Enteric nervous system as a target and source of SARS-CoV-2 and other viral infections

• Published in: American journal of physiology: Gastrointestinal and liver physiology Vol. 325; no. 2; pp. G93 - G108
• Main Authors: Valdetaro, Luisa, Thomasi, Beatriz, Ricciardi, Maria Carolina, Santos, Karoline de Melo, Coelho-Aguiar, Juliana de Mattos, Tavares-Gomes, Ana Lúcia
• Format: Journal Article
• Language: English
• Published: United States American Physiological Society 01.08.2023
• Series: Coronavirus Disease (COVID-19) and Digestive System
• Subjects: Attention; Autonomic nervous system; Central nervous system; Coronaviruses; COVID-19; Digestive system; Digestive tract; Enteric nervous system; Enteric Nervous System - physiology; Gastrointestinal Tract - physiology; Humans; Immune system; Inflammation; Nervous system; Neural plasticity; Review; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Viral infections; COVID-19; SARS-CoV-2; enteric glia; enteric nervous system; gut-brain axis
• ISSN: 0193-1857; 1522-1547
• DOI: 10.1152/ajpgi.00229.2022

Coronavirus disease 2019 (COVID-19) has been demonstrated to affect several systems of the human body, including the gastrointestinal and nervous systems. The enteric nervous system (ENS) is a division of the autonomic nervous system that extends throughout the gut, regulates gastrointestinal function, and is therefore involved in most gut dysfunctions, including those resulting from many viral infections. Growing evidence highlights enteric neural cells and microbiota as important players in gut inflammation and dysfunction. Furthermore, the ENS and gastrointestinal immune system work together establishing relevant neuroimmune interactions during both health and disease. In recent years, gut-driven processes have also been implicated as players in systemic inflammation and in the initiation and propagation of several central nervous system pathologies, which seem to be hallmarks of COVID-19. In this review, we aim to describe evidence of the gastrointestinal and ENS infection with a focus on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We discuss here viral-induced mechanisms, neuroplasticity, and neuroinflammation to call attention to the enteric neuroglial network as a nervous system with a sensitive and crucial position to be not only a target of the new coronavirus but also a way in and trigger of COVID-19-related symptoms.