红细胞置换治疗 SARS-CoV-2:治疗机会的双子星。

Red blood cell exchange for SARS-CoV-2: A Gemini of therapeutic opportunities.

机构信息

Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Northwell, New York, USA.

出版信息

Med Hypotheses. 2020 Nov;144:110227. doi: 10.1016/j.mehy.2020.110227. Epub 2020 Sep 2.

Abstract

As of now, therapeutic strategies for the novel coronavirus (SARS-CoV-2) are limited and much focus has been placed on social distancing techniques to "flatten the curve". Initial treatment efforts including ventilation and hydroxychloroquine garnered significant controversy and today, SARS-CoV-2 outbreaks are still occurring throughout the world. Needless to say, new therapeutic strategies are needed to combat this unprecedented pandemic. Nature Reviews Immunology recently published an article hypothesizing the pathogenesis of TAM (Tyro3, Axl, and Mer) receptor signaling in COVID-19. In it they expressed that hypercoagulation and immune hyper-reaction could occur secondary to decreased Protein S (PROS1). And hypoxia has been recently discovered to significantly decrease expression of PROS1. Regarding the cause of hypoxia in COVID-19; NIH funded research utilizing state-of-the-art topologies has recently demonstrated significant metabolomic, proteomic, and lipidomic structural aberrations in hemoglobin (Hb) secondary to infection with SARS-CoV-2. In this setting, Hb may be incapacitated and unable to respond to environmental variations, compromising RBCs and oxygen delivery to tissues. The use of red blood cell exchange would target hypoxia at its source; representing a Gemini of therapeutic opportunities.

摘要

截至目前,针对新型冠状病毒(SARS-CoV-2)的治疗策略有限,人们非常关注社交距离技术以“拉平曲线”。最初的治疗措施包括通气和羟氯喹,但引起了很大的争议,如今,SARS-CoV-2 仍在世界各地爆发。不用说,需要新的治疗策略来应对这一前所未有的大流行。《自然评论免疫学》最近发表了一篇文章,假设了 TAM(酪氨酸激酶受体 3、Axl 和 Mer)受体信号在 COVID-19 中的发病机制。文章表示,蛋白 S(PROS1)减少可能会导致过度凝血和免疫过度反应。最近发现缺氧会显著降低 PROS1 的表达。关于 COVID-19 中缺氧的原因;美国国立卫生研究院(NIH)资助的研究利用最先进的拓扑结构,最近表明 SARS-CoV-2 感染后血红蛋白(Hb)中的代谢组学、蛋白质组学和脂质组学结构出现显著异常。在这种情况下,Hb 可能会失去功能,无法响应环境变化,从而损害 RBC 和向组织输送氧气。使用红细胞交换将从源头上解决缺氧问题;这代表了治疗机会的双星。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5f9/7467009/fba3bf2c5356/gr1_lrg.jpg

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