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从病理系统总体论(一般病理过程)角度看 COVID-19 的发病机制和病因治疗问题。

Problems of Pathogenesis and Pathogenetic Therapy of COVID-19 from the Perspective of the General Theory of Pathological Systems (General Pathological Processes).

机构信息

Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia.

School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia.

出版信息

Int J Mol Sci. 2021 Jul 15;22(14):7582. doi: 10.3390/ijms22147582.

Abstract

The COVID-19 pandemic examines not only the state of actual health care but also the state of fundamental medicine in various countries. Pro-inflammatory processes extend far beyond the classical concepts of inflammation. They manifest themselves in a variety of ways, beginning with extreme physiology, then allostasis at low-grade inflammation, and finally the shockogenic phenomenon of "inflammatory systemic microcirculation". The pathogenetic core of critical situations, including COVID-19, is this phenomenon. Microcirculatory abnormalities, on the other hand, lie at the heart of a specific type of general pathological process known as systemic inflammation (SI). Systemic inflammatory response, cytokine release, cytokine storm, and thrombo-inflammatory syndrome are all terms that refer to different aspects of SI. As a result, the metabolic syndrome model does not adequately reflect the pathophysiology of persistent low-grade systemic inflammation (ChSLGI). Diseases associated with ChSLGI, on the other hand, are risk factors for a severe COVID-19 course. The review examines the role of hypoxia, metabolic dysfunction, scavenger receptors, and pattern-recognition receptors, as well as the processes of the hemophagocytic syndrome, in the systemic alteration and development of SI in COVID-19.

摘要

COVID-19 大流行不仅检验了实际医疗保健的状况,也检验了各国基础医学的状况。促炎过程远远超出了经典炎症概念的范围。它们以多种方式表现出来,从极端生理学开始,然后是低度炎症的全身适应,最后是“炎症性全身微循环”的休克发生现象。包括 COVID-19 在内的危急情况的发病核心是这种现象。另一方面,微循环异常是一种称为全身炎症(SI)的特定类型全身性病理过程的核心。全身炎症反应、细胞因子释放、细胞因子风暴和血栓炎症综合征都是指 SI 的不同方面。因此,代谢综合征模型不能充分反映持续性低度全身炎症(ChSLGI)的病理生理学。另一方面,与 ChSLGI 相关的疾病是 COVID-19 严重病程的危险因素。该综述探讨了缺氧、代谢功能障碍、清道夫受体和模式识别受体以及噬血细胞综合征的过程在 COVID-19 中全身改变和 SI 发展中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ba9/8304657/2421ce5f6c33/ijms-22-07582-g003.jpg

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