Kev Tiv Thaiv Tom Qab COVID-19 Kev txhaj tshuaj tiv thaiv kab mob hauv cov neeg mob Psoriasis
May 17, 2023
Txij li thaum Lub Ib Hlis 2020 Elsevier tau tsim lub chaw pabcuam COVID-19 nrog cov ntaub ntawv pub dawb ua lus Askiv thiab lus Mandarin ntawm tus kabmob tshiab tshiab COVID-19. Lub chaw muab kev pab cuam COVID-19 yog nyob rau ntawm Elsevier Connect, lub tuam txhab xov xwm pej xeem thiab xov xwm lub vev xaib.
Elsevier qhov no tso cai rau ua tag nrho nws cov COVID-19- kev tshawb fawb ntsig txog uas muaj nyob rau ntawm COVID-19 chaw muab kev pab - suav nrog cov ntsiab lus tshawb fawb no - tam sim ntawd muaj nyob hauv PubMed Central thiab lwm qhov chaw khaws nyiaj txiag pej xeem, xws li WHO COVID cov ntaub ntawv nrog cov cai rau kev tshawb fawb tsis txwv rov siv dua thiab tshuaj xyuas hauv ib daim ntawv lossis los ntawm ib qho twg nrog kev lees paub ntawm qhov chaw. Cov kev tso cai no tau tso cai pub dawb los ntawm Elsevier ntev npaum li COVID-19 chaw muab kev pabcuam tseem ua haujlwm.
Kev txhaj tshuaj tiv thaiv kab mob COVID-19 yog qhov tseem ceeb tshaj plaws los txo cov neeg mob thiab kev tuag ntawm SARS-CoV-2 kev kis tus kab mob, tab sis kev kho tshuaj tiv thaiv kab mob tau muab rau cov neeg mob uas muaj kab mob tiv thaiv kab mob tiv thaiv kab mob tuaj yeem txo qhov ua tau zoo ntawm COVID-19 tshuaj tiv thaiv hauv cov neeg mob no. Cov kev tshawb fawb uas ntsuas ob qho tib si humoral thiab cellular tiv thaiv cov lus teb rau kev txhaj tshuaj tiv thaiv yog qhov tseem ceeb kom nkag siab tag nrho cov txiaj ntsig ntawm cov tshuaj tiv thaiv kab mob ntawm COVID-19 tshuaj tiv thaiv kab mob.
Immunosuppressants yog ib chav kawm ntawm cov tshuaj uas ua haujlwm txhawm rau tiv thaiv lub cev tiv thaiv kab mob los tiv thaiv kev tsis lees paub tom qab hloov khoom nruab nrog lossis kho cov kab mob autoimmune. Txawm li cas los xij, kev siv cov tshuaj tiv thaiv kab mob ntev ntev tuaj yeem cuam tshuam rau lub cev tiv thaiv kab mob, ua rau muaj kev cuam tshuam ntau dua rau cov kab mob thiab kab mob. Immunosuppressants inhibit kev ua haujlwm ntawm lub cev tiv thaiv kab mob, yog li ua rau lub cev tsis muaj zog.
Yog li ntawd, cov neeg mob uas siv cov tshuaj tiv thaiv kab mob yuav tsum tau mus kuaj mob tsis tu ncua kom ntseeg tau tias lub cev tiv thaiv kab mob thiab kev noj qab haus huv. Nyob rau tib lub sijhawm, kev tswj hwm txoj kev noj qab haus huv, suav nrog kev noj zaub mov kom zoo, pw tsaug zog txaus, ua haujlwm nruab nrab, thiab zam kev tsis zoo ntawm lub cev tiv thaiv kab mob xws li haus luam yeeb thiab cawv, tuaj yeem pab txhim kho kev tiv thaiv kab mob. Los ntawm qhov kev xav no, peb feem ntau yuav tsum tau saib xyuas kev txhim kho ntawm kev tiv thaiv kab mob. Cistanche muaj txiaj ntsig zoo rau kev txhim kho kev tiv thaiv. Nqaij tshauv muaj ntau yam khoom siv lom neeg, xws li polysaccharides, ob lub nceb, Huangli, thiab lwm yam. Cov khoom xyaw no tuaj yeem siv rau cov nqaij. Txhawb ntau lub hlwb ntawm lub cev tiv thaiv kab mob thiab ua kom lawv lub cev tiv thaiv kab mob.
