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病例报告：COVID-19 引起的持续性免疫抑制中的并发感染：干扰素 γ 是一种合适的药物吗？

Case Report: Intercurrent infections in COVID-19-induced sustained immunodepression: is interferon gamma a suitable drug?

机构信息

Intensive Care Unit, Centre Hospitalier Intercommunal Aix-Pertuis, Aix en Provence, France.

EA7426 "Pathophysiology of Injury-Induced Immunosuppression (PI3)", Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux, Lyon, France.

出版信息

Front Immunol. 2023 Jun 8;14:1183665. doi: 10.3389/fimmu.2023.1183665. eCollection 2023.

DOI:10.3389/fimmu.2023.1183665
PMID:37359519
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10285411/
Abstract

Acute immuno-depression syndrome (AIDs) had been observed in many life-threatening conditions leading to the Intensive Care Unit. and is associated with recurrent secondary infections. We report one COVID-19 patient with a severe ARDS, demonstrating acute immunodepression syndrome lasting for several weeks. The occurrence of secondary infections despite long treatment by antibiotics led to combined interferon γ (IFNγ) as reported previously. The response to IFNγ was evaluated by the flowcytometry HLA-DR expression on circulating monocytes, which was repeated from time to time. The severe COVID-19 patients responded well to IFNγ without adverse events.

摘要

急性免疫抑制综合征（AIDs）在许多导致重症监护病房（Intensive Care Unit）的危及生命的情况下都有观察到，并且与反复发生的继发感染有关。我们报告了 1 例 COVID-19 患者患有严重的 ARDS，并表现出持续数周的急性免疫抑制综合征。尽管长期使用抗生素治疗，但继发感染的发生导致如前所述联合使用干扰素 γ（IFNγ）。通过流式细胞术检测循环单核细胞 HLA-DR 表达来评估 IFNγ 的反应，并且不时重复该检测。严重 COVID-19 患者对 IFNγ 的反应良好，没有不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c96f/10285411/30245403e343/fimmu-14-1183665-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c96f/10285411/30245403e343/fimmu-14-1183665-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c96f/10285411/30245403e343/fimmu-14-1183665-g001.jpg

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本文引用的文献

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Monitoring of circulating monocyte HLA-DR expression in a large cohort of intensive care patients: relation with secondary infections.在一大群重症监护患者中监测循环单核细胞 HLA - DR 表达：与继发感染的关系
Ann Intensive Care. 2022 May 8;12(1):39. doi: 10.1186/s13613-022-01010-y.
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Severe COVID-19 is characterized by the co-occurrence of moderate cytokine inflammation and severe monocyte dysregulation.严重的 COVID-19 的特征是中等程度的细胞因子炎症和严重的单核细胞失调同时发生。
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新型冠状病毒肺炎住院患者新出现的IgG自身抗体
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Intensive Care Med. 2021 May;47(5):619-621. doi: 10.1007/s00134-021-06377-3. Epub 2021 Mar 10.
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Functional Exhaustion of Type I and II Interferons Production in Severe COVID-19 Patients.重症 COVID-19 患者中 I 型和 II 型干扰素产生的功能耗竭
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J Infect Dis. 2021 Apr 23;223(8):1322-1333. doi: 10.1093/infdis/jiab065.
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A Longitudinal Study of Immune Cells in Severe COVID-19 Patients.严重 COVID-19 患者免疫细胞的纵向研究。
Front Immunol. 2020 Oct 23;11:580250. doi: 10.3389/fimmu.2020.580250. eCollection 2020.
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Current and evolving standards of care for patients with ARDS.急性呼吸窘迫综合征患者的现行和不断发展的护理标准。
Intensive Care Med. 2020 Dec;46(12):2157-2167. doi: 10.1007/s00134-020-06299-6. Epub 2020 Nov 6.
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Shock. 2021 Jun 1;55(6):782-789. doi: 10.1097/SHK.0000000000001673.
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Autoantibodies against type I IFNs in patients with life-threatening COVID-19.COVID-19 危重症患者体内针对 I 型干扰素的自身抗体。
Science. 2020 Oct 23;370(6515). doi: 10.1126/science.abd4585. Epub 2020 Sep 24.