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Title:Cabbage and fermented vegetables : from death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19
Authors:Bousquet, Jean (Author)
Antò i Boquè, Josep M. (Author)
Czarlewski, Wienczyslawa (Author)
Haahtela, Tari (Author)
Fonseca, Susana C. (Author)
Laccarino, Guido (Author)
Blain, Hubert (Author)
Vidal, Alain (Author)
Sheikh, Aziz (Author)
Akdis, Cezmi A. (Author)
Zuberbier, Torsten (Author)
Kreft, Samo (Author)
Jenko, Klemen (Author)
Jošt, Maja (Author)
Kopač, Peter (Author)
Košnik, Mitja (Author)
Kramer Vrščaj, Karmen (Author)
Madjar, Bojan (Author)
Plavec, Davor (Author)
Soklič, Tanja (Author)
Urbančič, Jure (Author)
Zidarn, Mihaela (Author)
Tipology:1.01 - Original Scientific Article
Organisation:Logo UKPBAG - University Clinic of Respiratory and Allergic Diseases Golnik
Abstract:Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage were associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin converting enzyme 2 (ACE2). As a result of SARS-Cov-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT1R) axis associated with oxidative stress. This leads to insulin resistanceas well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block the AT1R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are given: Kimchi in Korea, westernized foods and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects helpful in mitigating COVID-19 severity.
Keywords:COVID-19, diet, sulforaphane, Lactobacillus, Angiotensin converting enzyme 2, kimchi, cabbage, fermented vegetable
Year of publishing:2020
Publisher:John Wiley & Sons
Source:Velika Britanija
COBISS_ID:26203907 Link is opened in a new window
ISSN on article:1398-9995
OceCobissID:515009305 Link is opened in a new window
DOI:10.1111/all.14549 Link is opened in a new window
Note:Nasl. z nasl. zaslona; Opis vira z dne 26. 8. 2020;
Files:URL URL - Source URL, visit
Rights:2020 EAACI and John Wiley and Sons
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