Czura Christopher J, Bikson Marom, Charvet Leigh, Chen Jiande D Z, Franke Manfred, Fudim Marat, Grigsby Eric, Hamner Sam, Huston Jared M, Khodaparast Navid, Krames Elliot, Simon Bruce J, Staats Peter, Vonck Kristl
Convergent Medical Technologies, Inc., Oyster Bay, NY, United States.
Department of Biomedical Engineering, The City College of New York, New York, NY, United States.
Front Neurol. 2022 Jul 14;13:897124. doi: 10.3389/fneur.2022.897124. eCollection 2022.
Since the outbreak of the COVID-19 pandemic, races across academia and industry have been initiated to identify and develop disease modifying or preventative therapeutic strategies has been initiated. The primary focus has been on pharmacological treatment of the immune and respiratory system and the development of a vaccine. The hyperinflammatory state ("cytokine storm") observed in many cases of COVID-19 indicates a prognostically negative disease progression that may lead to respiratory distress, multiple organ failure, shock, and death. Many critically ill patients continue to be at risk for significant, long-lasting morbidity or mortality. The human immune and respiratory systems are heavily regulated by the central nervous system, and intervention in the signaling of these neural pathways may permit targeted therapeutic control of excessive inflammation and pulmonary bronchoconstriction. Several technologies, both invasive and non-invasive, are available and approved for clinical use, but have not been extensively studied in treatment of the cytokine storm in COVID-19 patients. This manuscript provides an overview of the role of the nervous system in inflammation and respiration, the current understanding of neuromodulatory techniques from preclinical and clinical studies and provides a rationale for testing non-invasive neuromodulation to modulate acute systemic inflammation and respiratory dysfunction caused by SARS-CoV-2 and potentially other pathogens. The authors of this manuscript have co-founded the International Consortium on Neuromodulation for COVID-19 to advocate for and support studies of these technologies in the current coronavirus pandemic.
自新冠疫情爆发以来，学术界和产业界纷纷展开竞赛，以识别和开发疾病改善或预防治疗策略。主要重点一直放在免疫系统和呼吸系统的药物治疗以及疫苗的研发上。在许多新冠病例中观察到的过度炎症状态（“细胞因子风暴”）表明疾病进展预后不良，可能导致呼吸窘迫、多器官衰竭、休克和死亡。许多重症患者仍然面临严重、长期发病或死亡的风险。人体免疫系统和呼吸系统受中枢神经系统的严格调控，干预这些神经通路的信号传导可能有助于对过度炎症和肺支气管收缩进行靶向治疗控制。有几种侵入性和非侵入性技术已获批准用于临床，但尚未在新冠患者细胞因子风暴的治疗中进行广泛研究。本手稿概述了神经系统在炎症和呼吸中的作用，目前对临床前和临床研究中神经调节技术的理解，并为测试非侵入性神经调节以调节由SARS-CoV-2及可能的其他病原体引起的急性全身炎症和呼吸功能障碍提供了理论依据。本手稿的作者共同创立了新冠神经调节国际联盟，以倡导和支持在当前冠状病毒大流行中对这些技术的研究。
