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针对黏液作为改善 COVID-19 患者肺功能的一种可行方法。

Mucus targeting as a plausible approach to improve lung function in COVID-19 patients.

机构信息

Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara P.O., Kochi, Kerala 682041, India.

Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara P.O., Kochi, Kerala 682041, India.

出版信息

Med Hypotheses. 2021 Nov;156:110680. doi: 10.1016/j.mehy.2021.110680. Epub 2021 Sep 15.

Abstract

COVID-19 (SARS-CoV-2) has emerged as one of the worst pandemics that have tormented the globe due to its highly contagious nature. Even if the disease manifests fever-like symptoms mostly, the disease may progress to the pulmonary-hyper inflammatory phase, with severe pneumonia, hypoxia and subsequent multiple organ infection. This subsequently creates a huge burden to the health care systems across the globe for an immediate arrangement of ventilator facilities, oxygen supply and advanced health care. We evaluated the pathological similarity of COVID-19 with other airway obstructive disorders such as COPD and asthma and found typical mucus hypersecretion and mucus plugging in COVID-19 subjects. From several bronchoscopy and clinical autopsy carried out in COVID-19 patients, the overexpression of mucin gene was evident which play a significant role in mucus hypersecretion and accumulation, leading to airway obstruction and further to respiratory distress. In the present work, we highlight the need for intense research inputs to elucidate the exact role the mucus plays in worsening COVID-19 symptoms. This will further help to find a proper approach to quantify the airway mucus plugging in each patient and to develop an appropriate therapy either to inhibit mucus secretion or to improve mucus clearance through well-designed clinical trials.

摘要

新型冠状病毒(SARS-CoV-2)是一种极具传染性的病毒,它引发的疾病已成为全球最严重的传染病之一。尽管这种疾病主要表现为类似发热的症状,但它可能会发展为肺部高炎症阶段,导致严重肺炎、缺氧和随后的多器官感染。这给全球的医疗保健系统带来了巨大的负担,需要立即安排呼吸机设备、氧气供应和高级医疗保健。我们评估了 COVID-19 与其他气道阻塞性疾病(如 COPD 和哮喘)的病理相似性,发现 COVID-19 患者存在典型的黏液过度分泌和黏液堵塞。在对 COVID-19 患者进行的几次支气管镜检查和临床尸检中,黏蛋白基因的过度表达是显而易见的,它在黏液过度分泌和积累中起着重要作用,导致气道阻塞,进一步导致呼吸窘迫。在本工作中,我们强调需要投入大量的研究来阐明黏液在 COVID-19 症状恶化中的的确切作用。这将有助于找到一种合适的方法来量化每个患者的气道黏液堵塞,并通过精心设计的临床试验来开发适当的治疗方法,要么抑制黏液分泌,要么改善黏液清除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49e7/8440041/e966c28e52a5/gr1_lrg.jpg

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