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抗氧化治疗是否对新冠病毒治疗有效?一种应用该疗法的算法。

Is Antioxidant Therapy a Useful Complementary Measure for Covid-19 Treatment? An Algorithm for Its Application.

机构信息

Immunology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico.

Physiology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico.

出版信息

Medicina (Kaunas). 2020 Jul 31;56(8):386. doi: 10.3390/medicina56080386.

Abstract

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes the corona virus disease-19 which is accompanied by severe pneumonia, pulmonary alveolar collapses and which stops oxygen exchange. Viral transmissibility and pathogenesis depend on recognition by a receptor in the host, protease cleavage of the host membrane and fusion. SARS-CoV-2 binds to the angiotensin converting enzyme 2 receptor. Here, we discuss the general characteristics of the virus, its mechanism of action and the way in which the mechanism correlates with the comorbidities that increase the death rate. We also discuss the currently proposed therapeutic measures and propose the use of antioxidant drugs to help patients infected with the SARS-CoV-2. Oxidizing agents come from phagocytic leukocytes such as neutrophils, monocytes, macrophages and eosinophils that invade tissue. Free radicals promote cytotoxicity thus injuring cells. They also trigger the mechanism of inflammation by mediating the activation of NFkB and inducing the transcription of cytokine production genes. Release of cytokines enhances the inflammatory response. Oxidative stress is elevated during critical illnesses and contributes to organ failure. In corona virus disease-19 there is an intense inflammatory response known as a cytokine storm that could be mediated by oxidative stress. Although antioxidant therapy has not been tested in corona virus disease-19, the consequences of antioxidant therapy in sepsis, acute respiratory distress syndrome and acute lung injury are known. It improves oxygenation rates, glutathione levels and strengthens the immune response. It reduces mechanical ventilation time, the length of stay in the intensive care unit, multiple organ dysfunctions and the length of stay in the hospital and mortality rates in acute lung injury/acute respiratory distress syndrome and could thus help patients with corona virus disease-19.

摘要

严重急性呼吸系统综合症冠状病毒 2(SARS-CoV-2)引起的冠状病毒病-19,伴有严重肺炎、肺泡塌陷和停止氧气交换。病毒的传染性和发病机制取决于宿主中的受体识别、宿主膜的蛋白酶切割和融合。SARS-CoV-2 与血管紧张素转换酶 2 受体结合。在这里,我们讨论了病毒的一般特征、作用机制以及机制与增加死亡率的合并症之间的相关性。我们还讨论了目前提出的治疗措施,并提出使用抗氧化药物来帮助感染 SARS-CoV-2 的患者。氧化剂来自吞噬白细胞,如中性粒细胞、单核细胞、巨噬细胞和嗜酸性粒细胞,它们侵入组织。自由基促进细胞毒性,从而损伤细胞。它们还通过介导 NFkB 的激活和诱导细胞因子产生基因的转录来触发炎症机制。细胞因子的释放增强了炎症反应。氧化应激在危重病中升高,并导致器官衰竭。在冠状病毒病-19 中,有一种强烈的炎症反应,称为细胞因子风暴,这可能是由氧化应激介导的。尽管抗氧化治疗在冠状病毒病-19 中尚未得到测试,但在败血症、急性呼吸窘迫综合征和急性肺损伤中抗氧化治疗的后果是已知的。它可以提高氧合率、谷胱甘肽水平并增强免疫反应。它减少机械通气时间、重症监护病房的住院时间、多器官功能障碍和急性肺损伤/急性呼吸窘迫综合征的住院时间以及死亡率,从而可以帮助冠状病毒病-19 患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d052/7466376/65a4ae18d9f9/medicina-56-00386-g001.jpg

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