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2019冠状病毒病对肺部的影响:聚焦潜在恶性表型

Effect of COVID-19 on Lungs: Focusing on Prospective Malignant Phenotypes.

作者信息

Sadhukhan Pritam, Ugurlu M Talha, Hoque Mohammad O

机构信息

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.

Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.

出版信息

Cancers (Basel). 2020 Dec 18;12(12):3822. doi: 10.3390/cancers12123822.

Abstract

Currently, the healthcare management systems are shattered throughout the world, even in the developed nations due to the COVID-19 viral outbreak. A substantial number of patients infected with SARS-CoV2 develop acute respiratory distress syndrome (ARDS) and need advanced healthcare facilities, including invasive mechanical ventilation. Intracellular infiltration of the SARS-CoV2 virus particles into the epithelial cells in lungs are facilitated by the spike glycoprotein (S Protein) on the outer side of the virus envelope, a membrane protein ACE2 (angiotensin-converting enzyme 2) and two proteases (TMPRSS2 and Furin) in the host cell. This virus has unprecedented effects on the immune system and induces a sudden upregulation of the levels of different pro-inflammatory cytokines. This can be a cause for the onset of pulmonary fibrosis in the lungs. Existence of a high concentration of inflammatory cytokines and viral load can also lead to numerous pathophysiological conditions. Although it is well established that cancer patients are among the high-risk population due to COVID-19-associated mortality, it is still unknown whether survivors of COVID-19-infected subjects are at high-risk population for developing cancer and whether any biologic and clinical features exist in post-COVID-19 individuals that might be related to carcinogenesis.

摘要

目前,由于新冠病毒的爆发,全球的医疗管理系统都受到了冲击,即使在发达国家也是如此。大量感染新冠病毒的患者会发展为急性呼吸窘迫综合征(ARDS),并需要先进的医疗设施,包括有创机械通气。新冠病毒颗粒通过病毒包膜外侧的刺突糖蛋白(S蛋白)、宿主细胞中的膜蛋白血管紧张素转换酶2(ACE2)和两种蛋白酶(TMPRSS2和弗林蛋白酶)促进其进入肺上皮细胞。这种病毒对免疫系统有前所未有的影响,并导致不同促炎细胞因子水平突然上调。这可能是肺部发生肺纤维化的原因。高浓度的炎性细胞因子和病毒载量的存在也会导致许多病理生理状况。尽管众所周知,癌症患者因新冠病毒相关死亡率而属于高危人群,但新冠病毒感染幸存者是否属于患癌高危人群,以及新冠康复个体中是否存在可能与致癌作用相关的任何生物学和临床特征,目前仍不清楚。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/320e/7766284/416fcacb0fc2/cancers-12-03822-g001.jpg

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