Amsterdam UMC location University of Amsterdam, Department of Intensive Care Medicine, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Laboratory of Experimental Intensive Care and Anesthesiology (L.E.I.C.A.), Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Department of Neurology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands.
Amsterdam UMC location University of Amsterdam, Department of Intensive Care Medicine, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Laboratory of Experimental Intensive Care and Anesthesiology (L.E.I.C.A.), Amsterdam, the Netherlands.
Blood Rev. 2023 Jan;57:100995. doi: 10.1016/j.blre.2022.100995. Epub 2022 Jul 30.
Increasing evidence suggests that activation of the complement system plays a key role in the pathogenesis and disease severity of Coronavirus disease 2019 (COVID-19). We used a systematic approach to create an overview of complement activation in COVID-19 based on histopathological, preclinical, multiomics, observational and clinical interventional studies. A total of 1801 articles from PubMed, EMBASE and Cochrane was screened of which 157 articles were included in this scoping review. Histopathological, preclinical, multiomics and observational studies showed apparent complement activation through all three complement pathways and a correlation with disease severity and mortality. The complement system was targeted at different levels in COVID-19, of which C5 and C5a inhibition seem most promising. Adequately powered, double blind RCTs are necessary in order to further investigate the effect of targeting the complement system in COVID-19.
越来越多的证据表明，补体系统的激活在 2019 年冠状病毒病（COVID-19）的发病机制和疾病严重程度中起着关键作用。我们使用系统的方法，根据组织病理学、临床前、多组学、观察性和临床干预研究，对 COVID-19 中的补体激活进行概述。从 PubMed、EMBASE 和 Cochrane 筛选了 1801 篇文章，其中 157 篇文章被纳入本范围综述。组织病理学、临床前、多组学和观察性研究表明，通过所有三种补体途径都明显存在补体激活，并与疾病严重程度和死亡率相关。补体系统在 COVID-19 中靶向不同的水平，其中 C5 和 C5a 的抑制似乎最有希望。为了进一步研究靶向 COVID-19 补体系统的效果，有必要进行充分的、双盲的 RCT。
