Down Tab sis deb ntawm Out: Lub Sij Hawm Ntawm SARS-CoV-2 Kev Tiv Thaiv Tom Qab Asymptomatic Infection

Txij li thaum pib ntawm tus kab mob SARS-CoV-2 muaj thoob qhov txhia chaw, cov lus nug tau nthuav tawm txog tiam neeg thiab kev saib xyuas kev tiv thaiv kev tiv thaiv kab mob thiab nws txoj kev sib raug zoo rau qhov mob hnyav. Cov ntaub ntawv qub los ntawm thawj tus mob hnyav ua pa nyuaj (SARS) thiab Middle East respiratory syndrome (MERS; Sariol thiab Perlman, 2020), nrog rau kev tshuaj xyuas ntxov ntawm kev tiv thaiv kab mob tom qab COVID-19 (Long et al., 2020), tsa kev txhawj xeeb txog qhov ua tau ntev ntawm kev tiv thaiv kev tiv thaiv los ntawm SARS-CoV-2 kab mob. Qhov cuam tshuam rau qhov kev txhawj xeeb no yog qhov sawv cev ntawm cov kab mob asymptomatic nyob rau hauv tag nrho cov caseload, nyob ib ncig ntawm qhov kev kwv yees muaj li 80 feem pua ​​(Ing li al., 2020). Ib zaug ntxiv, cov ntaub ntawv thaum ntxov tau qhia tias qhov loj ntawm kev tiv thaiv kab mob hauv ib tus neeg cuam tshuam nrog qhov hnyav ntawm tus kab mob, ua rau muaj kev txhawj xeeb tias cov kab mob asymptomatic siab yuav ua rau muaj kev cuam tshuam ntxiv rau kev tiv thaiv kab mob (Cervia li al., 2021; Ntev li al. ., 2020).

Mob hnyav ua pa nyuaj (SARS) yog ib yam kab mob ua pa uas tshwm sim muaj feem cuam tshuam nrog kev tiv thaiv kab mob. Tus kab mob SARS kis rau tib neeg lub cev los ntawm kev ua pa, ua rau lub cev tiv thaiv kab mob thiab ua rau muaj kev mob tshwm sim. Lub cev tiv thaiv kab mob ua lub luag haujlwm tseem ceeb hauv kev tiv thaiv tus kab mob SARS.

Tom qab tus kab mob SARS nkag mus rau tib neeg lub cev, nws yuav ua rau lub cev tiv thaiv kab mob, ua rau muaj kev loj hlob thiab sib txawv ntawm ntau lub cev tiv thaiv kab mob. Cov kab mob tiv thaiv kab mob no tuaj yeem tso cov kab mob sib kis, xws li cytokines, thiab lwm yam, ua rau lub cev tiv thaiv kab mob ntau dhau, yog li ua rau mob ntsws thiab cov ntaub so ntswg puas. Yog li ntawd, kev tswj hwm lub zog tiv thaiv kab mob thiab kev ua haujlwm ntawm lub cev ua lub luag haujlwm tseem ceeb hauv qhov pib thiab qhov hnyav ntawm SARS.

Tsis tas li ntawd, cov kev tshawb fawb tau pom tias tus kab mob SARS tuaj yeem cuam tshuam rau lub cev tiv thaiv kab mob, ua rau lub cev tsis muaj zog. Ntau tus cytokines tso tawm thiab cov ntaub so ntswg puas yuav ua rau lub cev tsis muaj zog tiv thaiv kab mob, ua rau lub cev muaj kev tiv thaiv kab mob thiab kab mob. Yog li ntawd, kev tswj hwm kev tiv thaiv zoo yog tus yuam sij rau kev tiv thaiv SARS.

Piv txwv li, kev sib raug zoo ntawm SARS thiab kev tiv thaiv kab mob yog kev sib raug zoo. Txhawm rau tiv thaiv thiab tswj qhov tshwm sim thiab kis ntawm SARS, nws yog ib qho tsim nyog yuav tsum tau ua kom muaj kev tswj hwm kev tiv thaiv kab mob thiab ntxiv dag zog rau lub cev tiv thaiv kab mob. Nws tuaj yeem pom tias peb yuav tsum txhim kho peb txoj kev tiv thaiv. Cistanche tuaj yeem txhim kho kev tiv thaiv zoo. Cistanche yog nplua nuj nyob rau hauv ntau yam antioxidants, xws li vitamin C, carotenoids, thiab lwm yam. Cov khoom xyaw no tuaj yeem tshem tawm cov dawb radicals thiab txo oxidative kev nyuaj siab. Txhim kho qhov tsis kam ntawm lub cev tiv thaiv kab mob.

