POETA, MARCO (2024) SARS-CoV-2-associated diarrhea: clinical features and therapeutic strategies based on its pathophysiology. [Tesi di dottorato]
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| Tipologia del documento: | Tesi di dottorato |
|---|---|
| Lingua: | English |
| Titolo: | SARS-CoV-2-associated diarrhea: clinical features and therapeutic strategies based on its pathophysiology |
| Autori: | Autore Email POETA, MARCO marco.poeta@unina.it |
| Data: | 6 Dicembre 2024 |
| Numero di pagine: | 90 |
| Istituzione: | Università degli Studi di Napoli Federico II |
| Dipartimento: | Scienze Mediche Traslazionali |
| Dottorato: | Medicina clinica e sperimentale |
| Ciclo di dottorato: | 37 |
| Coordinatore del Corso di dottorato: | nome email Beguinot, Francesco beguino@unina.it |
| Tutor: | nome email Guarino, Alfredo [non definito] |
| Data: | 6 Dicembre 2024 |
| Numero di pagine: | 90 |
| Parole chiave: | SARS-CoV-2, diarrhea, oxidative stress |
| Settori scientifico-disciplinari del MIUR: | Area 06 - Scienze mediche > MED/38 - Pediatria generale e specialistica |
| Informazioni aggiuntive: | Appartengo al 37° ciclo |
| Depositato il: | 17 Ott 2025 14:43 |
| Ultima modifica: | 12 Ago 2026 05:37 |
| URI: | https://www.fedoa.unina.it/id/eprint/16338 |
Abstract
SARS-CoV-2 is widely recognized as a respiratory virus. However, it frequently affects the gastrointestinal (GI) tract, particularly in pediatric patients, with diarrhea as the most common symptom. This thesis investigates the pathophysiology of SARS-CoV-2-associated diarrhea, aiming to delineate its mechanisms and explore therapeutic interventions. In vitro and ex vivo experiments utilizing Caco-2 cells and human intestinal tissues revealed that SARS-CoV-2 induces secretory diarrhea through an enterotoxin-like mechanism involving its spike protein. The spike protein disrupts ion transport in the intestinal epithelium via calcium-activated chloride channels (CaCCs), mimicking the action of known enterotoxins such as rotavirus NSP4. In addition, the oxidative stress was identified as a main contributing factor involved in the opening of this channel. The adsorbent clay diosmectite and a postbiotic preparation of Lacticaseibacillus rhamnosus GG demonstrated efficacy in neutralizing spike-induced intestinal effects, preventing ion secretion and oxidative stress, highlighting usefulness of these therapeutic agents previously tested in acute gastroenteritis. This research also evaluated the clinical characteristics of pediatric COVID-19 cases with and without diarrhea, identifying patterns and risk factors for GI involvement. The findings underscore the role of SARS-CoV-2 as an enteric pathogen capable of inducing secretory diarrhea through non-inflammatory mechanisms in milder cases and inflammation-driven processes in severe conditions, such as Multisystem Inflammatory Syndrome in Children (MIS-C). This work not only advances our understanding of COVID-19-related GI symptoms but also supports the inclusion of diosmectite and probiotics in management protocols.
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