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AbdelMassih AF, Ye J, Kamel A, et al. A multicenter consensus: A role of furin in the endothelial tropism in obese patients with COVID-19 infection. Obes Med. 2020;19:100281doi: 10.1016/j.obmed.2020.100281.
AbdelMassih, A. F., Ye, J., Kamel, A., Mishriky, F., Ismail, H. A., Ragab, H. A., El Qadi, L., Malak, L., Abdu, M., El-Husseiny, M., Ashraf, M., Hafez, N., AlShehry, N., El-Husseiny, N., AbdelRaouf, N., Shebl, N., Hafez, N., Youssef, N., Afdal, P., Hozaien, R., Menshawey, R., Saeed, R., & Fouda, R. (2020). A multicenter consensus: A role of furin in the endothelial tropism in obese patients with COVID-19 infection. Obesity medicine, 19100281. https://doi.org/10.1016/j.obmed.2020.100281
AbdelMassih, Antoine Fakhry, et al. "A multicenter consensus: A role of furin in the endothelial tropism in obese patients with COVID-19 infection." Obesity medicine vol. 19 (2020): 100281. doi: https://doi.org/10.1016/j.obmed.2020.100281
AbdelMassih AF, Ye J, Kamel A, Mishriky F, Ismail HA, Ragab HA, El Qadi L, Malak L, Abdu M, El-Husseiny M, Ashraf M, Hafez N, AlShehry N, El-Husseiny N, AbdelRaouf N, Shebl N, Hafez N, Youssef N, Afdal P, Hozaien R, Menshawey R, Saeed R, Fouda R. A multicenter consensus: A role of furin in the endothelial tropism in obese patients with COVID-19 infection. Obes Med. 2020 Sep;19:100281. doi: 10.1016/j.obmed.2020.100281. Epub 2020 Jul 15. PMID: 32835124; PMCID: PMC7362855.
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Obes Med. 2020 Sep;19:100281. doi: 10.1016/j.obmed.2020.100281. Epub 2020 Jul 15.

A multicenter consensus: A role of furin in the endothelial tropism in obese patients with COVID-19 infection.

Obesity medicine

Antoine Fakhry AbdelMassih, Jianping Ye, Aya Kamel, Fady Mishriky, Habiba-Allah Ismail, Heba Amin Ragab, Layla El Qadi, Lauris Malak, Mariam Abdu, Miral El-Husseiny, Mirette Ashraf, Nada Hafez, Nada AlShehry, Nadine El-Husseiny, Nora AbdelRaouf, Noura Shebl, Nouran Hafez, Nourhan Youssef, Peter Afdal, Rafeef Hozaien, Rahma Menshawey, Rana Saeed, Raghda Fouda

Affiliations

  1. Pediatric Cardiology Unit, Pediatrics' Department, Faculty of Medicine, Cairo University, Egypt.
  2. Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
  3. Student and Internship Research Program (Research Accessibility Team), Faculty of Medicine, Cairo University, Egypt.
  4. Faculty of Dentistry, Cairo University, Egypt.
  5. Pixagon Graphic Design Agency, Cairo, Egypt.
  6. University of Irvine California, USA.
  7. Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Pediatrics' Department, Faculty of Medicine, Cairo University, Egypt.

PMID: 32835124 PMCID: PMC7362855 DOI: 10.1016/j.obmed.2020.100281

Abstract

Furin, a cleavage enzyme, is increasingly recognized in the pathogenesis of metabolic syndrome. Its cleavage action is an essential activation step for the endothelial pathogenicity of several viruses including SARS-CoV-2. This Furin-mediated endothelial tropism seems to underlie the multi-organ system involvement of COVID-19; which is a feature that was not recognized in the older versions of coronaviridae. Obese and diabetic patients, males, and the elderly, have increased serum levels of Furin, with its increased cellular activity; this might explain why these subgroups are at an increased risk of COVID-19 related complications and deaths. In contrast, smoking decreases cellular levels of Furin, this finding may be at the origin of the decreased severity of COVID-19 in smokers. Chinese herbal derived luteolin is suggested to be putative Furin inhibitor, with previous success against Dengue Fever. Additionally, Furin intracellular levels are largely dependent on concentration of intracellular ions, notably sodium, potassium, and magnesium. Consequently, the use of ion channel inhibitors, such as Calcium Channel blockers or Potassium Channel blockers, can prevent cellular transfection early in the course of the illness. Nicotine patches and Colchicine have also been suggested as potential therapies due to Furin mediated inhibition of COVID-19.

© 2020 Elsevier Ltd. All rights reserved.

Keywords: COVID-19; Chinese herbals; Endothelial pathogenicity; Furin; Ion channel inhibitors; Polybasic cleavage site

Conflict of interest statement

The authors declare that there is no conflict of interest.

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