Nyem cistanche tubulosa cov txiaj ntsig

Qhov Kev Pabcuam Tiv Thaiv Kab Mob Kub Kub Kub Kub Kub Kub ntawm Duke University thiab National University of Singapore (DUKE-NUS) tau koom tes nrog lwm lub koom haum tshawb fawb hauv Singapore kom ua raws li kev tiv thaiv kab mob ntawm cov neeg nyob hauv lub tsev so neeg ua haujlwm tsiv teb tsaws chaw thaum lub hli pib ntawm SARS-CoV{ {2}} tshwm sim. Le Bert et al. (2021) muaj peev xwm txheeb xyuas thiab taug qab cov lus teb tiv thaiv kab mob ntawm cov uas pib tshaj tawm tias yog seropositive nrog rau cov uas tau hloov pauv thaum lub sijhawm kawm, muab kev kwv yees tsim nyog rau lub sijhawm dhau los tom qab kis kab mob.

Vim yog kev tshuaj ntsuam xyuas cov tsos mob tsis tu ncua ntawm lub tsev so (saib hauv qab), lawv muaj peev xwm txaus siab rau qhov kev txhawj xeeb tias cov ntaub ntawv tau txais tsis cuam tshuam los ntawm tus kab mob hnyav. Ib qho ntshav tau txais los ntsuas cov serology yooj yim thiab nruab nrab cov tshuaj tiv thaiv kab mob titers ntawm ntau lub sijhawm. Peripheral ntshav mononuclear hlwb (rau T cell tsom) tau txais los ntawm ib tug me me subset ntawm cov tib neeg los ntawm cov seropositive ntawm recruitment, nrog rau cov seroconverting mid-study.
Cov no tau muab piv nrog cov tshuaj tiv thaiv kab mob thiab T-cell cov lus teb los ntawm cov qauv tau los ntawm cov tsos mob uas tau mus pw hauv tsev kho mob nrog cov tsos mob me thiab mob hnyav. Sib sau ua ke, cov ntaub ntawv tso cai rau cov kws sau ntawv los taug qab kev sib raug zoo ntawm ntau yam T thiab B ntawm tes tsis zoo rau cov tsos mob thiab lub sijhawm los ntawm kev kis kab mob.

Rau cov lus nug ntawm kev ruaj ntseg ntawm kev tiv thaiv-SARS-CoV-2 serology, cov kws sau ntawv pom cov lus teb sib txawv nyob ntawm seb qhov serology tau ntsuas li cas. Raws li nyob rau hauv cov ntaub ntawv dhau los, N-cov tshuaj tiv thaiv tshwj xeeb tau poob qis dhau lub sijhawm, txawm hais tias thawj cov titers feem ntau muaj zog thiab muaj kev sib raug zoo nrog kev soj ntsuam tus neeg sawv cev rau kev txiav txim siab tsis muaj peev xwm. Qhov tseem ceeb, tsis yog tsuas yog ua rau cov titers tsis zoo yuav ua tau zoo dua cov N-cov tshuaj tiv thaiv tshwj xeeb, tab sis lawv kuj tsis poob qis li precipitously; titers ntawm anti-N tau ploj hauv 25 feem pua ​​​​ntawm cov tib neeg pom qhov zoo ntawm kev nrhiav neeg ua haujlwm, thaum tsuas yog 9 feem pua ​​​​ntawm cov seropositive rau neutralizing cov tshuaj tiv thaiv ntawm lub hauv paus pib ua tsis zoo nyob rau tib lub sijhawm.

