Suppr超能文献

在 COVID-19 中使用 ACE 抑制剂和 ARB 的风险:评估证据。

Risks of ACE Inhibitor and ARB Usage in COVID-19: Evaluating the Evidence.

机构信息

Department of Pharmacology, University of California San Diego, La Jolla, California, USA.

Department of Medicine, University of California San Diego, La Jolla, California, USA.

出版信息

Clin Pharmacol Ther. 2020 Aug;108(2):236-241. doi: 10.1002/cpt.1863. Epub 2020 May 10.

Abstract

Concerns have been raised regarding the safety of angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in patients with coronavirus disease of 2019 (COVID-19), based on the hypothesis that such medications may raise expression of ACE2, the receptor for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). We conducted a literature review of studies (n = 12) in experimental animals and human subjects (n = 12) and evaluated the evidence regarding the impact of administration of ACEIs and ARBs on ACE2 expression. We prioritized studies that assessed ACE2 protein expression data, measured directly or inferred from ACE2 activity assays. The findings in animals are inconsistent with respect to an increase in ACE2 expression in response to treatment with ACEIs or ARBs. Control/sham animals show little to no effect in the plurality of studies. Those studies that report increases in ACE2 expression tend to involve acute injury models and/or higher doses of ACEIs or ARBs than are typically administered to patients. Data from human studies overwhelmingly imply that administration of ACEIs/ARBs does not increase ACE2 expression. Available evidence, in particular, data from human studies, does not support the hypothesis that ACEI/ARB use increases ACE2 expression and the risk of complications from COVID-19. We conclude that patients being treated with ACEIs and ARBs should continue their use for approved indications.

摘要

基于血管紧张素转换酶抑制剂(ACEIs)和血管紧张素受体阻滞剂(ARBs)可能会增加严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)受体 ACE2 的表达这一假说,人们对这两类药物在 2019 年冠状病毒病(COVID-19)患者中的安全性产生了担忧。我们对实验动物和人类受试者的研究(n=12)进行了文献回顾(n=12),并评估了 ACEIs 和 ARBs 给药对 ACE2 表达影响的证据。我们优先考虑了评估 ACE2 蛋白表达数据的研究,这些数据是直接测量或根据 ACE2 活性测定推断得出的。动物研究的结果不一致,无法确定 ACEIs 或 ARBs 治疗是否会增加 ACE2 的表达。在大多数研究中,对照/假处理动物几乎没有影响。那些报告 ACE2 表达增加的研究往往涉及急性损伤模型和/或 ACEIs 或 ARBs 的剂量高于患者通常的给药剂量。来自人类研究的数据几乎都表明,ACEIs/ARBs 的给药不会增加 ACE2 的表达。现有证据,特别是来自人类研究的数据,并不支持 ACEI/ARB 使用会增加 ACE2 表达和 COVID-19 并发症风险的假说。我们的结论是,正在接受 ACEIs 和 ARBs 治疗的患者应继续按照批准的适应证使用。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验