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新型冠状病毒(SARS-CoV-2):发病机制以及诊断与治疗的最新进展。

SARS-CoV-2: Pathogenesis, and Advancements in Diagnostics and Treatment.

机构信息

Department of Cancer Immunology, Poznan University of Medical Sciences, Poznań, Poland.

Department of Cancer Diagnostics and Immunology, Greater Poland Cancer Center, Poznań, Poland.

出版信息

Front Immunol. 2020 Oct 6;11:570927. doi: 10.3389/fimmu.2020.570927. eCollection 2020.

Abstract

The emergence and rapid spread of SARS-CoV-2 in December 2019 has brought the world to a standstill. While less pathogenic than the 2002-2003 SARS-CoV, this novel presents a global threat due to its high transmission rate, ability to invade multiple tissues, and ability to trigger immunological hyperactivation. The identification of the animal reservoir and intermediate host were important steps toward slowing the spread of disease, and its genetic similarity to SARS-CoV has helped to determine pathogenesis and direct treatment strategies. The exponential increase in cases has necessitated fast and reliable testing procedures. Although RT-PCR remains the gold standard, it is a time-consuming procedure, paving the way for newer techniques such as serologic tests and enzyme immunoassays. Various clinical trials using broad antiviral agents in addition to novel medications have produced controversial results; however, the advancement of immunotherapy, particularly monoclonal antibodies and immune modulators is showing great promise in clinical trials. Non-orthodox medications such as anti-malarials have been tested in multiple institutions but definitive conclusions are yet to be made. Adjuvant therapies have also proven to be effective in decreasing mortality in the disease course. While no formal guidelines have been established, the multitude of ongoing clinical trials as a result of unprecedented access to research data brings us closer to halting the SARS-CoV-2 pandemic.

摘要

2019 年 12 月,SARS-CoV-2 的出现和迅速传播使世界陷入停顿。虽然它的致病性比 2002-2003 年的 SARS-CoV 要低,但由于其高传播率、能够侵袭多种组织以及能够引发免疫过度激活,这种新型病毒构成了全球性威胁。确定动物宿主和中间宿主是减缓疾病传播的重要步骤,其与 SARS-CoV 的遗传相似性有助于确定发病机制并指导治疗策略。病例的指数级增长需要快速可靠的检测程序。尽管 RT-PCR 仍然是金标准,但它是一个耗时的过程,为血清学检测和酶免疫测定等新技术铺平了道路。除了新型药物外,还使用了各种广谱抗病毒药物进行临床试验,结果产生了争议;然而,免疫疗法的进步,特别是单克隆抗体和免疫调节剂,在临床试验中显示出巨大的希望。多种非传统药物,如抗疟药,已经在多个机构进行了测试,但尚未得出明确的结论。辅助疗法在疾病过程中也已被证明可以有效降低死亡率。虽然尚未制定正式指南,但由于前所未有的研究数据获取,大量正在进行的临床试验使我们更接近阻止 SARS-CoV-2 大流行。

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