Ruscitti Piero, Giacomelli Roberto
Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Isr Med Assoc J. 2020 Aug;22(8):516-518.
A virally-induced cytokine storm syndrome, associated with a massive and overwhelming systemic inflammation, burdens a subgroup of patients with severe coronavirus disease-2019 (COVID-19), which leads to pulmonary inflammation and extensive lung damage. These severe COVID-19 patients are characterized by high ferritin levels. These findings mirror what was previously reported about the prognostic role of this iron storage protein in other inflammatory diseases included in the hyperferritinemic syndrome. The latter suggests that ferritin could be a further pathogenic mediator in enhancing the inflammatory process, stimulating inflammatory pathways, and thus perpetuating a vicious pathogenic loop. Considering its activity as an immune activator, a therapeutic approach targeting ferritin may be also postulated in these diseases. Considering these observations, high ferritin levels characterize severe COVID-19 and other diseases included in the hyperferritinemic syndrome. Because ferritin could enhance the inflammatory process, it could be tested as a possible new therapeutic target to improve the outcome of these patients.
病毒诱导的细胞因子风暴综合征与大规模、压倒性的全身炎症相关，给一部分患有严重2019冠状病毒病（COVID-19）的患者带来负担，这会导致肺部炎症和广泛的肺损伤。这些重症COVID-19患者的特征是铁蛋白水平升高。这些发现反映了先前关于这种铁储存蛋白在高铁蛋白血症综合征所包括的其他炎症性疾病中的预后作用的报道。后者表明铁蛋白可能是增强炎症过程、刺激炎症途径从而使致病性恶性循环持续的另一种致病介质。考虑到其作为免疫激活剂的活性，在这些疾病中也可以设想一种针对铁蛋白的治疗方法。基于这些观察结果，高铁蛋白水平是重症COVID-19和高铁蛋白血症综合征所包括的其他疾病的特征。由于铁蛋白可以增强炎症过程，因此可以将其作为一种可能的新治疗靶点进行测试，以改善这些患者的预后。
