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. 2021 Jun 2;1(1):ltab013. doi: 10.1093/immadv/ltab013

Figure 2.

Figure 2.

Metabolic modulators to treat COVID-19. 4-OI and DMF activate NRF2 which inhibit inflammatory cytokines. NRF2 activation prevents IRF-3 signalling, inhibiting interferon responses. 4-OI and DMF prevent TMPRSS2 expression which may prevent SARS-CoV-2 cell entry. MitoQ blocks SARS-CoV-2 replication. MitoQ increases autophagy and reduces mtROS to reduce inflammatory cytokines expression. TEPP-46 maintains PKM2 in an inactive conformation, preventing activation of HIF1α and associated inflammatory cytokines. Metformin phosphorylates ACE2 Ser680 which might prevent viral entry. Metformin upregulates ACE2, preventing RAS-mediated inflammation. Metformin inhibits inflammatory cytokine IL1β and upregulates anti-inflammatory cytokine IL-10. Created with Biorender.com.