Txawm hais tias tsis muaj tshuaj tiv thaiv kab mob, cov kws sau ntawv pom muaj T cell zaus tiv thaiv tag nrho cov kab mob sib kis tau txheeb xyuas (N, M, thiab S). Interestingly, qhov loj ntawm T cell reactivity thiab nws hierarchy (M-tshwj xeeb T cell teb dominated) yog zoo sib xws ntawm cov tsos mob thiab asymptomatic cov neeg, ib tug qhia tau hais tias ntau yam ntawm T cell teb tsis yog augmented los yog txwv los ntawm pathology. Hais txog qhov ua tau ntev ntawm cov lus teb, qee cov neeg mob poob cov lus teb rau cov antigens tshwj xeeb tom qab kis kab mob. Raws li lwm tus tau tshaj tawm, muaj pov thawj tias qhov kev poob qis no ntau dua li cov neeg mob asymptomatic, thiab raws li kev ua haujlwm ntawm kev txo qis cov tshuaj tiv thaiv kab mob rau N. Txawm li cas los xij, feem ntau ntawm cov neeg asymptomatic tau khaws cov lus teb tau yooj yim T cell tiv thaiv ntau yam antigens, thiab lawv. T hlwb ua ntau IL-2 thiab IFN- dua li cov neeg mob.

Cov txiaj ntsig pom tseeb ntawm cov ntaub ntawv no yog nkag siab txog qhov cuam tshuam ntawm tus kab mob hnyav ntawm qhov ntau thiab qhov zoo ntawm kev tiv thaiv-SARS-CoV-2-kev tiv thaiv tshwj xeeb tsim tawm. Qhov no tsis yog qhov ua tiav tsis tseem ceeb, feem ntau vim tias kev lees paub qhov kev kis tus kab mob tiag tiag (thiab tsis yog "presymptomatic") yog deb ntawm qhov ncaj. Txoj kev tshawb no los ntawm Le Bert et al. (2021) ua tiav qhov no los ntawm kev tso npe cov neeg ua haujlwm tsiv teb tsaws chaw nyob hauv ib lub tsev so hauv Singapore, tso cai rau lawv tsim lub sijhawm ntawm seroconversion thiab cov tsos mob ntsig txog; Txhua tus neeg tuaj koom tau saib xyuas ob zaug ib hnub rau qhov ntsuas kub thiab pulseOx kev nyeem ntawv thiab ntsuas los ntawm cov ntawv kho mob hauv tsev so.

Tsis tas li ntawd, txhua tus neeg ua haujlwm "tau txais cov nyiaj them poob haujlwm los ntawm tsoomfwv Singapore," cia siab tias yuav zam tsis tau "kev txhawb nqa kev lag luam los qhia txog lub xeev asymptomatic rau kev ntshai ntawm kev lag luam poob." Nrog rau qhov no raws li keeb kwm yav dhau los ntawm txoj kev tshawb no, cov ntaub ntawv txhawb nqa qhov kev txiav txim siab tias cov kab mob asymptomatic tuaj yeem tsim muaj kev tiv thaiv kev tiv thaiv, tshwj xeeb tshaj yog thaum ib tus xav txog kev ua haujlwm ntawm ob qho tib si neutralizing antibody titers nrog rau T-cell zaus thoob plaws txoj kev tshawb no.

Their results also support the general longevity of anti–SARS-CoV-2–specific immunity after infection. Since the beginning of the pandemic, the durability of protective immunity after COVID has been questioned and scrutinized. These concerns were bolstered by early emerging pandemic-related data that antibody responses were declining precipitously after recovery from COVID (Cervia et al., 2021; Long et al., 2020). Though later, a more comprehensive analysis of samples from >30, 000 cov neeg mob tau tshem tawm qhov kev xav thaum ntxov ntawm kev puas tsuaj ntawm kev tiv thaiv kev tiv thaiv (Wajnberg li al., 2020), kev txhawj xeeb tseem nyob, tsis yog rau kev tiv thaiv kab mob tom qab COVID nkaus xwb tab sis kuj tom qab txhaj tshuaj tiv thaiv ib yam nkaus.

