循环细胞因子和趋化因子在人类冠状病毒中的特征：系统评价和荟萃分析。
Profile of Circulatory Cytokines and Chemokines in Human Coronaviruses: A Systematic Review and Meta-Analysis.
机构信息
Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Vaccines and Immunotherapy Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
出版信息
Front Immunol. 2021 May 5;12:666223. doi: 10.3389/fimmu.2021.666223. eCollection 2021.
BACKGROUND
SARS, MERS, and COVID-19 share similar characteristics. For instance, the genetic homology of SARS-CoV-2 compared to SARS-CoV and MERS-CoV is 80% and 50%, respectively, which may cause similar clinical features. Moreover, uncontrolled release of proinflammatory mediators (also called a cytokine storm) by activated immune cells in SARS, MERS, and COVID-19 patients leads to severe phenotype development.
AIM
This systematic review and meta-analysis aimed to evaluate the inflammatory cytokine profile associated with three strains of severe human coronavirus diseases (MERS-CoV, SARS-CoV, and SARS-CoV-2).
METHOD
The PubMed, Embase, and Cochrane Library databases were searched for studies published until July 2020. Randomized and observational studies reporting the inflammatory cytokines associated with severe and non-severe human coronavirus diseases, including MERS-CoV, SARS-CoV, and SARS-CoV-2, were included. Two reviewers independently screened articles, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using a random-effects model with a 95% confidence interval to estimate the pooled mean of inflammatory biomarkers.
RESULTS
A high level of circulating IL-6 could be associated with the severity of infection of the three coronavirus strains. TNF, IL-10, and IL-8 are associated with the severity of COVID-19. Increased circulating levels of CXCL10/IP10 and CCL2/MCP-1 might also be related to the severity of MERS.
CONCLUSION
This study suggests that the immune response and immunopathology in the three severe human coronavirus strains are somewhat similar. The findings highlight that nearly all studies reporting severe cases of SARS, MERS, and COVID-19 have been associated with elevated levels of IL-6. This could be used as a potential therapeutic target to improve patients' outcomes in severe cases.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration 94 number: CRD42020209931.
背景
SARS、MERS 和 COVID-19 具有相似的特征。例如，SARS-CoV-2 与 SARS-CoV 和 MERS-CoV 的遗传同源性分别为 80%和 50%，这可能导致类似的临床特征。此外，SARS、MERS 和 COVID-19 患者激活的免疫细胞失控释放促炎介质（也称为细胞因子风暴），导致严重表型的发展。
目的
本系统评价和荟萃分析旨在评估与三种严重人冠状病毒病（MERS-CoV、SARS-CoV 和 SARS-CoV-2）相关的炎症细胞因子谱。
方法
检索 PubMed、Embase 和 Cochrane 图书馆数据库，直到 2020 年 7 月，检索与严重和非严重人冠状病毒疾病相关的炎症细胞因子的研究，包括 MERS-CoV、SARS-CoV 和 SARS-CoV-2。两名评审员独立筛选文章、提取数据并评估纳入研究的质量。使用具有 95%置信区间的随机效应模型进行荟萃分析，以估计炎症生物标志物的汇总均值。
结果
高水平的循环 IL-6 可能与三种冠状病毒株感染的严重程度有关。TNF、IL-10 和 IL-8 与 COVID-19 的严重程度有关。循环 CXCL10/IP10 和 CCL2/MCP-1 水平升高也可能与 MERS 的严重程度有关。
结论
本研究表明，三种严重人冠状病毒株的免疫反应和免疫病理学有些相似。研究结果表明，几乎所有报告 SARS、MERS 和 COVID-19 严重病例的研究都与升高的 IL-6 水平有关。这可以作为改善严重病例患者结局的潜在治疗靶点。
系统评价注册
PROSPERO 注册号：CRD42020209931。
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