瘤坏死因子-α抑制剂降低COVID-19中的死亡率:系统性审查和元分析
Ágoston Jánosi1,2, Blanka Bódy1,2, Rita Nagy1,2
1Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Critical care (London, England)
|June 6, 2025
概括
瘤坏死因子-α (TNF-α) 抑制剂通过降低死亡风险,在治疗严重的COVID-19方面表现有前途. 虽然它们没有影响通风需求,但它们显著降低了C-反应蛋白水平,这表明它们具有潜在的治疗作用.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 严重的COVID-19与细胞因子风暴有关,其中瘤坏死因子-α (TNF-α) 起着关键作用.
- 尽管接种疫苗,但对严重的SARS-CoV-2感染的有效治疗非常重要.
- 目前正在研究TNF-α抑制剂在治疗COVID-19并发症方面的潜力.
研究的目的:
- 系统地审查和分析TNF-α抑制剂在治疗COVID-19患者中的有效性,疗效和安全性.
- 为了比较用TNF-α抑制剂治疗的COVID-19患者与标准护理的结果.
- 为了评估TNF-α抑制剂对死亡率的影响,需要机械通风,以及炎症标志物.
主要方法:
- 对PubMed,Embase和CENTRAL数据库进行了系统的文献审查.
- 包括到2024年8月12日发表的研究,涉及使用TNF-α抑制剂治疗的COVID-19患者.
- 包括死亡率,侵入性机械通风和C-反应蛋白 (CRP) 水平在内的结果使用几率比率和平均差异进行了评估,并对RCT和非随机研究进行了子组分析.
主要成果:
- 与1393名患者进行的7项研究表明,使用TNF-α抑制剂与降低死亡风险有关 (OR 0.67,P=0.052),在RCT中尤其显著 (OR 0.75,P=0.042).
- 为了获得死亡益处,需要治疗的患者人数为16人.
- 在需要侵入性机械通风方面没有发现显著差异 (OR 0.95,P=0.822),但观察到CRP水平显著降低 (MD -21.9 mg/L,P=0.024).
结论:
- 抑制TNF-α显示出管理严重COVID-19的潜力,由降低死亡率和CRP水平证明.
- 需要进一步进行高质量的研究,以确定TNF-α抑制剂在COVID-19治疗中的确证据.
- 这些发现表明,在严重的SARS-CoV-2感染中,细胞因子风暴调节可能是治疗的途径.
更多相关视频
10:03Author Spotlight: Understanding Cytokine-Induced Cell Death in Intestinal Epithelial Cells Using Human Organoids
Published on: August 2, 2024
1.3K
08:19Transfer of Manipulated Tumor-associated Neutrophils into Tumor-Bearing Mice to Study their Angiogenic Potential In Vivo
Published on: July 20, 2019
5.9K
相关概念视频
Tumor Immunotherapy
491
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
491
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
119
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
119
Cancer Therapies
7.6K
Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
7.6K
Cancer Survival Analysis
331
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
331
