1.Blood-brain Barrier Damage is Pivotal for SARS-CoV-2 Infection to the Central Nervous System
Jahir RODRÍGUEZ-MORALES ; Sebastián GUARTAZACA-GUERRERO ; Salma A. RIZO-TÉLLEZ ; Rebeca VIURCOS-SANABRIA ; Eira Valeria BARRÓN ; Aldo F. HERNÁNDEZ-VALENCIA ; Porfirio NAVA ; Galileo ESCOBEDO ; José Damián CARRILLO-RUIZ ; Lucía A. MÉNDEZ-GARCÍA
Experimental Neurobiology 2022;31(4):270-276
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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