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肥胖症:一种伴发疾病获得性免疫缺陷综合征(CAIDS)。

Obesity: A comorbidity-acquired immunodeficiency syndrome (CAIDS).

机构信息

Institute for Physical Activity and Nutrition (IPAN), Burwood, Australia.

Faculty of Health, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.

出版信息

Int Rev Immunol. 2023;42(6):415-429. doi: 10.1080/08830185.2022.2083614. Epub 2022 Jun 6.

Abstract

Accumulating data emphasize a strong link between obesity and the severity of coronavirus disease-2019 (COVID-19), including mortality. Obesity interferes with several components of the immune system including lymphoid tissue's integrity, leukocytes' development and function, complement system's activation, and the coordination of innate and adaptive immune responses. Overall, obesity results in a less efficient immune response to infectious agents. Severe acute respiratory syndrome coronavirus 2 exploits this weakened immune system in people with obesity to precipitate COVID-19, and in some cases death. It is therefore the author's recommendation that obesity should be viewed as another form of acquired immunodeficiency syndrome and be treated with the appropriate seriousness. Unlike the previously described acquired immunodeficiency syndrome (AIDS) that is caused by the Human Immunodeficiency Virus (HIV), obesity is a comorbidity-acquired immunodeficiency syndrome. People with AIDS do not die from HIV, but may die from opportunistic pathogens such as Mycobacterium tuberculosis. However, AIDS is ascribed its due importance in the course of deterioration of the patient. Similarly, obesity should be acknowledged further as a risk factor for mortality from COVID-19. Obesity is a modifiable condition and even in people with a strong genetic predisposition, lifestyle modifications can reverse obesity, and even moderate weight loss can improve the inflammatory milieu. Strong public health actions are warranted to promote lifestyle measures to reduce the burden from overweight and obesity that currently affect more than one-third of the global population, with projections alarming this may reach 55-80% within the next thirty years.

摘要

越来越多的数据强调肥胖与 2019 冠状病毒病(COVID-19)严重程度之间存在密切联系,包括死亡率。肥胖症干扰了免疫系统的几个组成部分,包括淋巴组织的完整性、白细胞的发育和功能、补体系统的激活以及先天和适应性免疫反应的协调。总的来说,肥胖症导致对感染因子的免疫反应效率降低。严重急性呼吸综合征冠状病毒 2 利用肥胖症患者免疫系统的这种减弱来引发 COVID-19,并在某些情况下导致死亡。因此,作者建议将肥胖症视为另一种获得性免疫缺陷综合征,并以适当的认真程度对待。与先前描述的由人类免疫缺陷病毒(HIV)引起的获得性免疫缺陷综合征(AIDS)不同,肥胖症是一种合并症获得性免疫缺陷综合征。艾滋病患者不会死于 HIV,但可能死于结核分枝杆菌等机会性病原体。然而,在患者病情恶化的过程中,艾滋病被赋予了应有的重要性。同样,肥胖症也应被进一步确认为 COVID-19 死亡率的一个危险因素。肥胖症是一种可改变的状况,即使对于具有强烈遗传易感性的人,生活方式的改变也可以逆转肥胖症,甚至适度的体重减轻也可以改善炎症环境。需要采取强有力的公共卫生行动,以促进生活方式措施,减轻超重和肥胖的负担,目前全球有超过三分之一的人口受到这一问题的影响,预计在未来三十年这一比例可能会达到 55-80%。

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