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Publications: COVID-19
Massimo Caruso
Alfio Distefano
Rosalia Emmal
Michelino Di Rosa
et al
Role of cigarette smoke on ACE-2 protein membrane expression in bronchial epithelial cells using an air-liquid interface model

Prevalence studies of current smoking, among hospitalized COVID-19 patients, demonstrated an unexpectedly low prevalence among patients with COVID-19. The aim of the present study was to evaluate the effect of smoke from cigarettes on ACE-2 in bronchial epithelial cells. Normal bronchial epithelial cells (H292) were exposed to smoke by an air-liquid-interface (ALI) system and ACE-2 membrane protein expression was evaluated after 24 hours from exposure. Our transcriptomics data analysis showed a significant selective reduction of membrane ACE-2 expression (about 25%) following smoking exposure. Interestingly, we observed a positive direct correlation between ACE-2 reduction and nicotine delivery. Furthermore, by stratifying GSE52237 as a function of ACE-2 gene expression levels, we highlighted 1012 genes related to ACE-2 in smokers and 855 in non-smokers. Furthermore, we showed that 161 genes involved in the endocytosis process were highlighted using the online pathway tool KEGG. Finally, 11 genes were in common between the ACE-2 pathway in smokers and the genes regulated during endocytosis, while 12 genes with non-smokers. Interestingly, six in non-smokers and four genes in smokers were closely involved during the viral internalization process. Our data may offer a pharmaceutical role of nicotine as potential treatment option in COVID-19.    

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Harm reduction service delivery to people who use drugs during a public health emergency: Examples from the COVID-19 pandemic in selected countries

In some countries, there has been a positive recognition to the needs of people sleeping rough and their vulnerabilities during a public health emergency. It is incumbent upon governments to work with local partners to ensure that rapid responses to the housing of people sleeping rough addresses the often complex needs of such people through an interdisciplinary approach so that their immediate and longer-term medical, psycho-social and economic needs are integrated into the provision of accommodation. This can be accomplished through partnerships built with other stakeholders during normal times and by having multidisciplinary teams, that include mental health staff, working on the streets with people sleeping rough. Such responses to homelessness and rough sleeping during a public health emergency is an opportunity to advocate at all levels of government for a longerterm strategy to comprehensively and holistically address such issues, together with long-term sustainable funding to implement such a plan. Furthermore, it is vital to ensure that there is a buffer stock of vital medicines already in-country for at least the forthcoming 3-6 months; this applies to all sectors of society and particularly those medications most in need by vulnerable and marginalised individuals and communities – including the treatment of TB and HCV (especially Direct-Acting Antivirals) as well as for HIV (antiretrovirals) and Opioid Substitution Therapy (OST, meaning methadone and/or buprenorphine), as well as naloxone for opioid overdose.

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