狼性炎在COVID-19大流行期间:挑战和影响之前,期间和之后
Michał Komorniczak1, Piotr Stępniewski2, Barbara Bułło-Piontecka1
1Clinic and Department of Nephrology, Transplantology and Internal Diseases, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland.
Biomedicines
|December 30, 2025
概括
系统性红斑狼 (SLE) 患有狼性炎 (LN) 的患者在COVID-19大流行期间面临不同的结局. 接受移植的患者 (LN-RTX) 保持了稳定的功能,与保守管理的患者 (LN-CT) 不同.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 系统性红斑狼 (SLE) 和狼性炎 (LN) 增加了COVID-19的严重性风险,原因是免疫问题和治疗.
- 患有先前LN (LN-RTX) 的脏移植接受者面临持续的免疫抑制和自身免疫风险.
- 随着COVID-19大流行,SLE和LN患者的管理面临着独特的挑战.
研究的目的:
- 在COVID-19大流行期间,在LN患者中比较功能和疾病活性.
- 评估接受移植 (LN-RTX) 和保守管理 (LN-CT) 的LN患者之间的差异.
- 评估COVID-19疫苗接种对LN患者结局的影响.
主要方法:
- 从2019年到2023年对111名活检证明的LN患者进行了回顾性分析.
- 四个评估点:流行前,流行第一年,流行第二年和流行后.
- 在LN-CT和LN-RTX组之间对功能 (eGFR),疾病活性标志物和治疗方法进行比较,包括疫苗接种情况.
主要成果:
- 在LN-CT患者中,功能显著下降 (eGFR从76.5降至66.5毫升/分钟/1.73米2).
- 尽管并发症率较高,但LN-RTX患者保持了稳定的功能.
- 随着时间的推移,LN活性标志物和免疫抑制药物 (糖皮质类药物/MMF) 的使用量下降;接种疫苗的患者显示出显著的EGFR下降,尽管因果关系尚不清楚.
结论:
- 在大流行期间,LN患者的结局因治疗方式而异.
- LN-RTX患者表现出稳定的功能,可能是由于调整了免疫抑制和监测.
- 需要进一步的研究,以了解在LN群体中与疫苗相关的效应.
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