COVID-19肺炎における免疫血栓不調は,呼吸器不全と凝固病に関連している
Leo Nicolai1,2, Alexander Leunig1,2, Sophia Brambs1
1Medizinische Klinik und Poliklinik I (L.N., A.L., S.B., R.K., T.W., C.S., S.K., S.M., K.P., K.S.), University Hospital Ludwig-Maximilian University Munich, Germany.
Circulation
|August 7, 2020
まとめ
ニュートロフィルの細胞外トラップ,血小板,およびフィブリンを含む免疫血栓症は,重度のCOVID-19肺炎で臓器損傷および前血栓状態を引き起こす. この免疫血栓不調は,疾患の重度と急性呼吸器障害症候群と相関しています.
科学分野:
- * 免疫学
- * 病理学
- * 血液学
背景:
- *重症急性呼吸器症候群コロナウイルス2型 (SARS-CoV-2型) は,コロナウイルス病2019型 (COVID-19) を引き起こし,肺炎,呼吸器不全,腎臓および心臓の合併症を引き起こす可能性があります.
- * 組織性血栓状態は,COVID-19患者で頻繁に観察されるが,その背後にあるメカニズムは不明である.
研究 の 目的:
- * COVID-19における臓器の関与,プロトロンボティックな特徴,免疫トロンボシスの関連性を調査する.
- * COVID-19の重症度に関連して中性粒子の活性化パターンと血小板活性化パターンを特徴付ける.
主な方法:
- *COVID-19患者の解剖組織の組織病理学的評価.
- * ニュートロフィールと血小板の表面マーカーベースのフェノタイプ化
- * 血小板と中性粒子の機能の機能検査と凝固検査
主要な成果:
- * 中性粒子の細胞外トラップ (NETs),血小板,およびフィブリンを含む炎症性小血管血栓は,COVID-19患者の肺,腎臓,および心臓で発見されました.
- *COVID-19患者は,中性粒子と血小板の集積と,疾患の重さに応じて異なる中性粒子と血小板の活性化パターンを示した.
- * 重症のCOVID-19患者は,対照群と比較して血小板と中性粒子の活性化が過度であったが,中間症例では血小板が枯渇し,中性粒子の活性化が過度であった.
結論:
- * 免疫栓塞性失調は,COVID-19における臓器の関与と前血栓性状態を結びつける重要なメカニズムである.
- * 免疫血栓不調の程度は,COVID-19 疾患の重症性のマーカーとして機能する.
- * COVID-19の病原性における免疫血栓の役割を完全に解明するには,さらなる研究が必要である.
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