Crosstalk of TLR4, vascular NADPH oxidase, and COVID-19 in diabetes: What are the potential implications?

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Vascul Pharmacol. 2021, May 26: 106879. doi: 10.1016 / j.vph.2021.106879. Online before printing.

ABSTRACT

Toll-like receptor 4 (TLR4) contributes to the pathophysiology of diabetes. This happens, at least in part, because TLR4 modulates the enzyme NADPH oxidase, a primary source of ROS in vascular structures. Increased oxidative stress disrupts important vascular signaling mechanisms and drives the progression of diabetes, thereby increasing the likelihood of cardiovascular disease. Recently, it was shown that patients with diabetes are also at a higher risk of developing severe coronavirus disease 2019 (COVID-19). Given the importance of the interaction between TLR4 and NADPH oxidase for the disturbed diabetic vasculature, we hypothesize that TLR4-mediated ROS from NADPH oxidase may be a critical mechanism to explain why this inequality occurs in diabetics, but unfortunately There is still a lack of conclusive experimental evidence in the literature. Here we focus on discussing the pathological effects of this signal communication in the diabetic vasculature and examining this crosstalk in the context of diabetes-associated COVID-19.

PMID: 34051372 | DOI: 10.1016 / j.vph.2021.106879