Feem ntau cov txiaj ntsig thaum ntxov tau tso siab rau kev tshuaj xyuas ntawm cov tshuaj tiv thaiv kab mob ntshav qab zib, ua rau tsis muaj lub luag haujlwm rau SARS-CoV-2-cov lus teb tshwj xeeb T cell hauv kev tswj hwm tus tswv tsev tiv thaiv. Cov ntaub ntawv ntawm no muab cov ntaub ntawv ntawd nrog rau seb nws cuam tshuam li cas los ntawm tus kab mob hnyav. Cov kws sau ntawv tau pom txo T cell cov lus teb hauv cov neeg asymptomatic tom qab cov ntsiab lus tom qab kis kab mob, tab sis tsis muaj qhov sib txawv thaum ntxov tom qab kis kab mob. Raws li tau hais los ntawm Le Bert et al. (2021), cov ntaub ntawv no "txuas ntxiv txhawb nqa cov pov thawj uas muaj ntau ntawm SARS-CoV-2-Tspecific T cells tsis sib npaug rau cov kab mob hnyav thaum lub sijhawm pib kis mob."

Thib ob, txawm hais tias txo qis hauv cov sijhawm txheeb ze rau lawv cov tsos mob, cov lus teb T-cell hauv cov neeg asymptomatic tsis muaj qhov tsis txaus ntseeg thiab pom tias muaj kev tsim tawm cytokine, raws li tau sau tseg saum toj no. Txawm hais tias lo lus nug ntawm kev tiv thaiv kev tiv thaiv tsis tuaj yeem teb tau meej hauv cov ntaub ntawv no, lawv muaj peev xwm muab qee qhov kev ntseeg siab rau kev tiv thaiv kab mob hauv lub cev, txawm tias nyob rau hauv cov neeg mob tom qab asymptomatic.

Raws li tau sau tseg saum toj no, lub neej ntev ntawm SARSCoV-2– cov lus teb tshwj xeeb cov tshuaj tiv thaiv tau raug tshuaj xyuas zoo, thiab cov txiaj ntsig tau nthuav tawm ntawm no qhia tias cov lus teb rau lo lus nug ntawd nyob ntawm seb tus neeg tab tom nrhiav dab tsi. Kev tiv thaiv feem ntau wanes tom qab kis kab mob raws li txoj cai dav dav, thiab cov lus teb tus mob coronavirus tsis txawv. Cov kws sau ntawv cov ntaub ntawv pom zoo nrog cov neeg ntawm lwm tus hauv qhov antiN IgG poob rau lub sijhawm, txawm tias ntau dua hauv cov neeg asymptomatic (Cervia li al., 2021; Long et al., 2020). Qhov no zoo li qhia txog qee qhov kev sib raug zoo ntawm tus kab mob symptomology / pathology thiab kev ua haujlwm ntev ntawm cov tshuaj tiv thaiv kab mob. Txawm li cas los xij, cov ntawv tshaj tawm dhau los no kuj tau sau tseg qhov sib txawv ntawm tus nqi ntawm cov tshuaj tiv thaiv kab mob rau N lossis cov protein ntau hloov pauv lub sijhawm.

Hauv tsab ntawv ceeb toom tam sim no, Le Bert et al. (2021) tau coj txoj hauv kev los saib xyuas tus kab mob nruab nrab ua tus neeg sawv cev rau cov tshuaj tiv thaiv kab mob tshwj xeeb. Counter rau cov txiaj ntsig rau N-cov tshuaj tiv thaiv kab mob tshwj xeeb, cov tshuaj tiv thaiv kab mob tseem nyob ruaj khov nyob rau lub sijhawm tsis hais txog kev kis kab mob. Qhov no tsis yog tsuas yog xov xwm zoo rau lub zeem muag ntawm kev tiv thaiv kev tiv thaiv ruaj khov, tab sis nws kuj tseem ua tau raws li qhov kev xav tias yuav muaj kev sib raug zoo tsis tu ncua hauv kev teb rau cov tshuaj tiv thaiv residual tom qab kis kab mob, ua rau kev txhim kho cov tshuaj tiv thaiv zoo nyob rau lub sijhawm. Kev poob qis dua hauv N-cov lus teb tshwj xeeb rau cov neeg asymptomatic ces yuav qhia tau tias qhov mob hnyav ntawm tus kab mob ua rau muaj ntau ntxiv rau cov khoom seem ntawm nucleocapsid antigen ntau dua li qhov loj.

