The Potential Role of Bromelain in the Treatment of SARS-COV-۲

The biggest challenge of last year worldwide has undoubtedly been to deal with the outbreak of the novel coronavirus (SARS -COV-۲), which was spread from Wuhan, China to other parts of the world at the end of last year (۲۰۱۹).SARS-COV-۲ uses the ACE۲ receptor to enter human cells and involve these receptors (۱). ACE۲ is capable of cleaving, des-Arg bradykinin which is involved locally in vessel dilation through binding to the B۱ receptor (۲). Des-Arg-BK is the only active metabolite of BK (۳). It should be noted that activation of the B۱ receptor in lung endothelial cells causes severe deterioration and increased mortality in many diseases; on the other hand, this receptor on endothelial cells is upregulated by proinflammatory cytokines (۴).Followed local lung angioedema could chip into the disease by an increase of local immune cell influx and proinflammatory cytokines leading to increasing severity (۵). This inflammation persuades more B۱ expression, and possibly via antibody-dependent increase of viral infection leading to continued ACE۲ dysfunction in the lung because of the durability of the virus (۶). In this standpoint bradykinin-dependent, local lung angioedema via B۱ and B۲ receptors is a significant trait of SARS-COV-۲ (۷). Hence it seems that blocking the B۱ and B۲ receptors might have an ameliorating effect on disease caused by COVID-۱۹.