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. 2022 Nov 16;58(11):1658.
doi: 10.3390/medicina58111658.

The Relationship between Nrf2 and HO-1 with the Severity of COVID-19 Disease

Damir Mihić  1   2 , Domagoj Loinjak  1   2 , Lana Maričić  1   3 , Robert Smolić  4 , Ines Šahinović  1   5 , Kristina Steiner  6 , Sven Viland  1 , Vatroslav Šerić  1   5 , Mario Duvnjak  1   7
Affiliations

The Relationship between Nrf2 and HO-1 with the Severity of COVID-19 Disease

Damir Mihić et al. Medicina (Kaunas). .

Abstract

Nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) have significant roles in the development of a hyperinflammatory state in infectious diseases. We aimed to investigate the association of the serum concentrations of Nrf2 and HO-1 with the severity of COVID-19 disease. The study included 40 subjects with mild and moderately severe forms of the disease (MEWS scoring system ≤2). Twenty of the subjects had MEWS scores of 3 or 4, which indicate a severe form of the disease, and twenty subjects had a MEWS score of ≥5, which indicates a critical form of the disease. HO-1 and Nrf2 were measured using the commercially available Enzyme-Linked Immunosorbent Assay (ELISA). Subjects with the most severe form of COVID-19 (critically ill) had a lower concentration of Nrf2 that negatively correlated with the markers of hyperinflammatory response (CRP, IL-6, ferritin). This observation was not made for HO-1, and the correlation between Nrf2 and HO-1 values was not established. In the mild/moderate form of COVID-19 disease, Nrf2 was associated with an increased 1,25 dihydroxy vitamin D concentration. The results of this study show that Nrf2 has a role in the body's anti-inflammatory response to COVID-19 disease, which makes it a potential therapeutic target.

Keywords: COVID-19; NF-E2-related factor 2 (Nrf2); heme oxygenase-1 (HO-1).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Serum concentrations of Nrf2 (A) and HO-1 (B) in patients with COVID-19 disease. *** p < 0.05.
See this image and copyright information in PMC

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