Clinic of Nephrology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
Department of Nephrology, Baskent University School of Medicine, Ankara, Turkey.
Ann Transplant. 2021 Mar 12;26:e929279. doi: 10.12659/AOT.929279.
Coronavirus disease 19 (COVID-19) has been an ongoing pandemic since December 2019. Unfortunately, kidney transplant recipients are a high-risk group during the disease course, and scientific data are still limited in this patient group. Beyond the dosage of immunosuppressive drugs, pharmacological immunosuppression may also alter the infection response in the COVID-19 course. The effects of immunosuppressive agents on the development and process of infection should not be decided only by determining how potent they are and how much they suppress the immune system; it is also thought that the direct effect of the virus, increased oxidative stress, and cytokine storm play a role in the pathogenesis of COVID-19 disease. There are data about immunosuppressive drugs like calcineurin inhibitors (CNI) or mammalian target of rapamycin inhibitors (mTORi) therapy related to their beneficial effects during any infection course. Limited data suggest that the use of CNI or mTORi may have beneficial effects on the process. In this hypothetical review, the probable impacts of CNI and mTORi on the pathogenesis of the COVID-19 were investigated.
自 2019 年 12 月以来，新型冠状病毒病（COVID-19）一直是一种持续存在的大流行疾病。不幸的是，肾移植受者在疾病过程中属于高风险群体，而针对该患者群体的科学数据仍然有限。除了免疫抑制剂的剂量外，药物免疫抑制也可能改变 COVID-19 病程中的感染反应。免疫抑制剂对感染发展和进程的影响不应仅通过确定其效力和对免疫系统的抑制程度来决定；还认为病毒的直接作用、氧化应激增加和细胞因子风暴在 COVID-19 疾病的发病机制中发挥作用。有数据表明，钙调神经磷酸酶抑制剂（CNI）或雷帕霉素哺乳动物靶蛋白抑制剂（mTORi）等免疫抑制剂的治疗与任何感染过程中的有益作用有关。有限的数据表明，CNI 或 mTORi 的使用可能对病程有有益影响。在本假设性综述中，研究了 CNI 和 mTORi 对 COVID-19 发病机制的可能影响。
