摘要
2019年12月,中国武汉出现了一种新发现的病毒,被命名为严重急性呼吸综合征冠状病毒2 (SARS-CoV-2),并导致了冠状病毒病2019 (COVID-19)。SARS-CoV-2与前两次冠状病毒大流行MERS(中东呼吸综合征)和SARSCoV在系统发育起源、结构组成和临床症状等方面存在相似性,导致了共同的致病机制。本文通过比较白细胞介素-6 (IL-6)在SARS-CoV和MERS病例中的作用,探讨其在COVID-19发病机制、预后和治疗中的作用。IL-6水平的升高是细胞因子风暴的刺激和SARS、中东呼吸综合征和COVID-19病例进展的关键。特别是在COVID-19患者中,冠状病毒刺突蛋白S与肺泡上皮细胞结合导致NF-kΒ过度激活,上调IL-6并促进其体循环,导致肺泡损伤和肺外损伤。此外,IL-6可用于评估呼吸衰竭和识别无症状患者。Tocilizumab (TCZ)是一种阻断IL-6信号通路的单克隆抗体,包含对COVID-19的治疗选项。TCZ可以改善氧合,降低发烧,降低IL-6水平。IL-6在细胞因子风暴的发病机制和COVID-19的进展中发挥重要作用,可能作为抗COVID-19的治疗靶点。但IL-6在COVID-19病例中的关系尚需进一步研究,TCZ作为治疗方案还需要更多的临床试验。
关键词: COVID-19,白细胞介素6,托西利珠单抗,SARS-CoV-2,大流行,冠状病毒
Current Medicinal Chemistry
Title:The Role of Interleukin-6 in the Pathogenesis, Prognosis and Treatment of Severe COVID-19
Volume: 28 Issue: 26
关键词: COVID-19,白细胞介素6,托西利珠单抗,SARS-CoV-2,大流行,冠状病毒
摘要: A newly identified virus appeared in Wuhan, China, in December 2019, was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and caused the coronavirus disease 2019 (COVID-19). SARS-CoV-2 presents similarities with two previous coronavirus pandemics, MERS (Middle East Respiratory Syndrome) and SARSCoV, concerning phylogenetic origin, structural composition, and clinical symptoms, thus, leading to common pathogenic mechanisms. The purpose of this review is to declare the role of interleukin-6 (IL-6) in the pathogenesis, prognosis, and treatment of COVID-19 by comparing its effect on SARS-CoV and MERS cases. Increased levels of IL-6 comprise the key for the stimulation of cytokine storm and the progression of SARS, MERS, and COVID-19 cases. Especially, in COVID-19 patients, the overactivation of NF-kΒ, which is caused by the binding of coronavirus spike protein S to alveolar epithelial cells, up-regulates IL-6 and promotes its systematic circulation, causing alveolar damage and extrapulmonary injury. Additionally, IL-6 can be used to evaluate respiratory failure and identify asymptomatic patients. Tocilizumab (TCZ), a monoclonal antibody which blocks IL-6 signaling, comprises a remedial option against COVID-19. TCZ improves oxygenation, reduces fever, and decreases levels of IL-6. IL-6 plays a major role in the pathogenesis of cytokine storm and the progression of COVID-19 and may be used as a therapeutic target against COVID-19. However, further research is needed concerning the relation of IL-6 in COVID-19 cases, and more clinical trials are required to declare TCZ as a treatment option.
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The Role of Interleukin-6 in the Pathogenesis, Prognosis and Treatment of Severe COVID-19, Current Medicinal Chemistry 2021; 28 (26) . https://dx.doi.org/10.2174/0929867328666201209100259
DOI https://dx.doi.org/10.2174/0929867328666201209100259 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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