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Its production and reception involve two key players: astrocytes and norepinephrine-releasing neurons
In the lungs, after entering in type II alveolar cells, SARS-CoV-2 infected cells become defective for surfactant production (Ghati et al., 2021) and release cytokines, like IL-8 among others, which in turn activate alveolar macrophages to release IL-1, IL-6, and TNF-, that induce natural killer and dendritic cell differentiation and macrophage M1 polarization, enhancing the proinflammatory response with increased vasodilation causing neutrophil and activated T cell influx from the capillaries into the alveolus, all leading to the cytokine storm (Carcaterra and Caruso, 2021
Previous studies have suggested that mRNA expression transfected via LNP can be improved by replacing cholesterol 44 with equal amount of -sitosterol, which is a plant cholesterol analog that lowers blood pressure and lipids as a medicine 15,45
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