在危急的COVID-19中增加上腺类固醇生成和抑制皮质类固醇反应能力
Tian-Zi Wen1, Tian-Ran Li1, Xin-Yu Chen1
1Institute of Pathology, Southwest Hospital, Third Military Medical University (Army Medical University), and Key Laboratory of Tumor Immunopathology, Ministry of Education of China, Chongqing, China.
Metabolism: clinical and experimental
|July 25, 2024
概括
危急的COVID-19增强了上腺类固醇生成,增加了炎症和细胞分化,但降低了皮质类固醇受体的响应能力. 这表明在严重病例中,标准皮质类固醇治疗的有效性下降.
科学领域:
- 内分泌学 在内分泌学.
- 病毒学 病毒学
- 病理学 病理学 病理学
背景情况:
- 2019年冠状病毒病 (COVID-19) 对严重病患者上腺内分泌功能的影响尚不清楚.
- 在严重的COVID-19中,上腺类固醇活性变化及其机制需要调查.
研究的目的:
- 为了调查上腺类固醇活性在临界COVID-19中的变化.
- 阐明潜在的机制和组织病理学证据.
- 检查这些上腺变化的临床影响.
主要方法:
- 从致命的COVID-19患者和对照对上腺皮的比较分析.
- 鉴定SARS-CoV-2,病理检查,并通过组织学,免疫组织化学和蛋白质学评估皮质类固醇生物合成.
- 量化测量矿物质皮质醇和葡萄糖皮质醇受体活性和基因表达.
主要成果:
- 在COVID-19上腺体中,球和囊区域的皮质类固醇生物合成增强,与炎症和分化相关.
- 在COVID-19患者中观察到双区域球菌/状细胞身份细胞的增加.
- 尽管增强了类固醇生成,但激活的矿物质皮质醇和葡萄皮质醇受体和响应基因显著减少.
结论:
- 临界COVID-19的特征是上腺类固醇生成的增加,炎症和细胞特征的改变,加上抑制的皮质类固醇反应.
- 这些发现表明,传统的皮质类固醇治疗的疗效可能有所降低.
- 对上腺轴和皮质类固醇敏感性的评估对于管理危急的COVID-19至关重要.
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