Mast cell stabilizers as a supportive therapy can contribute to alleviate fatal inflammatory responses and severity of pulmonary complications in COVID-19 infection

Abstract

SARS-CoV-2(COVID-19) leads to severe acute respiratory syndrome by settling the pulmonary system. Mast cells (MCs) are multifunctional immune cells that are extensively distributed throughout the body and mostly present in pulmonary system. MCs play a vital role in acquired and innate immunity, and to maintain immune homeostasis of the body through a wide range of mediators in their cytoplasmic granules. Severe acute respiratory syndrome with proinflammatory cytokine release and pneumonia during COVID-19 infection can result in the death, in particular in debilitated individuals or those suffering from related chronic disorders. In this review, we attempt to discuss potential relationship between COVID-19 symptoms and mast cells as well as potential use of mast cell stabilizers as a supportive therapeutic option in COVID-19 infection. MCs are main source of pro-inflammatory cytokines such as IL-1, IL-6 and TNF-α as well as bronchoconstrictor mediators such as histamine, prostaglandin-D2 and leukotriene-C4 that can lead to fatal inflammatory responses and pulmonary complications during COVID-19 infection. SARS-CoV-2 may activate MCs through toll-like receptors or by inducing the cross-linking of the IgE-FcεRI, thus leading to release of those mediators. SARS-CoV-2-induced abnormal production and release of these mediators from MCs can further exacerbate inflammation in respiratory system, consequently pulmonary complications.Therefore administration of MC stabilizers as a supportive therapy may be useful to alleviate inflammatory responses and pulmonary complications in order to reduce deaths from SARS-CoV-2 infection.