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后 COVID-19 时代心血管疾病的表型全基因组关联研究和精准医学。

Phenome-wide association study and precision medicine of cardiovascular diseases in the post-COVID-19 era.

机构信息

Center for Phenomics of Traditional Chinese Medicine, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China.

Institute of Integrated Chinese and Western Medicine, Southwest Medical University, Luzhou, 646000, China.

出版信息

Acta Pharmacol Sin. 2023 Dec;44(12):2347-2357. doi: 10.1038/s41401-023-01119-1. Epub 2023 Aug 2.

Abstract

SARS-CoV-2 infection causes injuries of not only the lungs but also the heart and endothelial cells in vasculature of multiple organs, and induces systemic inflammation and immune over-reactions, which makes COVID-19 a disease phenome that simultaneously affects multiple systems. Cardiovascular diseases (CVD) are intrinsic risk and causative factors for severe COVID-19 comorbidities and death. The wide-spread infection and reinfection of SARS-CoV-2 variants and the long-COVID may become a new common threat to human health and propose unprecedented impact on the risk factors, pathophysiology, and pharmacology of many diseases including CVD for a long time. COVID-19 has highlighted the urgent demand for precision medicine which needs new knowledge network to innovate disease taxonomy for more precise diagnosis, therapy, and prevention of disease. A deeper understanding of CVD in the setting of COVID-19 phenome requires a paradigm shift from the current phenotypic study that focuses on the virus or individual symptoms to phenomics of COVID-19 that addresses the inter-connectedness of clinical phenotypes, i.e., clinical phenome. Here, we summarize the CVD manifestations in the full clinical spectrum of COVID-19, and the phenome-wide association study of CVD interrelated to COVID-19. We discuss the underlying biology for CVD in the COVID-19 phenome and the concept of precision medicine with new phenomic taxonomy that addresses the overall pathophysiological responses of the body to the SARS-CoV-2 infection. We also briefly discuss the unique taxonomy of disease as Zheng-hou patterns in traditional Chinese medicine, and their potential implications in precision medicine of CVD in the post-COVID-19 era.

摘要

SARS-CoV-2 感染不仅会导致肺部损伤,还会导致多个器官血管中的心脏和内皮细胞损伤,并引发全身炎症和免疫过度反应,使 COVID-19 成为同时影响多个系统的疾病表现。心血管疾病(CVD)是 COVID-19 严重并发症和死亡的固有风险和致病因素。SARS-CoV-2 变体的广泛感染和再感染以及长 COVID-19 可能成为人类健康的新共同威胁,并在很长一段时间内对包括 CVD 在内的许多疾病的危险因素、病理生理学和药理学产生前所未有的影响。COVID-19 凸显了对精准医学的迫切需求,需要新的知识网络来创新疾病分类学,以实现更精确的诊断、治疗和预防疾病。在 COVID-19 表型中更深入地了解 CVD 需要从当前关注病毒或单个症状的表型研究范式转变为 COVID-19 表型学,以解决临床表型即临床表型的互联性。在这里,我们总结了 COVID-19 全临床谱中 CVD 的表现,以及与 COVID-19 相关的 CVD 表型广泛关联研究。我们讨论了 COVID-19 表型中 CVD 的潜在生物学基础以及精准医学的概念,该概念采用新的表型分类学来解决机体对 SARS-CoV-2 感染的整体病理生理反应。我们还简要讨论了传统中医中疾病的独特分类法——仲景模式,及其在 COVID-19 后时代 CVD 精准医学中的潜在意义。

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