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与新型冠状病毒肺炎相关的凝血病——使用生物反应调节剂葡聚糖的观点及预防策略

Coagulopathy associated with COVID-19 - Perspectives & Preventive strategies using a biological response modifier Glucan.

作者信息

Ikewaki Nobunao, Rao Kosagi-Sharaf, Archibold Armando Durant, Iwasaki Masaru, Senthilkumar Rajappa, Preethy Senthilkumar, Katoh Shojiro, Abraham Samuel J K

机构信息

Department of Medical Life Science, Kyushu University of Health and Welfare, Nobeoka, Miyazaki Japan.

Institute of Immunology, Junsei Educational Institute, Nobeoka, Miyazaki Japan.

出版信息

Thromb J. 2020 Oct 16;18:27. doi: 10.1186/s12959-020-00239-6. eCollection 2020.

Abstract

Direct endothelial injury by viruses and dysregulation of clotting mechanisms due to cytokine storm are the major precipitating factors of mortality in COVID-19; both are attributed to a fundamental dysregulation of the immune system. While immune dysregulation can be attributed to several factors, the risk of associated thrombogenic disruption varies across individuals. This variation depends on several factors, such as comorbidities, including diabetes, hypertension, and cardiovascular diseases. When considering ethnic variations, the vulnerability of Caucasians, African Americans and Hispanics needs to be addressed before arriving at strategies to handle thromboembolic complications, which have been identified in recent reports as the leading causes of mortality in COVID-19. Although evaluation of D-dimer and prothrombin during admission is considered to predict prognosis and mortality, there are no preventive or prophylactic strategies before hospital admission. Herein, we present our perspectives on the effect of regular supplementation with the biological response modifier beta glucan based on its relevance to immune modulation. This effect is of paramount importance in decreasing the development of severe COVID-19 and reducing mortality against the background of coagulopathy, especially in vulnerable populations.

摘要

病毒直接导致的内皮损伤以及细胞因子风暴引起的凝血机制失调是新冠肺炎死亡的主要促成因素;这两者都归因于免疫系统的根本失调。虽然免疫失调可归因于多种因素,但相关血栓形成破坏的风险在个体间存在差异。这种差异取决于几个因素,如合并症,包括糖尿病、高血压和心血管疾病。在考虑种族差异时,在制定应对血栓栓塞并发症的策略之前,需要考虑白种人、非裔美国人和西班牙裔的易感性,近期报告已将这些并发症确定为新冠肺炎死亡的主要原因。虽然入院时对D - 二聚体和凝血酶原的评估被认为可预测预后和死亡率,但在入院前尚无预防或预防性策略。在此,我们基于生物反应调节剂β - 葡聚糖与免疫调节的相关性,阐述其定期补充的效果。在凝血病背景下,这种效果对于减少重症新冠肺炎的发生及降低死亡率至关重要,尤其是在易感人群中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7291/7566055/c3403b513785/12959_2020_239_Fig1_HTML.jpg

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