Thaum kawg, cov ntaub ntawv nthuav tawm ntawm no txhais tau hais tias tej zaum kev kwv yees ntawm qhov zaus ntawm cov kab mob asymptomatic nyob ntawm seb koj nyob qhov twg ntawm lub ntiaj teb. Le Bert et al. (2021) hais tias tawm ntawm tag nrho lawv cov neeg seropositive, 93 feem pua ​​​​tau tshaj tawm tias asymptomatic. Txhua yam uas feem ntau yuav tshwm sim nrog cov tsos mob tshwm sim (hnub nyoog qis dua 65 xyoos, muaj ntshav siab lossis ntshav qab zib) tau tsiv mus rau lwm qhov chaw, qhov tseeb uas yuav luag cuam tshuam rau lawv cov kab mob asymptomatic siab rau qee qhov. Txawm hais tias cov neeg no tau suav nrog, txawm li cas los xij, nws zoo li tsis zoo li nws yuav ua rau muaj tus asymptomatic ntau dua nrog qhov kev pom zoo tam sim no, qhov chaw nyob ib puag ncig 20 feem pua ​​(Rasmussen thiab Popescu, 2021).

Txhua yam kev kawm hauv qhov kev tshawb fawb no yog cov txiv neej los ntawm Is Nrias teb lossis Bangladesh, ob qho chaw nyob rau hauv qhov chaw uas COVID-txog cov neeg tuag, thaum txaus ntshai, tsis tau siab npaum li hauv Teb Chaws Asmeskas, tshwj xeeb tshaj yog thaum kho cov pej xeem loj thiab ntom. Cov kev soj ntsuam zoo sib xws tsis ntev los no tau ua rau subSaharan thiab sab hnub poob Africa (Lawal, 2021), uas tau pom tsawg dua ib tus neeg tuag li piv nrog Europe thiab Asmeskas.

Qhov no tau ua rau muaj kev cia siab tias kev tiv thaiv kev tiv thaiv kab mob sib kis tau nce siab tuaj yeem muaj nyob hauv ntau qhov chaw hauv ntiaj teb. Yog tias muaj tseeb, qhov no tej zaum yuav xav tias yuav tsim kom muaj ntau dua ntawm cov kab mob asymptomatic los ntawm cov cheeb tsam no. Txawm hais tias tseem tsis tau txiav txim siab, qhov muaj cov qauv ua ntej-COVID-19 cov qauv los ntawm ntau qhov chaw hauv ntiaj teb yuav ua rau qhov kev xav no ua tau zoo heev thiab tuaj yeem kawm tau.

Sib sau ua ke, cov ntaub ntawv no tsa peb cov kev cia siab rau qhov zoo thiab ruaj khov ntawm kev tiv thaiv kab mob tom qab asymptomatic. Txoj kev tshawb no tau ua tiav thaum ntxov ntawm kev sib kis, yog li tsis muaj cov ntaub ntawv hais txog, lossis qhov kev cia siab tiag tiag ntawm, cov tshuaj tiv thaiv kab mob sib kis tiv thaiv cov kab mob tshiab. Txawm li cas los xij, raws li cov kab mob sib txawv tshiab muaj kev hloov pauv tsawg dua sab nraud ntawm cov kab mob sib kis, qhov kev pheej hmoo ntawm T hlwb tshwj xeeb rau ntau yam SARS-CoV-2 antigens hauv ob qho tib si cov tsos mob thiab asymptomatic cov neeg tuaj yeem txhawb qhov kev cia siab tsawg kawg ntawm qee qhov T. cell crossreactivity, thiab yog li ntawd cross-tiv thaiv. Raws li peb tsiv mus rau lwm qhov, thiab cia siab tias kawg, theem ntawm kev sib kis tam sim no, sib piv qhov ua haujlwm ntawm ob qho tib si humoral thiab cellular tiv thaiv kab mob rau SARS-CoV-2 tom qab kis kab mob, txhaj tshuaj tiv thaiv, lossis ob qho tib si yuav muab kev nkag siab tseem ceeb rau kev tswj hwm kev tshwm sim yav tom ntej. kab mob.

Cov ntaub ntawv

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