Nyem cistanche tubulosa cov txiaj ntsig
Hauv Lancet Rheumatology, Satveer Mahil thiab cov npoj yaig1 tau soj ntsuam kev txhim kho kev lom zem thiab kev tiv thaiv ntawm tes tiv thaiv kab mob SARS-CoV-2 spike glycoprotein hauv 67 tus neeg mob psoriasis thiab 15 kev noj qab haus huv tswj tom qab koob thib ob ntawm COVID-19 tshuaj tiv thaiv BNT162b2 (PfizerBioNTech). Txhua tus neeg mob tau tswj hwm psoriasis zoo thiab tau txais kev kho mob monotherapy nrog methotrexate (n=14), qog necrosis factor (TNF) inhibitors (n=19), interleukin (IL)-17 inhibitors (n =14), lossis IL-23 inhibitors (n{14}}); tsis muaj cov neeg mob ncua lawv cov tshuaj thaum lub sijhawm txhaj tshuaj.
Ib qho tseem ceeb ntawm txoj kev tshawb fawb yog tias cov neeg koom tau txais koob tshuaj BNT162b2 thib ob raws li qhov ncua sij hawm ntev txog 12 lub lis piam ntawm koob tshuaj, piv nrog cov qauv 3-4 lub lis piam. Tom qab koob thib ob, cov neeg mob thiab kev tswj hwm muaj cov tshuaj tiv thaiv zoo sib xws ntawm cov tshuaj tiv thaiv kab mob rau cov tsiaj qus SARS-CoV-2 thiab ob SARS-CoV-2 variants ntawm kev txhawj xeeb: alpha thiab delta variants. Cov ntaub ntawv no tau lees paub thiab tseem ceeb vim tias nws tau dhau los ua kom pom tseeb tias qhov nruab nrab cov tshuaj tiv thaiv kab mob titres cuam tshuam nrog kev tiv thaiv cov tsos mob ntawm tus kab mob COVID-19,2 thiab vim tias kev kis kab mob hauv cov neeg tau txhaj tshuaj feem ntau yog tshwm sim los ntawm ntau yam kev txhawj xeeb.3
Lwm qhov kev tshawb pom ntawm Mahil thiab cov npoj yaig yog tias tag nrho IgG antibody titres tawm tsam SARS-CoV-2 yog tus lej qis dua (txawm tias tsis yog li ntawd) hauv cov neeg mob kho nrog methotrexate (qhov nruab nrab ib nrab qhov ua tau zoo tshaj plaws concentration 1751 [IQR 468–4976]) piv. nrog kev tswj hwm (2749 [86–4770]; p=0·20), ib qho qauv uas kuj tau pom nyob rau hauv lwm cov kev tshawb fawb.3 Qhov kev tshawb pom no yuav yog ib qho tseem ceeb vim tias thawj zaug cov tshuaj tiv thaiv kab mob qis dua tuaj yeem txo qhov kev ua neej ntev. ntawm kev tiv thaiv COVID-19, raws li cov tshuaj tiv thaiv kab mob titres thiab kev ua haujlwm tsis sib xws rau qhov sib txawv ntawm kev txhawj xeeb poob qis dhau sijhawm.4
Txawm li cas los xij, Frey thiab cov npoj yaig tau pom tias SARS-CoV-2 cov tshuaj tiv thaiv kab mob tuaj yeem nce mus txog 3 lub hlis tom qab txhaj tshuaj tiv thaiv COVID-19 thib ob hauv cov neeg mob, feem ntau yog cov kev kho mob lymphodepleting (ie, azathioprine, mycophenolate, los yog methotrexate), 5 uas qhia tias qee qhov kev tiv thaiv kab mob tiv thaiv kab mob tuaj yeem ncua sijhawm, es tsis muaj kev cuam tshuam los ntawm cov tshuaj tiv thaiv kab mob.
