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Publication : Serotonin reduction in post-acute sequelae of viral infection.

First Author  Wong AC Year  2023
Journal  Cell Volume  186
Issue  22 Pages  4851-4867.e20
PubMed ID  37848036 Mgi Jnum  J:343776
Mgi Id  MGI:7544781 Doi  10.1016/j.cell.2023.09.013
Citation  Wong AC, et al. (2023) Serotonin reduction in post-acute sequelae of viral infection. Cell 186(22):4851-4867.e20
abstractText  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.
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