对于COVID-19的血管风险因素是ARDS:内皮,接触因系统
Melanie Bailey1, Dermot Linden1,2, Hong Guo-Parke2
1Mater Infirmorum Hospital, Belfast Health and Social Care Trust, Belfast, United Kingdom.
Frontiers in medicine
|July 14, 2023
概括
SARS-CoV-2 感染触发了接触素通路,导致肺部凝血和炎症. 监测血小板,淋巴细胞和激活的部分血栓形成时间 (APTT) 可以帮助预测严重的COVID-19急性呼吸困扰综合征 (ARDS).
科学领域:
- 病理学 病理学 病理学
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
背景情况:
- SARS-CoV-2针对肺部的ACE2受体,这种情况由与高血压,糖尿病和肥胖相关的内皮病理加剧.
- 病毒感染促进了XII因子的激活,启动了接触素路径,内在凝固级联和血卡利克林-素系统.
- 这种复杂的相互作用导致血栓形成和炎症性肺病,这是COVID-19急性呼吸窘迫综合征 (ARDS) 的特征.
研究的目的:
- 审查有关接触宁通路在COVID-19病变发生过程中的作用的文献.
- 探索住院患者血液标志物的时间趋势.
- 突出特定生物标志物对预测ARDS发展的重要性.
主要方法:
- 文献综述侧重于COVID-19中的接触-亲线路.
- 从住院患者的血液结果中分析时间趋势.
- 检查凝血,炎症和ARDS之间的关系.
主要成果:
- 长时间活化部分血栓形成时间 (APTT) 和第一周血小板数下降表明凝血因子消耗.
- 淋巴衰竭在第一周左右出现,与淋巴细胞性肺炎和COVID-19 ARDS相关.
- 布拉迪基宁是接触基宁通路的产物,有助于胀,磨砂玻璃不透明度和IL-6释放,驱动炎症和淋巴细胞招募.
结论:
- 血栓形成和淋巴细胞性肺炎是COVID-19 ARDS的关键特征.
- 血小板,淋巴细胞和APTT的测量对于严重感染的风险分层至关重要.
- 了解接触因通路对于管理COVID-19并发症至关重要.
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