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美维单抗在包括SARS-CoV-2感染在内的病毒感染中的有效性——简要综述

Effectiveness of Mavrilimumab in Viral Infections Including SARS-CoV-2 Infection - A Brief Review.

作者信息

Bhatt Kinal, Garimella Radhika, Taugir Rahima, Mehta Isha, Jamal Muhammad, Vijayan Rupalakshmi, Offor Rita, Nwankwo Kanayo, Arif Uroosa, Waheed Khurram, Kumari Priyanka, Lathiya Maulik, Michel George, Pandya Naushira, Halpern John, Nasir Hassan, Sanchez-Gonzalez Marcos A

机构信息

Division of Clinical & Translational Research, Larkin Health System, South Miami, FL, USA.

Dr. NTR University of Health Sciences, Andhra Pradesh, India.

出版信息

Infect Chemother. 2021 Mar;53(1):1-12. doi: 10.3947/ic.2020.0109.

Abstract

Hyperinflammation and cytokine storm has been noted as a poor prognostic factor in patients with severe pneumonia related to coronavirus disease 2019 (COVID-19). In COVID-19, pathogenic myeloid cell overactivation is found to be a vital mediator of damage to tissues, hypercoagulability, and the cytokine storm. These cytokines unselectively infiltrate various tissues, such as the lungs and heart, and nervous system. This cytokine storm can hence cause multi-organ dysfunction and life-threatening complications. Mavrilimumab is a monoclonal antibody (mAb) that may be helpful in some cases with COVID-19. During an inflammation, Granulocyte-macrophage colony-stimulating factor (GM-CSF) release is crucial to driving both innate and adaptive immune responses. The GM-CSF immune response is triggered when an antigen attaches to the host cell and induces the signaling pathway. Mavrilimumab antagonizes the action of GM-CSF and decreases the hyperinflammation associated with pneumonia in COVID-19, therefore strengthening the rationale that mavrilimumab when added to the standard protocol of treatment could improve the clinical outcomes in COVID-19 patients, specifically those patients with pneumonia. With this review paper, we aim to demonstrate the inhibitory effect of mavrilimumab on cytokine storms in patients with COVID-19 by reviewing published clinical trials and emphasize the importance of extensive future trials.

摘要

高炎症反应和细胞因子风暴已被视为2019冠状病毒病(COVID-19)相关重症肺炎患者的不良预后因素。在COVID-19中,致病性髓系细胞过度活化被发现是组织损伤、高凝状态和细胞因子风暴的重要介质。这些细胞因子无选择性地浸润各种组织,如肺、心脏和神经系统。因此,这种细胞因子风暴可导致多器官功能障碍和危及生命的并发症。玛夫利单抗是一种单克隆抗体(mAb),在某些COVID-19病例中可能有用。在炎症过程中,粒细胞-巨噬细胞集落刺激因子(GM-CSF)的释放对于驱动先天性和适应性免疫反应至关重要。当抗原附着于宿主细胞并诱导信号通路时,GM-CSF免疫反应被触发。玛夫利单抗拮抗GM-CSF的作用,并减少与COVID-19肺炎相关的高炎症反应,因此强化了以下理论基础:将玛夫利单抗添加到标准治疗方案中可改善COVID-19患者,特别是肺炎患者的临床结局。通过这篇综述文章,我们旨在通过回顾已发表的临床试验来证明玛夫利单抗对COVID-19患者细胞因子风暴的抑制作用,并强调未来进行广泛试验的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7825/8032909/cc11038fadc6/ic-53-1-g001.jpg

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