A Historical Overview of the Neurological Disorders Associated with Gastrointestinal Ailments from the Viewpoint of Avicenna

Reviewing historical medical manuscripts shows that neurological disorders have been previously described in the Islamic Golden Age. Ibn Sina, also known as Avicenna (980-1037 AD), was one of the most renowned scientists during this period. He widely practiced medicine, especially those disorders related to neurology, neurosurgery, and psychiatry in conventional medicine. In his extant book al-Qānūn fī al-Tibb (the Canon of Medicine), he claimed that some types of brain diseases can be related to the "marāqq" and called them marāqq-related disorders. From Avicenna's viewpoint, "marāqq" is considered a membranous structure in the abdomen. Ibn Sina has illustrated the association between the "marāqq" and the brain through some direct and indirect pathways. As a result, some disturbances in the "marāqq" can influence the brain, which can contribute to the pathogenesis of a number of brain diseases. Accordingly, those patients who regularly had gastrointestinal discomforts experienced a higher prevalence of headache, melancholia, and epilepsy. This study aimed to explore the relationship between abdominal and brain diseases from Avicenna's viewpoint. Furthermore, the definition, clinical manifestation, and therapeutic strategies of marāqq-related disorders were described.

Renal aspergillosis after COVID-19-associated pulmonary aspergillosis: A case report

Key Clinical Message

Renal aspergillosis is a rare condition and this case the first case of Renal aspergillosis reported after COVID-19-associated pulmonary aspergillosis. Renal symptoms should arise clinical suspicion to renal involvement that happened as a result of hematogenous spreading of pulmonary aspergillosis.

Abstract

Secondary fungal infections are among the most significant complications that can arise after COVID-19 and have the potential to lead to a high rate of morbidity and mortality. As COVID-19 primarily involves the airway, the majority of fungal infections reported have been related to the respiratory system. However, renal aspergillosis that we have reported is a rare condition that also can occur. A 67-year-old man was referred to our hospital and admitted as a COVID-19 patient. After the initial recovery, he experienced a recurrence of fever accompanied by a productive cough. The histopathological studies were conducted on the sputum and bronchoalveolar lavage samples, which revealed the presence of Aspergillus flavus. We treated the patient with voriconazole and the patient was discharged after a period of time. However, after approximately 6 months, he returned to the hospital with a fever and abdominal pain. We started a fever workup. Two new hypoechoic abscess-like masses were spotted in the right kidney in the ultrasonography (U/S) and the direct molecular studies of the biopsy sample obtained under U/S guidance identified Aspergillus flavus. Although renal aspergillosis is a rare condition, it should not be overlooked, especially in patients with severe COVID-19 and pulmonary aspergillosis, as these conditions can lead to renal aspergillosis, which may present with symptoms such as abdominal pain with fever. Therefore, it is necessary to perform radiological and histopathological studies when renal aspergillosis is suspected.

Diabetes as one of the long-term COVID-19 complications: from the potential reason of more diabetic patients' susceptibility to COVID-19 to the possible caution of future global diabetes tsunami

According to recent researches, people with diabetes mellitus (type 1 and 2) have a higher incidence of coronavirus disease 2019 (COVID-19), which is caused by a SARS-CoV-2 infection. In this regard, COVID-19 may make diabetic patients more sensitive to hyperglycemia by modifying the immunological and inflammatory responses and increasing reactive oxygen species (ROS) predisposing the patients to severe COVID-19 and potentially lethal results. Actually, in addition to COVID-19, diabetic patients have been demonstrated to have abnormally high levels of inflammatory cytokines, increased virus entrance, and decreased immune response. On the other hand, during the severe stage of COVID-19, the SARS-CoV-2-infected patients have lymphopenia and inflammatory cytokine storms that cause damage to several body organs such as β cells of the pancreas which may make them as future diabetic candidates. In this line, the nuclear factor kappa B (NF-κB) pathway, which is activated by a number of mediators, plays a substantial part in cytokine storms through various pathways. In this pathway, some polymorphisms also make the individuals more competent to diabetes via infection with SARS-CoV-2. On the other hand, during hospitalization of SARS-CoV-2-infected patients, the use of some drugs may unintentionally lead to diabetes in the future via increasing inflammation and stress oxidative. Thus, in this review, we will first explain why diabetic patients are more susceptible to COVID-19. Second, we will warn about a future global diabetes tsunami via the SARS-CoV-2 as one of its long-term complications.

CD147 and cyclophilin A: a promising potential targeted therapy for COVID-19 and associated cancer progression and chemo-resistance

Coronavirus disease-2019 (COVID-19), as a worldwide serious issue has been shown to lead to progression and poor outcomes in cancer patients. The underlying mechanisms for SARS-CoV-2 infection's adverse effects on cancer patients have not been fully understood. We hypothesized that CD147 and Cyclophilin A (CyPA) not only can play a significant role in infection severity but also can contribute to cancer progression and chemotherapy resistance in cancer patients with COVID-19. In addition, we hypothesized that the expression of both CD147 and CyPA could be increased by Hypoxia-inducible Factor-1 alpha (HIF-1α) activation during hypoxic conditions that occurred during COVID-19. Therefore, this evidence can open a new window in the management of cancer patients during the pandemic and therapeutic approaches targeting CD147 and CyPA could be a potentially promising therapeutic approach for such patients.

Quercetin as a JAK-STAT inhibitor: a potential role in solid tumors and neurodegenerative diseases

The Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway is involved in many immunological processes, including cell growth, proliferation, differentiation, apoptosis, and inflammatory responses. Some of these processes can contribute to cancer progression and neurodegeneration. Owing to the complexity of this pathway and its potential crosstalk with alternative pathways, monotherapy as targeted therapy has usually limited long-term efficacy. Currently, the majority of JAK-STAT-targeting drugs are still at preclinical stages. Meanwhile, a variety of plant polyphenols, especially quercetin, exert their inhibitory effects on the JAK-STAT pathway through known and unknown mechanisms. Quercetin has shown prominent inhibitory effects on the JAK-STAT pathway in terms of anti-inflammatory and antitumor activity, as well as control of neurodegenerative diseases. This review discusses the pharmacological effects of quercetin on the JAK-STAT signaling pathway in solid tumors and neurodegenerative diseases.

Hypoxia-inducible factor 1 alpha (HIF-1α) stimulated and P2X7 receptor activated by COVID-19, as a potential therapeutic target and risk factor for epilepsy

Based on available evidence, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a neuroinvasive virus. According to the centers for disease control and prevention (CDC), coronavirus disease 2019 (COVID-19) may cause epilepsy. In this line, COVID-19 can stimulate hypoxia-inducible factor-1 alpha (HIF-1α) and activate P2X7 receptor. Both HIF-1α and P2X7 receptors are linked to epileptogenesis and seizures. Therefore, in the current study, we suggested that COVID-19 may have a role in epileptogenesis and seizure through HIF-1α stimulation and P2X7 receptor activation. Consequently, pharmacological targeting of these factors could be a promising therapeutic approach for such patients.