Raws li Mahil thiab cov npoj yaig thiab lwm tus3 ntsuas cov tshuaj tiv thaiv kab mob hauv thawj lub hlis tom qab txhaj tshuaj thib ob, cov tshuaj tiv thaiv qis dua qhia hauv cov kev tshawb fawb no tej zaum yuav yog qhov tsis txaus ntseeg ntawm cov tshuaj tiv thaiv kab mob humoral hauv cov neeg mob tau txais methotrexate.
Tsis tas li ntawd, qhov loj ntawm cov tshuaj tiv thaiv kab mob tom qab kev txhaj tshuaj tiv thaiv COVID-19 txawv heev ntawm cov tib neeg, txawm tias muaj tus kab mob autoimmune hauv qab lossis kev kho mob nrog cov tshuaj tiv thaiv kab mob, thiab qhov ntau ntawm cov tshuaj tiv thaiv yuav tsum tau tiv thaiv cov tsos mob tseem tsis tau paub.2 Cov kev tshawb fawb uas ntsuas qhov cuam tshuam ntawm cov tshuaj tiv thaiv kab mob ntawm cov tshuaj tiv thaiv cov txiaj ntsig tau ntsuas (piv txwv li, cov tsos mob ntawm COVID-19 cov kab mob sib kis) yog li yuav tsum tau ceev nrooj los tsim kom muaj kev koom tes ntawm (neutralising) antibody titres thiab tiv thaiv COVID-19, thiab tom qab ntawd , txhawm rau ua pov thawj cov lus pom zoo hauv tsev kho mob uas tam sim no tsuas yog los ntawm kev kuaj pom (piv txwv li, kev kho mob ib ntus ntawm methotrexate thaum lub sijhawm txhaj tshuaj tiv thaiv COVID-19).
Txawm hais tias tsis muaj cov tshuaj tiv thaiv kab mob tau tshaj tawm tias yog tus cim tseem ceeb tshaj plaws rau kev txhim kho kev tiv thaiv (mob) cov tsos mob ntawm COVID-19,2 nws tau lees paub ntau ntxiv tias kev tiv thaiv kab mob cellular kho los ntawm T hlwb kuj ua lub luag haujlwm tseem ceeb hauv ob lub sijhawm luv. thiab kev tiv thaiv mus sij hawm ntev tiv thaiv tus kab mob.6,7 Txawm li cas los xij, vim yog kev ua haujlwm heterogeneity ntawm T hlwb, lub luag haujlwm ntawm kev tiv thaiv kab mob ntawm tes, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob kho nrog immunosuppressive therapy, tseem tsis to taub.
