Abstract
Coronavirus disease 2019 (CoVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 has affected more than 100 million lives. Severe CoVID-19 infection may lead to acute respiratory distress syndrome and death of the patient, and is associated with hyperinflammation and cytokine storm. The broad spectrum immunosuppressant corticosteroid, dexamethasone, is being used to manage the cytokine storm and hyperinflammation in CoVID-19 patients. However, the extensive use of corticosteroids leads to serious adverse events and disruption of the gut-lung axis. Various micronutrients and probiotic supplementations are known to aid in the reduction of hyperinflammation and restoration of gut microbiota. The attenuation of the deleterious immune response and hyperinflammation could be mediated by short chain fatty acids produced by the gut microbiota. Butyric acid, the most extensively studied short chain fatty acid, is known for its anti-inflammatory properties. Additionally, butyric acid has been shown to ameliorate hyperinflammation and reduce oxidative stress in various pathologies, including respiratory viral infections. In this review, the potential anti-inflammatory effects of butyric acid that aid in cytokine storm depletion, and its usefulness in effective management of critical illness related to CoVID-19 have been discussed.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative factor for the Coronavirus disease 2019 (CoVID-19)[1]
Based on the various positive reports, we presume that butyric acid possesses potent anti-inflammatory activity, which suggests it as an alternative to dexamethasone for the preventive management of primary and secondary complications related to CoVID-19
Seriously ill CoVID-19 patients are succumbing to respiratory distress syndrome due to significant hyperinflammation and cytokine storm
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative factor for the Coronavirus disease 2019 (CoVID-19)[1]. This article reviews the anti-inflammatory properties of butyric acid or butyrate and its associated molecular pathways involved in controlling the cytokine storm and hyperinflammation associated with SARS-CoV-2 infection. Vitamin D supplementation in SARS-CoV-2 infected patients attenuates the production of proinflammatory cytokines like Interferon (IFN)-γ, IL-6, IL-2 and TNF-α by inhibiting NF-κB and other pathways[57,58,59]. CoVID-19 associated inflammatory signalling pathways including NF-κB, Mitogen-Activated Protein Kinase (MAPK) and phosphatidylinositol 3-kinase/ protein kinase B (PI3K/ AKT) and innate immune response pathways, such as Toll-like signalling and NOD-like signalling modulation and regulation can be mediated by the combination of curcumin, vitamin C, and glycyrrhizic acid[60]. Resveratrol acts as an anti-inflammatory molecule that inhibits the NFκB pathway and thereby reduces circulatory cytokines, such as IL-6 and TNF-α levels, which are observed in severe SARS-CoV-2 infection[77]. For 12 days: 8.5 × 1010 CFU/kg/ day pre-treatment, in vivo (CCR2-deficient and C57BL/6 mice)
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