Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, China.
Department of Infectious Disease, Peking University International Hospital, Beijing, China.
J Med Virol. 2021 Mar;93(3):1378-1386. doi: 10.1002/jmv.26634. Epub 2020 Nov 1.
Since December 2019, coronavirus disease (COVID-19) has rapidly swept the world. So far, more than 30 million people have been infected and nearly one million have died. Although the world is still in the stage of COVID-19 pandemic, the treatment of new cases and critically ill patients is the focus of the current work. However, COVID-19 patients lead to pulmonary fibrosis, such a serious threat to the prognosis of complications were also worthy of our attention. First of all, we proposed the possible mechanism of pulmonary fibrosis caused by SARS-CoV-2, based on the published data of COVID-19 ((i) Direct evidence: pulmonary fibrosis was found in autopsy and pulmonary puncture pathology. (ii) Indirect evidence: increased levels of fibrosis-related cytokines[transforming growth factor [TGF]- β, tumor necrosis factor [TNF]- α, interleukin [IL]-6, etc] in peripheral blood of severe patients.) What is more, we summarized the role of three fibrosis-related signaling pathways (TGF- β signal pathway, WNT signal pathway and YAP/TAZ signal pathway) in pulmonary fibrosis. Finally, we suggested the therapeutic value of two drugs (pirfenidone and nintedanib) for idiopathic pulmonary fibrosis in COVID-19-induced pulmonary fibrosis.
自 2019 年 12 月以来，冠状病毒病（COVID-19）迅速席卷全球。到目前为止，已有超过 3000 万人感染，近 100 万人死亡。虽然世界仍处于 COVID-19 大流行阶段，但新病例和危重症患者的治疗仍是当前工作的重点。然而，COVID-19 患者可导致肺纤维化，如此严重的并发症对预后的威胁也值得我们关注。首先，我们根据 COVID-19 的已发表数据，提出了由 SARS-CoV-2 引起肺纤维化的可能机制((i)直接证据：在尸检和肺穿刺病理学中发现了肺纤维化。(ii)间接证据：严重患者外周血中纤维化相关细胞因子[转化生长因子[TGF]-β、肿瘤坏死因子[TNF]-α、白细胞介素[IL]-6 等]水平升高。)更重要的是，我们总结了三种纤维化相关信号通路（TGF- β 信号通路、WNT 信号通路和 YAP/TAZ 信号通路）在肺纤维化中的作用。最后，我们提出了两种药物（吡非尼酮和尼达尼布）在 COVID-19 引起的肺纤维化中的治疗价值。
