通过调节炎症信号和活性氧及氮物种治疗脓毒症的纳米治疗:治疗 COVID-19 的新见解。

Nanotherapies for sepsis by regulating inflammatory signals and reactive oxygen and nitrogen species: New insight for treating COVID-19.

机构信息

Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, 410008, China; Hunan Provincial Key Laboratory of Cardiovascular Research, Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, 410008, China.

Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 410087, Hunan, China.

出版信息

Redox Biol. 2021 Sep;45:102046. doi: 10.1016/j.redox.2021.102046. Epub 2021 Jun 15.

Abstract

SARS-CoV-2 has caused up to 127 million cases of COVID-19. Approximately 5% of COVID-19 patients develop severe illness, and approximately 40% of those with severe illness eventually die, corresponding to more than 2.78 million people. The pathological characteristics of COVID-19 resemble typical sepsis, and severe COVID-19 has been identified as viral sepsis. Progress in sepsis research is important for improving the clinical care of these patients. Recent advances in understanding the pathogenesis of sepsis have led to the view that an uncontrolled inflammatory response and oxidative stress are core factors. However, in the traditional treatment of sepsis, it is difficult to achieve a balance between the inflammation, pathogens (viruses, bacteria, and fungi), and patient tolerance, resulting in high mortality of patients with sepsis. In recent years, nanomaterials mediating reactive oxygen and nitrogen species (RONS) and the inflammatory response have shown previously unattainable therapeutic effects on sepsis. Despite these advantages, RONS and inflammatory response-based nanomaterials have yet to be extensively adopted as sepsis therapy. To the best of our knowledge, no review has yet discussed the pathogenesis of sepsis and the application of nanomaterials. To help bridge this gap, we discuss the pathogenesis of sepsis related to inflammation and the overproduction RONS, which activate pathogen-associated molecular pattern (PAMP)-pattern recognition receptor (PRR) and damage-associated molecular pattern (DAMP)-PRR signaling pathways. We also summarize the application of nanomaterials in the treatment of sepsis. As highlighted here, this strategy could synergistically improve the therapeutic efficacy against both RONS and inflammation in sepsis and may prolong survival. Current challenges and future developments for sepsis treatment are also summarized.

摘要

SARS-CoV-2 已导致多达 1.27 亿例 COVID-19 病例。大约 5%的 COVID-19 患者会发展为重症,而大约 40%的重症患者最终死亡,这对应着超过 278 万人。COVID-19 的病理特征类似于典型的败血症,重症 COVID-19 已被确定为病毒性败血症。败血症研究的进展对于改善这些患者的临床护理非常重要。对败血症发病机制的最新认识表明,不受控制的炎症反应和氧化应激是核心因素。然而,在败血症的传统治疗中,很难在炎症、病原体(病毒、细菌和真菌)和患者耐受性之间取得平衡,导致败血症患者的死亡率居高不下。近年来,介导活性氧和氮物种(RONS)以及炎症反应的纳米材料在败血症治疗方面显示出了以前难以达到的治疗效果。尽管具有这些优势,但基于 RONS 和炎症反应的纳米材料尚未广泛应用于败血症治疗。据我们所知,尚无综述讨论过败血症的发病机制和纳米材料的应用。为了帮助弥补这一空白,我们讨论了与炎症和 RONS 过度产生相关的败血症发病机制,这些机制会激活病原体相关分子模式(PAMP)-模式识别受体(PRR)和损伤相关分子模式(DAMP)-PRR 信号通路。我们还总结了纳米材料在败血症治疗中的应用。正如这里所强调的,这种策略可以协同改善败血症中 RONS 和炎症的治疗效果,并可能延长生存时间。还总结了败血症治疗的当前挑战和未来发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cef8/8243006/71865ea0466f/gr1.jpg

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