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. 2023 Jan 20;13(2):207. doi: 10.3390/biom13020207

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© 2023 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Proposed mechanism of epithelial-enteric neuronal crosstalk in SARS-CoV-2 induced diarrhea. The SARS-CoV-2 infection causes ER stress and the production of DAMPs, which increase the expression and release of VIP by enteric neurons. The presence of ER stress, together with the produced VIP, restricts fluid absorption by downregulating the brush–border membrane expression of NHE3 in enterocytes, resulting in the luminal fluid buildup and increased intestinal motility, which contributes to the onset of diarrhea.