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托珠单抗在细胞因子风暴及改善 COVID-19 结局中的作用。

The Role of Tocilizumab in Cytokine Storm and Improving Outcomes in COVID-19.

机构信息

Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States.

Division of Rheumatology, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States.

出版信息

Recent Pat Antiinfect Drug Discov. 2020;15(2):104-112. doi: 10.2174/1574891X15666200922155712.

Abstract

To date, severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) has infected millions of individuals worldwide. This virus causes coronavirus disease 2019 (COVID-19) and has led to numerous deaths worldwide. A large percentage of infected patients present asymptomatically, augmenting the spread of the virus. Symptomatic COVID-19 commonly causes mild to severe respiratory disease and fever, but some individuals experience serious complications resulting in death. Immune compromised, high risk, and elderly individuals are at an increased risk of more severe consequences of the illness such as respiratory failure, organ dysfunction, and shock. Cytokine storm (also known as cytokine release syndrome (CRS)), a systemic inflammatory response that can be triggered by an infection, has been associated with the symptom progression of COVID-19. This review evaluates several published studies that have implemented tocilizumab (TCZ), an IL-6 receptor antibody (US20120253016A1), in COVID-19 treatment. Outcomes and biomarkers of patients treated with TCZ are compared to patients treated with standard of care regimens. Interleukin-6 (IL-6), a prominent inflammatory cytokine involved in CRS in various inflammatory conditions, may have a vital role in the underlying mechanism involved in debilitating SARS-CoV-2 infections and could serve as a viable treatment target. Studies suggest that TCZ may aid in the recovery of patients with COVID-19 and reduce mortality.

摘要

截至目前,严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)已在全球范围内感染了数百万人。该病毒引发了 2019 年冠状病毒病(COVID-19),并在全球范围内导致了众多死亡。很大一部分受感染的患者无症状,这增加了病毒的传播。有症状的 COVID-19 通常会引起轻度至重度呼吸道疾病和发热,但一些患者会出现严重并发症,导致死亡。免疫功能低下、高危和老年患者患重病的风险更高,例如呼吸衰竭、器官功能障碍和休克。细胞因子风暴(也称为细胞因子释放综合征(CRS)),是一种由感染引发的全身性炎症反应,与 COVID-19 的症状进展有关。这篇综述评估了几项已发表的研究,这些研究已将托珠单抗(TCZ),一种白细胞介素-6 受体抗体(US20120253016A1),用于 COVID-19 的治疗。接受 TCZ 治疗的患者的结局和生物标志物与接受标准护理方案治疗的患者进行了比较。白细胞介素-6(IL-6)是一种在各种炎症情况下的 CRS 中起重要作用的促炎细胞因子,可能在严重 SARS-CoV-2 感染的潜在机制中发挥重要作用,也可能成为一种可行的治疗靶点。研究表明,TCZ 可能有助于 COVID-19 患者的康复并降低死亡率。

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