People with diabetes are at greater risk of developing severe COVID-19 and dying from the illness, which is caused by a virus known as SARS-CoV-2. The high blood sugar levels associated with diabetes appear to be a contributing factor to this heightened risk. However, diabetes is a complex condition encompassing a range of metabolic disorders, and it is therefore likely that other factors may contribute. Previous research identified a link between an enzyme called cathepsin L and more severe COVID-19 in people with diabetes. Elevated cathepsin L levels are known to contribute to diabetes complications, such as kidney damage and vision loss. It has also been shown that cathepsin L helps SARS-CoV-2 to enter and infect cells. This raised the question of whether elevated cathepsin L is responsible for the increased COVID-19 vulnerability in patients with diabetes. To investigate, He, Zhao et al. monitored disease severity and cathepsin L levels in patients with COVID-19. This confirmed that people with diabetes had more severe COVID-19 and that higher levels of cathepsin L are linked to more severe disease. Analysis also revealed that cathepsin L activity increases as blood glucose levels increase. In laboratory experiments, cells exposed to glucose or fluid from the blood of people with diabetes were more easily infected with SARS-CoV-2, with cells genetically modified to lack cathepsin L being more resistant to infection. Further experiments revealed this was due to glucose promoting maturation and migration of cathepsin L in the cells. The findings of He, Zhao et al. help to explain why people with diabetes are more likely to develop severe or fatal COVID-19. Therefore, controlling blood glucose levels in people with diabetes may help to prevent or reduce the severity of the disease. Additionally, therapies targeting cathepsin L could also potentially help to treat COVID-19, especially in patients with diabetes, although more research is needed to develop and test these treatments.
糖尿病患者患严重COVID-19并死于这种疾病的风险更大,这是由一种称为SARS-CoV-2的病毒引起的。与糖尿病相关的高血糖水平似乎是导致这种风险增加的因素。然而,糖尿病是一种复杂的疾病,包括一系列代谢紊乱,因此,其他因素可能会有所贡献。先前的研究确定了一种称为组织蛋白酶L的酶与糖尿病患者中更严重的COVID-19之间的联系。已知升高的组织蛋白酶L水平有助于糖尿病并发症。如肾脏损伤和视力丧失。还显示组织蛋白酶L有助于SARS-CoV-2进入并感染细胞。这提出了一个问题,即升高的组织蛋白酶L是否导致糖尿病患者COVID-19脆弱性增加。为了调查,他,赵等人。监测COVID-19患者的疾病严重程度和组织蛋白酶L水平。这证实了糖尿病患者的COVID-19更为严重,组织蛋白酶L水平越高,疾病越严重。分析还显示组织蛋白酶L活性随着血糖水平的增加而增加。在实验室实验中,糖尿病患者血液中暴露于葡萄糖或液体的细胞更容易感染SARS-CoV-2,而经过基因修饰而缺乏组织蛋白酶L的细胞对感染的抵抗力更强。进一步的实验表明,这是由于葡萄糖促进了细胞中组织蛋白酶L的成熟和迁移。他的发现,赵等人。这有助于解释为什么糖尿病患者更容易患上严重或致命的COVID-19。因此,控制糖尿病患者的血糖水平可能有助于预防或减轻疾病的严重程度。此外,针对组织蛋白酶L的治疗也可能有助于治疗COVID-19,特别是在糖尿病患者中,尽管需要更多的研究来开发和测试这些治疗方法。