Medical hypotheses2021，Vol.1486.DOI:10.1016/j.mehy.2021.110520

The potential use of lactate blockers for the prevention of COVID-19 worst outcome, insights from exercise immunology

Elshawarbi, Passant Gamal, Nada Messiha, Mariam Ghazy, Marihan Abdelfatah, Emmy Gayed, Ramy Eesa, Marian Luis, Merna Eskandar, Estfana Yacoub, Shenoda Saud, Alaa Rajab, Maram Abdelaziz, Mariam Elgamal, Nadine Jaber, Hutaf Tayssir, Sara Michael, Mark Sabry, Ahmed Shehata, Joseph Abdelaziz, Rania Rateb, Sherry Mahjoub, Yara Amr, Alaa Mabrouk, Amin Kelada, Peter El-Maghraby, Ahmed Ragab, Shahd Eltaher, Basant Galal, Rahma Hassan Aly, Omnya Mahmoud Aly, Taquwa AbdelHaleem, Rana ElShaarawy, Areeg Mohamed, Omnia AbdelMassih, Antoine Fakhry Menshawey, Rahma Hozaien, Rafeef Kamel, Aya Mishriky, Fady Nasry, Febronia Husseiny, Reem J. Hanoura, Aia Mohamed Yacoub, Elaria AlShehry, Nada Menshawey, Esraa El-Husseiny, Nadine Yasser, Reem Arsanyous, Mariem Nathan, Lauren Seyam, Mahmoud Massoud, Doaa Ali, Nada Kassim, Assem AmanAllah, Mostafa Elsayed, Rokaya Sheashaa, Hesham Husseiny, Yousef Hassan, Nourhan Hatem Badr, Kirollos Elkhateb, Amr Fouad, Verina Elfishawy, Mayada Medhat, Omar Mustafa, Mai Khalil, Noha Elsayed, Rawan Nada, Youssef Abdelmoneim, Noha
Medical hypotheses2021，Vol.1486.DOI:10.1016/j.mehy.2021.110520
✕
  • NSTL
  • Elsevier

The potential use of lactate blockers for the prevention of COVID-19 worst outcome, insights from exercise immunology

Elshawarbi, Passant 1Gamal, Nada 1Messiha, Mariam 1Ghazy, Marihan 1Abdelfatah, Emmy 1Gayed, Ramy 1Eesa, Marian 1Luis, Merna 2Eskandar, Estfana 1Yacoub, Shenoda 1Saud, Alaa 1Rajab, Maram 1Abdelaziz, Mariam 1Elgamal, Nadine 1Jaber, Hutaf 1Tayssir, Sara 3Michael, Mark 1Sabry, Ahmed 1Shehata, Joseph 1Abdelaziz, Rania 1Rateb, Sherry 1Mahjoub, Yara 1Amr, Alaa 1Mabrouk, Amin 1Kelada, Peter 1El-Maghraby, Ahmed 1Ragab, Shahd 1Eltaher, Basant 4Galal, Rahma Hassan 1Aly, Omnya Mahmoud 1Aly, Taquwa 1AbdelHaleem, Rana 1ElShaarawy, Areeg 1Mohamed, Omnia 5AbdelMassih, Antoine Fakhry 6Menshawey, Rahma 1Hozaien, Rafeef 1Kamel, Aya 1Mishriky, Fady 1Nasry, Febronia 1Husseiny, Reem J. 1Hanoura, Aia Mohamed 7Yacoub, Elaria 1AlShehry, Nada 1Menshawey, Esraa 1El-Husseiny, Nadine 8Yasser, Reem 9Arsanyous, Mariem 1Nathan, Lauren 1Seyam, Mahmoud 1Massoud, Doaa 1Ali, Nada 1Kassim, Assem 1AmanAllah, Mostafa 1Elsayed, Rokaya 1Sheashaa, Hesham 1Husseiny, Yousef 10Hassan, Nourhan Hatem 1Badr, Kirollos 11Elkhateb, Amr 12Fouad, Verina 1Elfishawy, Mayada 1Medhat, Omar 1Mustafa, Mai 1Khalil, Noha 1Elsayed, Rawan 1Nada, Youssef 1Abdelmoneim, Noha1
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作者信息

  • 1. Cairo Univ, Fac Med, Res Accessibil Team, Student & Internship Res Program, Cairo, Egypt
  • 2. Alexandria Univ, Fac Med, Student & Internship Res Program, Res Accessibil Team, Alexandria, Egypt
  • 3. Cairo Univ, Fac Med, Pediat Residency Program, Cairo, Egypt
  • 4. Ain Shams Univ, Fac Med, Student & Internship Res Program, Res Accessibil Team, Cairo, Egypt
  • 5. Cairo Univ, Fac Physiotherapy, Sports Med, Cairo, Egypt
  • 6. Cairo Univ, Pediat Cardiol Unit, Pediat Dept, Fac Med, Cairo, Egypt
  • 7. Cairo Univ, Fac Med, Anat Dept, Cairo, Egypt
  • 8. Cairo Univ, Fac Dent, Cairo, Egypt
  • 9. Padova Univ, Fac Med, Dept Pharmaceut & Pharmacol Sci, Padua, Italy
  • 10. New Giza Univ, Fac Med, Student & Internship Res Program, Res Accessibil Team, Giza, Egypt
  • 11. Future Univ, Fac Pharm, Cairo, Egypt
  • 12. Tanta Univ, Fac Med, Tanta, Egypt
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Abstract

Following the decline in Physical Activity (PA) due to COVID-19 restrictions in the form of government mandated lockdowns and closures of public spaces, the modulatory effect of physical exercise on immunity is being heavily revisited. In an attempt to comprehend the wide discrepancy in patient response to COVID-19 and the factors that potentially modulate it, we summarize the findings relating PA to inflammation and immunity. A distinction is drawn between moderate intensity and high intensity physical exercise based on the high lactate production observed in the latter. We hypothesize that, the lactate production associated with high intensity anaerobic exercise is implicated in the modulation of several components of the innate and adaptive immunity. In this review, we also summarize these immunomodulatory effects of lactate. These include increasing serum IL-6 levels, the main mediator of cytokine storms, as well as affecting NK cells, Macrophages, Dendritic cells and cytotoxic T-lymphocytes. The implications of high lactate levels in athletic performance are highlighted where athletes should undergo endurance training to increase VO2 max and minimize lactate production. Tumor models of hypoxia were also reported where lactate levels are elevated leading to increased invasiveness and angiogenesis. Accordingly, the novel lactate blocking strategy employed in cancer treatment is evaluated for its potential benefit in COVID-19 in addition to the readily available beta-blockers as an antagonist to lactate. Finally, we suggest the diagnostic/prognostic purpose of the elevated lactate levels that can be determined through sweat lactate testing. It is the detrimental effect of lactate on immunity and its presence in sweat that qualify it to be used as a potential non-invasive marker of poor COVID-19 outcome.

Key words

Covid-19/Sweat lactate/Endurance training/Lactate blockers

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出版年

2021
Medical hypotheses

Medical hypotheses

SCI
ISSN：0306-9877
被引量1
参考文献量38
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