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五聚体 C 反应蛋白是一种更好的预后生物标志物,在 COVID-19 住院患者中的半衰期长于单体 C 反应蛋白。

Pentameric C-reactive protein is a better prognostic biomarker and remains elevated for longer than monomeric CRP in hospitalized patients with COVID-19.

机构信息

Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Department of Pathology & Laboratory Medicine, University of Louisville, Louisville, KY, United States.

出版信息

Front Immunol. 2023 Sep 1;14:1259005. doi: 10.3389/fimmu.2023.1259005. eCollection 2023.

Abstract

The differing roles of the pentameric (p) and monomeric (m) C-reactive protein (CRP) isoforms in viral diseases are not fully understood, which was apparent during the COVID-19 pandemic regarding the clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Herein, we investigated the predictive value of the pCRP and mCRP isoforms for COVID-19 severity in hospitalized patients and evaluated how the levels of the protein isoforms changed over time during and after acute illness. This study utilized samples from a well-characterized cohort of Swedish patients with SARS-CoV-2 infection, the majority of whom had known risk factors for severe COVID-19 and required hospitalization. The levels of pCRP were significantly raised in patients with severe COVID-19 and in contrast to mCRP the levels were significantly associated with disease severity. Additionally, the pCRP levels remained elevated for at least six weeks post inclusion, which was longer compared to the two weeks for mCRP. Our data indicates a low level of inflammation lasting for at least six weeks following COVID-19, which might indicate that the disease has an adverse effect on the immune system even after the viral infection is resolved. It is also clear that the current standard method of testing pCRP levels upon hospitalization is a useful marker for predicting disease severity and mCRP testing would not add any clinical relevance for patients with COVID-19.

摘要

五聚体(p)和单体(m)C 反应蛋白(CRP)同工型在病毒病中的不同作用尚未完全阐明,这在 COVID-19 大流行期间关于严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染的临床过程中表现得很明显。在此,我们研究了 pCRP 和 mCRP 同工型对住院患者 COVID-19 严重程度的预测价值,并评估了蛋白同工型在急性疾病期间和之后随时间的变化。本研究利用了来自瑞典 SARS-CoV-2 感染患者的特征明确队列的样本,其中大多数患者具有严重 COVID-19 的已知危险因素,需要住院治疗。严重 COVID-19 患者的 pCRP 水平显著升高,与 mCRP 不同,其水平与疾病严重程度显著相关。此外,pCRP 水平在纳入后至少 6 周内仍保持升高,这比 mCRP 的 2 周时间要长。我们的数据表明,COVID-19 后至少持续 6 周的炎症水平较低,这可能表明即使病毒感染得到解决,疾病对免疫系统仍有不利影响。显然,目前在住院时检测 pCRP 水平的标准方法是预测疾病严重程度的有用标志物,而 mCRP 检测对 COVID-19 患者没有任何临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be91/10505432/8802b7817c65/fimmu-14-1259005-g001.jpg

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