Intrinsic factors behind long COVID: exploring the role of nucleocapsid protein in thrombosis

COVID-19, caused by the SARS-CoV-2, poses significant global health challenges. A key player in its pathogenesis is the nucleocapsid protein (NP), which is crucial for viral replication and assembly. While NPs from other coronaviruses, such as SARS-CoV and MERS-CoV, are known to increase inflammatio...

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Main Authors: Ahmed Eltayeb, Muhamed Adilović, Maryam Golzardi, Altijana Hromić-Jahjefendić, Alberto Rubio-Casillas, Vladimir N. Uversky, Elrashdy M. Redwan
Format: Article
Language:English
Published: PeerJ Inc. 2025-05-01
Series:PeerJ
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Online Access:https://peerj.com/articles/19429.pdf
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author Ahmed Eltayeb
Muhamed Adilović
Maryam Golzardi
Altijana Hromić-Jahjefendić
Alberto Rubio-Casillas
Vladimir N. Uversky
Elrashdy M. Redwan
author_facet Ahmed Eltayeb
Muhamed Adilović
Maryam Golzardi
Altijana Hromić-Jahjefendić
Alberto Rubio-Casillas
Vladimir N. Uversky
Elrashdy M. Redwan
author_sort Ahmed Eltayeb
collection DOAJ
description COVID-19, caused by the SARS-CoV-2, poses significant global health challenges. A key player in its pathogenesis is the nucleocapsid protein (NP), which is crucial for viral replication and assembly. While NPs from other coronaviruses, such as SARS-CoV and MERS-CoV, are known to increase inflammation and cause acute lung injury, the specific effects of the SARS-CoV-2 NP on host cells remain largely unexplored. Recent findings suggest that the NP acts as a pathogen-associated molecular pattern (PAMP) that binds to Toll-like receptor 2 (TLR2), activating NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) and MAPK (mitogen-activated protein kinase) signaling pathways. This activation is particularly pronounced in severe COVID-19 cases, leading to elevated levels of soluble ICAM-1 (intercellular adhesion molecule 1) and VCAM-1 (vascular cell adhesion molecule 1), which contribute to endothelial dysfunction and multiorgan damage. Furthermore, the NP is implicated in hyperinflammation and thrombosis—key factors in COVID-19 severity and long COVID. Its potential to bind with MASP-2 (mannan-binding lectin serine protease 2) may also be linked to persistent symptoms in long COVID patients. Understanding these mechanisms, particularly the role of the NP in thrombosis, is essential for developing targeted therapies to manage both acute and chronic effects of COVID-19 effectively. This comprehensive review aims to elucidate the multifaceted roles of the NP, highlighting its contributions to viral pathogenesis, immune evasion, and the exacerbation of thrombotic events, thereby providing insights into potential therapeutic targets for mitigating the severe and long-term impacts of COVID-19.
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spelling doaj-art-09a84fa7ec9a4bfabd53a82fb29668ca2025-08-20T02:25:48ZengPeerJ Inc.PeerJ2167-83592025-05-0113e1942910.7717/peerj.19429Intrinsic factors behind long COVID: exploring the role of nucleocapsid protein in thrombosisAhmed Eltayeb0Muhamed Adilović1Maryam Golzardi2Altijana Hromić-Jahjefendić3Alberto Rubio-Casillas4Vladimir N. Uversky5Elrashdy M. Redwan6Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi ArabiaDepartment of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, International University of Sarajevo, Sarajevo, Bosnia and HerzegovinaDepartment of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, International University of Sarajevo, Sarajevo, Bosnia and HerzegovinaDepartment of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, International University of Sarajevo, Sarajevo, Bosnia and HerzegovinaAutlan Regional Hospital, Jalisco Health Services, Jalisco, MexicoDepartment of Molecular Medicine and USF Health Byrd Alzheimer’s Research Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, United States of AmericaDepartment of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi ArabiaCOVID-19, caused by the SARS-CoV-2, poses significant global health challenges. A key player in its pathogenesis is the nucleocapsid protein (NP), which is crucial for viral replication and assembly. While NPs from other coronaviruses, such as SARS-CoV and MERS-CoV, are known to increase inflammation and cause acute lung injury, the specific effects of the SARS-CoV-2 NP on host cells remain largely unexplored. Recent findings suggest that the NP acts as a pathogen-associated molecular pattern (PAMP) that binds to Toll-like receptor 2 (TLR2), activating NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) and MAPK (mitogen-activated protein kinase) signaling pathways. This activation is particularly pronounced in severe COVID-19 cases, leading to elevated levels of soluble ICAM-1 (intercellular adhesion molecule 1) and VCAM-1 (vascular cell adhesion molecule 1), which contribute to endothelial dysfunction and multiorgan damage. Furthermore, the NP is implicated in hyperinflammation and thrombosis—key factors in COVID-19 severity and long COVID. Its potential to bind with MASP-2 (mannan-binding lectin serine protease 2) may also be linked to persistent symptoms in long COVID patients. Understanding these mechanisms, particularly the role of the NP in thrombosis, is essential for developing targeted therapies to manage both acute and chronic effects of COVID-19 effectively. This comprehensive review aims to elucidate the multifaceted roles of the NP, highlighting its contributions to viral pathogenesis, immune evasion, and the exacerbation of thrombotic events, thereby providing insights into potential therapeutic targets for mitigating the severe and long-term impacts of COVID-19.https://peerj.com/articles/19429.pdfSARS-CoV-2Endothelial cellsNucleocapsid proteinLong COVIDThrombosis
spellingShingle Ahmed Eltayeb
Muhamed Adilović
Maryam Golzardi
Altijana Hromić-Jahjefendić
Alberto Rubio-Casillas
Vladimir N. Uversky
Elrashdy M. Redwan
Intrinsic factors behind long COVID: exploring the role of nucleocapsid protein in thrombosis
PeerJ
SARS-CoV-2
Endothelial cells
Nucleocapsid protein
Long COVID
Thrombosis
title Intrinsic factors behind long COVID: exploring the role of nucleocapsid protein in thrombosis
title_full Intrinsic factors behind long COVID: exploring the role of nucleocapsid protein in thrombosis
title_fullStr Intrinsic factors behind long COVID: exploring the role of nucleocapsid protein in thrombosis
title_full_unstemmed Intrinsic factors behind long COVID: exploring the role of nucleocapsid protein in thrombosis
title_short Intrinsic factors behind long COVID: exploring the role of nucleocapsid protein in thrombosis
title_sort intrinsic factors behind long covid exploring the role of nucleocapsid protein in thrombosis
topic SARS-CoV-2
Endothelial cells
Nucleocapsid protein
Long COVID
Thrombosis
url https://peerj.com/articles/19429.pdf
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