探索SEPSIS后和COVID-19后综合征:从病理生理学到治疗方法的交叉
Darcy Holmes1, Marta Colaneri2, Emanuele Palomba2
1Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Frontiers in medicine
|January 22, 2024
概括
败血症幸存者,包括COVID-19患者,可能会患上败血症后综合征 (PSS) 或PASC,导致多器官功能障碍. 向氨酸-血管素系统 (RAS) 为这些复杂的疾病提供了潜在的治疗途径.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 败血症,包括COVID-19,可以导致后败血症综合征 (PSS) 和COVID-19 (PASC) 的后急性后续.
- 这些情况具有相似之处,呈现出持续的多器官功能障碍 (呼吸道,心血管,脏,神经系统) 和失调的免疫反应 (免疫抑制,高炎症).
- 缺乏明确的定义和诊断标准阻碍了有效的治疗策略,强调了需要统一的治疗方法.
研究的目的:
- 探索PSS和PASC之间共同的临床和病理生理学相似之处.
- 确定潜在的治疗点,重点关注氨酸 - 血管新生素系统 (RAS).
- 强调需要采用多方面的方法,并进一步研究有效的治疗策略.
主要方法:
- 审查关于败血症,PSS,PASC和氨酸-血管新生系统的现有文献.
- 分析共享的免疫机制和病理生理路径.
- 识别针对RAS的潜在干预措施,如ACE抑制剂,ACE受体抑制剂和复合人类ACE2 (rhACE2).
主要成果:
- PSS和PASC表现出显著的临床和病理生理重叠,其特点是多器官功能障碍和免疫失调.
- 氨酸-血管素系统 (RAS) 在免疫调节中起着至关重要的作用,其不平衡可能会使这些情况恶化.
- 鉴定出ACE抑制剂,ACE受体抑制剂和rhACE2作为潜在的RAS向干预措施.
结论:
- 对于PSS和PASC,需要一个统一的治疗策略,解决共享的免疫机制和RAS参与.
- 进一步的研究,定义的标准化,增加资金和临床试验对于推进治疗至关重要.
- 准RAS是一个有前途的途径,用于管理败血症和COVID-19的复杂后果.
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