Kimura-Ohba Shihoko, Takabatake Yoshitsugu, Takahashi Atsushi, Tanaka Yoko, Sakai Shinsuke, Isaka Yoshitaka, Kimura Tomonori
Reverse Translational Research Project, Center for Rare Disease Research, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), 567-0085, Japan.
KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), 567-0085, Japan.
Biochem Biophys Rep. 2023 Jul;34:101452. doi: 10.1016/j.bbrep.2023.101452. Epub 2023 Mar 7.
d-Amino acids, rare enantiomers of amino acids, have been identified as biomarkers and therapeutic options for COVID-19. Methods for monitoring recovery are necessary for managing COVID-19. On the other hand, the presence of SARS-CoV2 virus in the blood is associated with worse outcomes. We investigated the potential of d-amino acids for assessing recovery from severe COVID-19. In patients with severe COVID-19 requiring artificial ventilation, the blood levels of d-amino acids, including d-alanine, d-proline, d-serine, and d-asparagine, which were lower than the normal range before treatment, quickly and transiently increased and surpassed the upper limit of the normal range. This increase preceded the recovery of respiratory function, as indicated by ventilation weaning. The increase in blood d-amino acid levels was associated with the disappearance of the virus in the blood, but not with inflammatory manifestations or blood cytokine levels. d-Amino acids are sensitive biomarkers that reflect the recovery of the clinical course and blood viral load. Dynamic changes in blood d-amino acid levels are key indicators of clinical course.
d-氨基酸是氨基酸的稀有对映体，已被确定为新冠病毒病（COVID-19）的生物标志物和治疗选择。监测康复情况的方法对于管理COVID-19至关重要。另一方面，血液中严重急性呼吸综合征冠状病毒2（SARS-CoV2）病毒的存在与更差的预后相关。我们研究了d-氨基酸在评估重度COVID-19康复情况方面的潜力。在需要人工通气的重度COVID-19患者中，包括d-丙氨酸、d-脯氨酸、d-丝氨酸和d-天冬酰胺在内的d-氨基酸血液水平在治疗前低于正常范围，但迅速且短暂地升高并超过了正常范围的上限。这种升高先于呼吸功能的恢复，如撤机所示。血液d-氨基酸水平的升高与血液中病毒的消失有关，但与炎症表现或血液细胞因子水平无关。d-氨基酸是反映临床病程恢复和血液病毒载量的敏感生物标志物。血液d-氨基酸水平的动态变化是临床病程的关键指标。