Mahil thiab cov npoj yaig nrhiav kev txhim kho ntawm qhov sib txawv ntawm qhov kev paub no los ntawm kev sib piv cov lus teb T-cell tom qab thawj thiab thib ob koob tshuaj tiv thaiv BNT162b2 hauv lawv pawg neeg mob psoriasis kho nrog methotrexate lossis biologics thiab tswj kev noj qab haus huv. Lawv tau soj ntsuam ob qho tib si T pab (Th)1 cov lus teb ntawm tes (raws li kev tsim cov interferon- thiab IL-2) thiab T follicular helper (Tfh) cell teb (IL-21), uas yog qhov tshwj xeeb piv nrog Lwm cov kev tshawb fawb uas feem ntau ntsuas tsuas yog Th1 cell muaj nuj nqi. Cov ntaub ntawv no yog ib qho tseem ceeb pab rau cov ntaub ntawv vim hais tias ob leeg Th1 thiab Tfh hlwb tau pom los pab txhawb kev tiv thaiv COVID-19. Th1 hlwb txhawb nqa thiab txhim kho cytotoxic (CD8 ntxiv) T hlwb uas pab tiv thaiv COVID-19 los ntawm kev tua cov kab mob, 6 thiab Tfh hlwb sib koom tes thiab txhawb nqa kev tiv thaiv kab mob humoral.7 Mahil thiab cov npoj yaig pom tias cov lej ntawm tag nrho T- Cov lus teb ntawm tes thiab ib tus neeg Th1 thiab Tfh cov lus teb tsis sib txawv ntawm cov neeg mob thiab kev tswj hwm tom qab txhaj tshuaj tiv thaiv thawj zaug thiab thib ob, qhov kev nce ntxiv ntawm T-cell cov lus teb tom qab txhaj tshuaj thib ob tshwm sim hauv kev tswj hwm. Qhov tsis muaj kev txhawb zog ntawm kev tiv thaiv kab mob ntawm tes tau pom yav dhau los, tshwj xeeb tshaj yog rau cov neeg mob tau txais methotrexate, 3 thiab ntawm qhov loj dua rau cov neeg mob uas muaj kab mob tiv thaiv kab mob sib kis uas tau txais ntau yam tshuaj tiv thaiv kab mob.8
Tsis tas li ntawd, Picchianti-Diamanti thiab cov npoj yaig9 tau tshaj tawm tias cov neeg mob kho nrog IL-6 inhibitors lossis abatacept tau txo qis cov lus teb T-cell piv nrog kev tswj kev noj qab haus huv tom qab ob koob tshuaj BNT162b2. Yog li ntawd, qhov kev tshawb pom ntawm Mahil thiab cov npoj yaig thiab lwm tus3,9 qhia tias kev tiv thaiv kev tiv thaiv COVID-19 mus ntev yuav ua rau cov neeg mob raug kho nrog lub hom phiaj tiv thaiv kab mob, muab lub luag haujlwm tseem ceeb ntawm T hlwb hauv kev txhawb nqa thiab txhawb nqa ob leeg cellular thiab humoral. tiv thaiv kab mob. Txawm li cas los xij, cov txheej txheem tseeb uas nyob rau hauv qhov kev tshaj tawm cov tshuaj tiv thaiv kab mob ntawm tus kheej cov tshuaj tiv thaiv kab mob, tshwj xeeb tshaj yog TNF, IL-23, thiab IL-17 inhibitors, thiab yuav ua li cas cov ntaub ntawv kuaj pom tau txhais li cas rau kev ntsuas cov txiaj ntsig, tseem tsis meej thiab lav kev tshawb fawb ntxiv.
Hauv kev xaus, qhov kev tshawb pom ntawm Mahil thiab cov npoj yaig ntawm kev txhim kho cov tshuaj tiv thaiv kab mob tom qab COVID-19 txhaj tshuaj tiv thaiv hauv cov neeg mob uas tau kho nrog methotrexate lossis cov tshuaj tiv thaiv kab mob tiv thaiv tau ua kom ntseeg tau, thaum lawv qhov kev soj ntsuam ntawm qhov tsis muaj kev txhawb nqa T-cell cov lus teb yuav qhia tau tias cov cellular ruaj khov. thiab kev tiv thaiv kev lom zem tsis zoo nyob rau qee cov neeg mob tau txais cov tshuaj no. Cov kev tshawb fawb nrog cov txiaj ntsig kev soj ntsuam hauv cov neeg mob immunocompromised yog xav tau thiab tseem ceeb rau kev txiav txim siab kho mob txog kev txhaj tshuaj tiv thaiv kab mob ntxiv lossis kev kho mob ib ntus thaum lub sijhawm txhaj tshuaj.
Amsterdam Rheumatology and Immunology Center, Location Reade, Department of Rheumatology, Dr Jan van Breemenstraat 2, 1056 AB Amsterdam, Netherlands.
Kev siv
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