Gianni Panagiota, Goldin Mark, Ngu Sam, Zafeiropoulos Stefanos, Geropoulos Georgios, Giannis Dimitrios
Department of Internal Medicine III, Hematology, Oncology, Palliative Medicine, Rheumatology and Infectious Diseases, University Hospital Ulm, Ulm 89070, Germany.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, New York, NY 11549, United States.
World J Exp Med. 2022 Jul 20;12(4):53-67. doi: 10.5493/wjem.v12.i4.53.
Coronavirus disease 2019 (COVID-19) causes acute microvascular thrombosis in both venous and arterial structures which is highly associated with increased mortality. The mechanisms leading to thromboembolism are still under investigation. Current evidence suggests that excessive complement activation with severe amplification of the inflammatory response (cytokine storm) hastens disease progression and initiates complement-dependent cytotoxic tissue damage with resultant prothrombotic complications. The concept of thromboinflammation, involving overt inflammation and activation of the coagulation cascade causing thrombotic microangiopathy and end-organ damage, has emerged as one of the core components of COVID-19 pathogenesis. The complement system is a major mediator of the innate immune response and inflammation and thus an appealing treatment target. In this review, we discuss the role of complement in the development of thrombotic microangiopathy and summarize the current data on complement inhibitors as COVID-19 therapeutics.
2019年冠状病毒病（COVID-19）会导致静脉和动脉结构出现急性微血管血栓形成，这与死亡率增加高度相关。导致血栓栓塞的机制仍在研究中。目前的证据表明，补体过度激活并伴有炎症反应（细胞因子风暴）的严重放大，会加速疾病进展，并引发补体依赖性细胞毒性组织损伤，从而导致血栓形成并发症。血栓炎症的概念，即明显的炎症和凝血级联反应的激活导致血栓性微血管病和终末器官损伤，已成为COVID-19发病机制的核心组成部分之一。补体系统是先天性免疫反应和炎症的主要介质，因此是一个有吸引力的治疗靶点。在这篇综述中，我们讨论了补体在血栓性微血管病发展中的作用，并总结了目前关于补体抑制剂作为COVID-19治疗药物的数据。
