. Larazotide acetate: A pharmacological peptide approach to tight junction regulation. American Journal of Physiology-Gastrointestinal and Liver Physiology. 2021 Jun 1;320(6):G983-9.
34. Sun, J. T., Chen, Z., Nie, P., Ge, H., Shen, L., Yang, F., et al. (2020). Lipid profile features and their associations with disease severity and mortality in patients with COVID-19. Front. Cardiovasc. Med. 7:584987.
35. Theken KN, Tang SY, Sengupta S, FitzGerald GA. The roles of lipids in SARS-CoV-2 viral replication and the host immune response. Journal of lipid research. 2021 Jan 1;62.
36. Tripathi A, Lammers KM, Goldblum S, Shea-Donohue T, Netzel-Arnett S, Buzza MS, Antalis TM, Vogel SN, Zhao A, Yang S, Arrietta MC. Identification of human zonulin, a physiological modulator of tight junctions, as prehaptoglobin-2. Proceedings of the National Academy of Sciences. 2009 Sep 29;106(39):16799-804.
37. Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, et al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis. (2020) 20:669–77.
38. Wang D, Li R, Wang J, Jiang Q, Gao C, Yang J, Ge L, Hu Q. Correlation analysis between disease severity and clinical and biochemical characteristics of 143 cases of COVID-19 in Wuhan, China: a descriptive study. BMC infectious diseases. 2020 Dec; 20:1-9.
39. Weitz JI, Fredenburgh JC, Eikelboom JW. A test in context: D-dimer. Journal of the American College of Cardiology. 2017 Nov 7;70(19):2411-20.
40. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. Jama. 2020 Aug 25;324(8):782-93.
41. Zhao T, Wang C, Duan B, Yang P, Wu J, Zhang Q. Altered lipid profile in COVID-19 patients and metabolic reprogramming. Frontiers in Microbiology. 2022;13.
42. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet. 2020 Mar 28;395(10229):1054-62.
43. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus From Patients With Pneumonia in China, 2019. N Engl J Med (2020) 382 (8):727–33.
44. Zinellu A, Paliogiannis P, Fois AG, Solidoro P, Carru C, Mangoni AA. Cholesterol and triglyceride concentrations, COVID-19 severity, and mortality: a systematic review and meta-analysis with meta-regression. Frontiers in public health. 2021 Aug 18;9:705916.
Published
2024-06-26
How to Cite
Mahmoud, M. S. A. M., Hassen, A. T. J., AbdulLatif, Z. T. A., & Hassen, A. saadon B. (2024). Evaluation of Serum Zonulin Levels in Iraqi Patients Infected With the Emerging Coronavirus (CoV-19). Central Asian Journal of Medical and Natural Science, 5(3), 677-690. Retrieved from https://www.cajmns.centralasianstudies.org/index.php/CAJMNS/article/view/2494
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Copyright (c) 2024 Mahdi Salih Abdul Mahdi Mahmoud, Amal Talab Jameel Hassen, Ziyad Tariq Adnan AbdulLatif, Aseel saadon Baker Hassen
This work is licensed under a Creative Commons Attribution 4.0 International License.
