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SARS-CoV-2 过度炎症反应的机制和潜在治疗靶点。

Mechanisms and potential therapeutic targets of hyperinflammatory responses in SARS-CoV-2.

出版信息

Acta Virol. 2021;65(1):3-9. doi: 10.4149/av_2021_102.

Abstract

Coronavirus infection is now the leading cause of death globally. Despite the several bedsides- to- bench investigations carried out by researchers all over the world to identify the best prophylactic and therapeutic options for this deadly virus, no novel vaccine or treatment drug has been developed. Accumulating evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with hyper inflammation characterized by excessive release of pro-inflammatory cytokines known as a cytokine storm. The hallmark of this unregulated inflammatory response includes viral sepsis, pneumonitis shock, coagulopathy, and acute respiratory distress syndrome (ARDS) which is the major cause of death in COVID-19 patients. In the midst of cytokine storm and coagulopathy, anti-viral agents alone will not provide the much-needed therapeutic effect. Hence, the need to combine anti-inflammatory agents such as interferons, angiotensinogen converting enzyme 2 (ACE-2) inhibitors, interleukin 6 (IL-6), and Janus kinase (JAK) family inhibitors, anticoagulants and other agents involved in inflammation resolution. This review critically presented a comprehensive overview of SAR-CoV-2, unveiled the mechanisms of the inflammatory response in SARS-CoV-2 and also highlighted possible specific prophylactic and therapeutic interventions that will circumvent inflammatory induced deaths in COVID-19 patients. Keywords: COVID-19; SARS-CoV-2; cytokine storm; coagulopathy and anti-inflammatory.

摘要

冠状病毒感染现已成为全球首要致死病因。尽管世界各地的研究人员开展了大量床边到临床的研究,以确定针对这种致命病毒的最佳预防和治疗选择,但仍未研发出新的疫苗或治疗药物。越来越多的证据表明,严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)与以过度释放细胞因子为特征的过度炎症有关,这种细胞因子被称为细胞因子风暴。这种不受调节的炎症反应的标志包括病毒性败血症、肺炎性休克、凝血功能障碍和急性呼吸窘迫综合征(ARDS),这是 COVID-19 患者死亡的主要原因。在细胞因子风暴和凝血功能障碍中,单独使用抗病毒药物将无法提供急需的治疗效果。因此,需要联合使用抗炎药物,如干扰素、血管紧张素转化酶 2(ACE-2)抑制剂、白细胞介素 6(IL-6)和 Janus 激酶(JAK)家族抑制剂、抗凝剂和其他参与炎症消退的药物。本综述批判性地介绍了 SARS-CoV-2 的全面概述,揭示了 SARS-CoV-2 中炎症反应的机制,并强调了可能规避 COVID-19 患者炎症诱导性死亡的特定预防和治疗干预措施。

关键词

COVID-19;SARS-CoV-2;细胞因子风暴;凝血功能障碍和抗炎。

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