在COVID-19二次细菌性肺炎中微生物动力学和肺免疫反应
Natasha Spottiswoode1, Alexandra Tsitsiklis1, Victoria T Chu2,3
1Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, CA, USA.
在COVID-19患者中,二次细菌性肺炎与较高的死亡率和皮质类固醇使用有关. 肺部细菌增加在诊断之前,这表明免疫抑制允许病原体生长.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 二次性细菌性肺炎 (2°BP) 在病毒感染后显著增加患病率,但人们对其了解甚少.
- COVID-19患者有2°BP的风险,影响临床结果.
研究的目的:
- 为了调查呼吸道微生物组和肺转录组变化在危急病的COVID-19患者和没有2°BP.
- 确定与2°BP发展相关的因素及其对宿主免疫力的影响.
主要方法:
- 对112位被直管的COVID-19患者进行前性队列研究.
- 纵向气道微生物组 (细菌RNA质量) 和肺转录组的比较分析.
- 微生物发现与临床数据的相关性,包括死亡率和皮质类固醇治疗.
主要成果:
- 2°BP与增加的死亡率和皮质类固醇治疗显著相关.
- 2°BP的肺微生物组在临床诊断前几天显示出更高的细菌RNA质量和病原体优势.
- 在2°BP患者中观察到抑制的TNFα信号,可能由皮质类固醇介导.
- 增加的细菌RNA质量与降低的先天性和适应性免疫基因表达相关.
结论:
- 与COVID-19相关的2°BP涉及不同的微生物和免疫特征.
- 皮质类固醇治疗可能会抑制免疫信号,促进机会性细菌病原体的扩张.
- 结果提供了对2°BP病原和潜在治疗点的见解.
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