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冠状病毒肺炎细胞因子风暴及免疫调控治疗
汪婷1,蒋政宇2,万小健1,3*,卞金俊1*
0
(1. 海军军医大学(第二军医大学)长海医院麻醉科, 上海 200433;
2. 海军军医大学(第二军医大学)海军特色医学中心麻醉科, 上海 200052;
3. 湖北省武汉市火神山医院感染二科, 武汉 430100
*通信作者)
摘要:
细胞因子风暴是一种失控的过度免疫应答,是冠状病毒肺炎的重要发病机制。病毒劫持机体的免疫系统,导致免疫调节的负反馈丧失、多种细胞因子异常升高,损害了肺泡弥散功能并造成多器官功能障碍。靶向冠状病毒细胞因子风暴的特异性治疗研究,如粒细胞集落刺激因子、托珠单抗、卡莫他特、血液净化治疗等已取得系列成果,其可能是缓解新型冠状病毒肺炎(COVID-19)疫情的有效手段。但COVID-19具有独特的病理特征,上述治疗的研究成果仍需进一步临床试验来验证。本文就冠状病毒肺炎细胞因子风暴及免疫调控治疗进展进行综述。
关键词:  冠状病毒感染  肺炎  细胞因子风暴  粒细胞集落刺激因子  托珠单抗  卡莫他特
DOI:10.16781/j.0258-879x.2020.08.0818
投稿时间:2020-03-03修订日期:2020-06-21
基金项目:国家自然科学基金(81671939,81871579).
Cytokine storm and immunoregulatory therapy of coronavirus pneumonia
WANG Ting1,JIANG Zheng-yu2,WAN Xiao-jian1,3*,BIAN Jin-jun1*
(1. Department of Anesthesiology, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Anesthesiology, Naval Special Medical Center, Naval Medical University(Second Military Medical University), Shanghai 200052, China;
3. Department of Infectious Diseases(Ⅱ), Huoshenshan Hospital, Wuhan 430100, Hubei, China
*Corresponding authors)
Abstract:
Cytokine storm, a runaway overwhelming immune response, plays an important part in the pathogenesis of coronavirus. The virus hijacks the immune system, resulting in a loss of negative feedback on the immune regulation and an overproduction of inflammatory cytokines, which subsequently impairs the pulmonary diffusion function and leads to multi-organ dysfunction. A series of progresses have been achieved in studies targeting the coronavirus cytokine storm, such as granulocyte colony-stimulating factor, tocilizumab, camostat mesylate, and blood purification treatment, which may provide effective ways to alleviate the coronavirus disease 2019 (COVID-19) epidemic. Nevertheless, further clinical verifications of the above research findings are requested due to the unique pathology of COVID-19. This paper reviews the advances in cytokine storm and immunoregulatory therapy of coronavirus pneumonia.
Key words:  coronavirus infections  pneumonia  cytokine storm  granulocyte colony-stimulating factor  tocilizumab  camostat mesylate