Exp Neurobiol.
2022 Aug;31(4):270-276. 10.5607/en21049.
Blood-brain Barrier Damage is Pivotal for SARS-CoV-2 Infection to the Central Nervous System
- Affiliations
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- 1Neurosurgery Specialty, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico
- 2Neurology and Neurosurgery Unit, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico
- 3Laboratory of Immunometabolism, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico
- 4PECEM, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico
- 5Genomic Medicine, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico
- 6Unit for Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Mexico City 06720, Mexico
- 7Direction of Research, General Hospital of Mexico, Mexico City 06720, Mexico
- 8Faculty of Health Sciences, Anahuac University, Mexico City 52786, Mexico
- 9Departments of Physiology, Biophysics and Neurosciences, CINVESTAV-IPN, Mexico City 07360, Mexico
- KMID: 2532837
- DOI: http://doi.org/10.5607/en21049
Abstract
- Transsynaptic transport is the most accepted proposal to explain the SARS-CoV-2 infection of the CNS. Nevertheless, emerging evidence shows that neurons do not express the SARS-CoV-2 receptor ACE2, which highlights the importance of the blood-brain barrier (BBB) in preventing virus entry to the brain. In this study, we examine the presence of SARS-CoV-2 messenger ribonucleic acid (mRNA) and the cytokine profile in cerebrospinal fluids (CSF) from two patients with a brain tumor and COVID-19. To determine the BBB damage, we evaluate the Q- albumin index, which is an indirect parameter to assess the permeability of this structure. The Q-albumin index of the patient with an intraventricular brain tumor suggests that the BBB is undamaged, preventing the passage of SARS-CoV-2 and pro-inflammatory molecules. The development of brain tumors that disrupt the BBB (measured by the Q-albumin index), in this case, a petroclival meningioma (Case 1), allows the free passage of the SARS-CoV-2 virus and probably lets the free transit of pro-inflammatory molecules to the CNS, which leads to a possible activation of the microglia (astrogliosis) and an exacerbated immune response represented by IL-13, IFN-γ, and IL-2 trying to inhibit both the infection and the carcinogenic process.
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