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Serotonin reduction in post-acute sequelae of viral infection.


ABSTRACT: Post-acute sequelae of COVID-19 (PASC, "Long COVID") pose a significant global health challenge. The pathophysiology is unknown, and no effective treatments have been found to date. Several hypotheses have been formulated to explain the etiology of PASC, including viral persistence, chronic inflammation, hypercoagulability, and autonomic dysfunction. Here, we propose a mechanism that links all four hypotheses in a single pathway and provides actionable insights for therapeutic interventions. We find that PASC are associated with serotonin reduction. Viral infection and type I interferon-driven inflammation reduce serotonin through three mechanisms: diminished intestinal absorption of the serotonin precursor tryptophan; platelet hyperactivation and thrombocytopenia, which impacts serotonin storage; and enhanced MAO-mediated serotonin turnover. Peripheral serotonin reduction, in turn, impedes the activity of the vagus nerve and thereby impairs hippocampal responses and memory. These findings provide a possible explanation for neurocognitive symptoms associated with viral persistence in Long COVID, which may extend to other post-viral syndromes.

SUBMITTER: Wong AC 

PROVIDER: S-EPMC11227373 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Serotonin reduction in post-acute sequelae of viral infection.

Wong Andrea C AC   Devason Ashwarya S AS   Umana Iboro C IC   Cox Timothy O TO   Dohnalová Lenka L   Litichevskiy Lev L   Perla Jonathan J   Lundgren Patrick P   Etwebi Zienab Z   Izzo Luke T LT   Kim Jihee J   Tetlak Monika M   Descamps Hélène C HC   Park Simone L SL   Wisser Stephen S   McKnight Aaron D AD   Pardy Ryan D RD   Kim Junwon J   Blank Niklas N   Patel Shaan S   Thum Katharina K   Mason Sydney S   Beltra Jean-Christophe JC   Michieletto Michaël F MF   Ngiow Shin Foong SF   Miller Brittany M BM   Liou Megan J MJ   Madhu Bhoomi B   Dmitrieva-Posocco Oxana O   Huber Alex S AS   Hewins Peter P   Petucci Christopher C   Chu Candice P CP   Baraniecki-Zwil Gwen G   Giron Leila B LB   Baxter Amy E AE   Greenplate Allison R AR   Kearns Charlotte C   Montone Kathleen K   Litzky Leslie A LA   Feldman Michael M   Henao-Mejia Jorge J   Striepen Boris B   Ramage Holly H   Jurado Kellie A KA   Wellen Kathryn E KE   O'Doherty Una U   Abdel-Mohsen Mohamed M   Landay Alan L AL   Keshavarzian Ali A   Henrich Timothy J TJ   Deeks Steven G SG   Peluso Michael J MJ   Meyer Nuala J NJ   Wherry E John EJ   Abramoff Benjamin A BA   Cherry Sara S   Thaiss Christoph A CA   Levy Maayan M  

Cell 20231016 22


Post-acute sequelae of COVID-19 (PASC, "Long COVID") pose a significant global health challenge. The pathophysiology is unknown, and no effective treatments have been found to date. Several hypotheses have been formulated to explain the etiology of PASC, including viral persistence, chronic inflammation, hypercoagulability, and autonomic dysfunction. Here, we propose a mechanism that links all four hypotheses in a single pathway and provides actionable insights for therapeutic interventions. We  ...[more]

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