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[新型冠状病毒病COVID-19(冠状病毒科:冠状病毒亚科:β冠状病毒:沙贝病毒属)中干扰素的应用问题]

[The problem of the use of interferons in the novel coronavirus disease COVID-19 (Coronaviridae: Coronavirinae: Betacoronavirus: Sarbecovirus)].

作者信息

Ershov F I, Narovlyansky A N

机构信息

FSBI «National Research Centre for Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya» of the Ministry of Health of Russia.

出版信息

Vopr Virusol. 2022 May 5;67(2):115-125. doi: 10.36233/0507-4088-103.

Abstract

By the end of 2021, about 200 studies on the effect of interferons (IFNs) on the incidence and course of the new coronavirus infection COVID-19 (Coronaviridae: Coronavirinae: Betacoronavirus: Sarbecovirus) have been reported worldwide, with the number of such studies steadily increasing. This review discusses the main issues of the use of IFN drugs in this disease. The literature search was carried out in the PubMed, Scopus, Cochrane Library, Web of Science, RSCI databases, as well as in the Google Scholar preprint database using the available search queries «MeSH for coronavirus», «SARS-CoV-2», «IFN drugs», and «COVID-19». Interferon therapy is indicated for early administration (within the first 5 days of patient admission) in cases of mild to moderate COVID-19 to take advantage of the narrow therapeutic window of IFNs action. Control and suppression of viral replication requires therapy with IFNs and other effective antiviral agents that inhibit the reproduction of SARS-CoV-2 and induce several interferon-stimulated genes (ISG). Type I IFNs (IFN-I) exhibit potent pro-inflammatory properties and activate a wide variety of different cell types that respond to IFNs stimulation and pathogen entry. IFN-III confer local mucosal antiviral immunity without inducing the strong systemic pro-inflammatory responses associated with IFN-I. The use of IFNs drugs in the therapy of new coronavirus infection requires a cautious and differentiated approach, because in severe cases they can aggravate viral pathogenesis by causing excessive intensity of inflammatory reactions. The unique biological properties of substances of this class allow us to consider them as therapeutic agents with significant potential for use in patients with COVID-19.

摘要

截至2021年底,全球已报道约200项关于干扰素(IFNs)对新型冠状病毒感染COVID-19(冠状病毒科:冠状病毒亚科:β冠状病毒:沙贝病毒)发病率和病程影响的研究,且此类研究数量在稳步增加。本综述讨论了IFN药物在该疾病治疗中的主要问题。在PubMed、Scopus、Cochrane图书馆、科学网、俄罗斯科学引文索引数据库以及谷歌学术预印本数据库中进行文献检索,使用了可用的检索词“冠状病毒的医学主题词”、“严重急性呼吸综合征冠状病毒2”、“IFN药物”和“COVID-19”。对于轻度至中度COVID-19病例,建议早期(患者入院后5天内)给予干扰素治疗,以利用IFN作用的狭窄治疗窗口。控制和抑制病毒复制需要使用IFN和其他有效抗病毒药物进行治疗,这些药物可抑制严重急性呼吸综合征冠状病毒2的复制并诱导多种干扰素刺激基因(ISG)。I型干扰素(IFN-I)具有强大的促炎特性,可激活多种不同的细胞类型,这些细胞对IFN刺激和病原体入侵有反应。III型干扰素可赋予局部黏膜抗病毒免疫力,而不会诱导与IFN-I相关的强烈全身促炎反应。在新型冠状病毒感染的治疗中使用IFN药物需要谨慎且有区别地对待,因为在严重病例中,它们可能会因引起过度强烈的炎症反应而加重病毒发病机制。这类物质独特的生物学特性使我们可以将它们视为在COVID-19患者中具有显著应用潜力 的治疗药物。

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