Giszas Benjamin, Reuken Philipp A, Katzer Katrin, Kiehntopf Michael, Schmerler Diana, Rummler Silke, Stallmach Andreas, Klink Anne
Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena, Germany.
Institute of Clinical Chemistry and Laboratory Diagnostics and Integrated Biobank Jena (IBBJ), Jena University Hospital-Friedrich Schiller University, Jena, Germany.
Ther Apher Dial. 2023 Aug;27(4):790-801. doi: 10.1111/1744-9987.13974. Epub 2023 Feb 16.
Following SARS-CoV-2-infection up to 21% of patients will develop post-COVID-syndrome. Autoantibodies (AAbs) targeting neuronal-ß-adrenergic and muscarinic receptors may provide crucial contributions to the pathophysiology of this condition. Immunoadsorption (IA) has been identified as an effective means of removing AAbs and has resulted in clinical improvements of other autoantibody-associated diseases.
We determined AAb-levels (anti-ß1/ß2 and anti-M3/M4 receptor) in 178 patients diagnosed with post-COVID-syndrome and described the clinical courses of two patients with elevated AAb-levels that underwent IA-treatment.
AAbs were detected in 57% (101/178) of patients diagnosed with post-COVID-syndrome. Substantial reductions in AAb-levels and clinical remission were achieved in one of two patients who was treated with IA. However, this patient relapsed within 6 weeks with a concomitant increase in AAb-levels.
Collectively, AAbs may play a pathophysiologic role in post-COVID and their removal provide transient benefits in some patients. However, these findings should be further investigated in randomized-controlled-trials.
感染新型冠状病毒后，高达21%的患者会出现新冠后遗症。靶向神经元β-肾上腺素能和毒蕈碱受体的自身抗体可能对这种疾病的病理生理过程起到关键作用。免疫吸附已被确定为清除自身抗体的有效方法，并已使其他自身抗体相关疾病的临床症状得到改善。
我们测定了178例被诊断为新冠后遗症患者的自身抗体水平（抗β1/β2和抗M3/M4受体），并描述了2例自身抗体水平升高且接受免疫吸附治疗患者的临床病程。
在178例被诊断为新冠后遗症的患者中，57%（101/178）检测到自身抗体。接受免疫吸附治疗的2例患者中，有1例自身抗体水平大幅降低且临床症状缓解。然而，该患者在6周内复发，自身抗体水平随之升高。
总体而言，自身抗体可能在新冠后遗症中发挥病理生理作用，清除自身抗体在部分患者中可带来短暂益处。然而，这些发现应在随机对照试验中进一步研究。
