在COVID-19肺炎中的免疫血栓失调与呼吸衰竭和凝血病有关
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
概括
免疫血栓,涉及中性粒细胞外陷,血小板和纤维素,导致严重的COVID-19肺炎的器官损伤和前血栓性状态. 这种免疫血栓失调与疾病严重程度和急性呼吸困难综合征相关.
科学领域:
- * 免疫学
- * 病理问题
- * 血液学
背景情况:
- * 严重急性呼吸综合征冠状病毒2 (SARS-CoV-2) 导致冠状病毒疾病2019 (COVID-19),导致肺炎,呼吸衰竭以及潜在的和心脏并发症.
- * 经常在COVID-19患者中观察到全身血栓状况,但潜在的机制尚不清楚.
研究的目的:
- * 调查COVID-19中器官参与,前血栓性特征和免疫血栓症之间的联系.
- * 根据COVID-19的严重程度来描述中性粒细胞和血小板激活模式.
主要方法:
- *对COVID-19患者的尸检组织进行细胞病理学评估.
- * 基于表面标记的中性粒细胞和血小板的表型.
- * 功能测定血小板和中性粒细胞功能,以及凝血测试.
主要成果:
- 在COVID-19患者的肺部,脏和心脏中发现了含有中性粒细胞外陷 (NETs),血小板和纤维素的炎症性微血管血栓.
- * COVID-19 患者表现出中性粒细胞-血小板聚合物和中性粒细胞和血小板的独特激活模式,这些模式因疾病的严重程度而有所不同.
- * 与对照组相比,严重的COVID-19患者的血小板和中性粒细胞活化过高,而中等病例的血小板和中性粒细胞活化过低.
结论:
- 免疫血栓失调是COVID-19中器官参与和前血栓状态之间的关键机制.
- * 免疫血栓失调的程度可以作为COVID-19疾病严重程度的标志.
- * 需要进一步研究,以充分阐明免疫血栓在COVID-19病变发生过程中的作用.
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