Bicarbonate: An Ancient Concept to Defeat Pathogens in Light of Recent Findings Beneficial for COVID-19 Patients?

17 Pages Posted: 7 May 2020

See all articles by Ákos Zsembery

Ákos Zsembery

Semmelweis University - Department of Oral Biology

Kristóf Kádár

Semmelweis University - Department of Oral Biology

Pongsiri Jaikumpun

Semmelweis University - Department of Oral Biology

Mária Deli

Hungarian Academy of Sciences (HAS) - Biological Research Centre

Ferenc Jakab

University of Pécs - National Coronavirus Research Center

Orsolya Dobay

Semmelweis University - eInstitute of Medical Microbiology

Date Written: April 26, 2020

Abstract

A century ago during the Spanish influenza pandemic bicarbonate was suggested to be effective in pathogen defense. Nevertheless, modern physiology has focused on its role as the principal buffer of extracellular fluid. Recently, scientific data have accumulated pointing to critical roles of bicarbonate in calcium chelation and antimicrobial defense. In view of the worldwide attention focused on the COVID-19 pandemic, we analyze possible roles of bicarbonate in viral infections. Since SARS-CoV entry is heavily dependent on extracellular Ca2+, bicarbonate may hamper the viral replication. Respiratory viruses could inhibit epithelial bicarbonate secretion, which decreases the airway pH. Administration of bicarbonate increases the pH thus, enhances the activity of antimicrobial peptides. Bicarbonate potentiates neutrophil extracellular trap formation and regulates macrophage polarization modulating inflammatory responses. Most importantly, inhalation of nebulized NaHCO3 has been reported to be safe in various pulmonary diseases. Thus, we propose bicarbonate as a simple management option for COVID-19 patients.

Note: Funding: This work was supported by the Hungarian Human Resources Development Operational Program (Grant No. EFOP-3.6.2-16-2017-00006).

Conflict of Interest: The authors declare no conflicts of interest.

Keywords: airways, bicarbonate, calcium chelation, antimicrobial peptides, bacterial infections, viral infections

Suggested Citation

Zsembery, Ákos and Kádár, Kristóf and Jaikumpun, Pongsiri and Deli, Mária and Jakab, Ferenc and Dobay, Orsolya, Bicarbonate: An Ancient Concept to Defeat Pathogens in Light of Recent Findings Beneficial for COVID-19 Patients? (April 26, 2020). Available at SSRN: https://ssrn.com/abstract=3589403 or http://dx.doi.org/10.2139/ssrn.3589403

Ákos Zsembery (Contact Author)

Semmelweis University - Department of Oral Biology ( email )

Nagyvárad tér 4.
Budapest, 1089

Kristóf Kádár

Semmelweis University - Department of Oral Biology ( email )

Nagyvárad tér 4.
Budapest, 1089

Pongsiri Jaikumpun

Semmelweis University - Department of Oral Biology ( email )

Nagyvárad tér 4.
Budapest, 1089

Mária Deli

Hungarian Academy of Sciences (HAS) - Biological Research Centre ( email )

Hungary

Ferenc Jakab

University of Pécs - National Coronavirus Research Center ( email )

Rákóczi út 80
Pécs, 7622
Hungary

Orsolya Dobay

Semmelweis University - eInstitute of Medical Microbiology ( email )

Nagyvárad tér 4.
Budapest, 1089
Hungary

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