Kev Tiv Thaiv Tawm tsam SARS-CoV-2 Variants With COVID-19 Kev txhaj tshuaj rau hauv raum hloov cov neeg tau txais
Mar 16, 2022
Yog xav paub ntxiv:ali.ma@wecistanche.com
Dominique Bertrand: koj puas xav tau ntau tus thwjtim?1thiab Sophie Candon2
1Department of Nephrology, Transplantation and Dialysis, Rouen UniversityHospital, Rouen, France 2 Department of Immunologyand Biotherapies, Rouen UniversityHospital, Rouen, Fabkis
Cov ntawv xov xwm: Dr. Dominique Bertrand,1 Rue de Germont, Rouen University Tsev Kho Mob, 76000 Rouen, Fabkis. Email: Dominique. ib bertrand@chu-rouen.fr
Kev txhaj tshuaj tiv thaiv kab mob ua pa hnyav 2 (SARS-CoV-2) tau dhau los ua tus qauv kev saib xyuas rau kev tiv thaiv tus kab mob coronavirus hnyav 2019 (COVID-19), nrog rau kev cuam tshuam zoo heev hauv cov tebchaws uas txhaj tshuaj tiv thaiv tau txais kev txhawb nqa zoo. Txawm li cas los xij, qhov tshwm sim ntawm qhov sib txawv ntawm kev txhawj xeeb, xws li B.1.617.2 (Delta), tau ua rau muaj kev kub ntxhov thoob plaws ntiaj teb, ua rau muaj lus nug txog kev tiv thaiv los ntawm cov tshuaj tiv thaiv. Txawm hais tias BNT162b2 mRNA txhaj tshuaj tiv thaiv kab mob tiv thaiv kab mob SARS-CoV-2 tshwm sim sai sai tom qab nws qhov siab tshaj plaws tom qab koob thib ob, kev tiv thaiv kev mus pw hauv tsev kho mob thiab kev tuag tseem muaj zog rau 6 lub hlis tom qab koob thib ob (1) .Lub raumCov neeg tau txais kev hloov pauv tau muaj kev pheej hmoo loj ntawm kev tsim cov kab mob SARS-CoV-2 mob hnyav (2), thiab kev txhaj tshuaj tiv thaiv mRNA tau raug pom zoo sai los ntawm cov lus qhia thoob ntiaj teb, txawm hais tias lawv tau raug cais tawm ntawm "Phase 3 trial" kev tshawb fawb tshuaj tiv thaiv. Hmoov tsis zoo, cov ntaub ntawv tau tshaj tawm rau hnub timraumCov neeg tau txais kev hloov pauv tau poob siab, nrog tus nqi qis ntawm seroconversion tom qab ob koob tshuaj, thaum qhov tshwm sim ntawm kev kis mob hnyav tom qab txhaj tshuaj yog muaj kev txhawj xeeb (3). Ntau qhov kev siv zog tau ua los txhim kho cov tshuaj tiv thaiv kab mob hauv lub raum hloov cov neeg tau txais kev pab, xws li koob thib peb ntawm cov tshuaj tiv thaiv, tab sis qib kev tiv thaiv ntawm Delta variants nyob rau hauv lub raum hloov cov neeg tau txais cov lus teb tseem tsis tau paub. Cov ntawv ceeb toom tsis ntev los no tau qhia meej txog qhov tseem ceeb ntawm kev tsim cov tshuaj tiv thaiv kab mob nruab nrab (4), ua haujlwm los ntawm kev khi rau cov protein ntau ntawm SARS-CoV-2, yog li tshem tawm cov kab mob extracellular thiab tiv thaiv lawv nkag mus rau hauv cov tswv tsev. Txawm li cas los xij, cov tshuaj tiv thaiv kab mob ua rau muaj qhov txo qis kom tsis txhob muaj kev txhawj xeeb (Beta thiab Delta) hauv cov tib neeg noj qab haus huv (5). Txog tam sim no, xws li cov ntaub ntawv hauvraumTsis muaj cov neeg txais kev hloov pauv.
Hauv qhov teeb meem no ntawm CJASN, Benning et al. (6) qhia qhov kev tshawb fawb thawj zaug uas muab ib qho kev qhia tob tob ntawm cov lus teb humoral rau ntau qhov sib txawv ntawm kev txhawj xeeb hauvraumcov neeg txais kev hloov pauv. Txij thaum Lub Kaum Ob Hlis 29, 2020, txog rau Lub Rau Hli 21, 2021, lawv tuaj yeem tso npe rau 173.raumCov neeg tau txais kev hloov pauv thiab 166 kev tswj hwm kev noj qab haus huv tau txais kev txhaj tshuaj SARS-CoV-2. Anti-S1 IgG thiab neutralizing antibodies raug ntsuas nyob rau hauv 73 thiab 135 raum hloov pauv tau txais thiab hauv 115 thiab 134
tswj kev noj qab haus huv tom qab txhaj tshuaj tiv thaiv thawj zaug thiab thib ob (feem ntau yog mRNA), raws li. Cov tshuaj tiv thaiv-S1 IgG cov tshuaj tiv thaiv kab mob tau qis qis hauvraumhloov pauv piv nrog kev tswj hwm kev noj qab haus huv. Ib qho tseem ceeb txo qis cov tshuaj tiv thaiv kab mob ntawm surrogateneutralization tau pom nyob rau hauvraumhloov cov neeg tau txais kev pab tom qab txhaj tshuaj tiv thaiv ob zaug. Tom qab koob tshuaj thib ob, 135 tus neeg tau txais kev hloov pauv lub raum, piv nrog 25 qhov kev tswj hwm kev noj qab haus huv zoo sib xws rau hom tshuaj tiv thaiv, poj niam txiv neej, thiab hnub nyoog, pom tau tias txo qis cov tshuaj tiv thaiv kab mob tiv thaiv kab mob sib txawv (S1, S2, thiab RBD). Kev ua haujlwm nruab nrab tiv thaiv qhov sib txawv ntawm kev txhawj xeeb tau ntsuas ntawm VeroE6 hlwb hauv 36 seropositive raum hloov pauv cov neeg tau txais txiaj ntsig, piv rau 25 kev tswj hwm kev noj qab haus huv. Txhua tus neeg tau txais kev hloov hauv lub raum seropositive tau pom, hauv VeroE6 cell neutralization assay, neutralizing kev ua si tawm tsam B.1.1.7(Alpha) variant nrog ib tug nruab nrab (interquartile range) ID5{{30}} (nruab nrab dilution uas txo tus kab mob. ntawm cov hlwb los ntawm 50 feem pua ) ntawm 80 (80–320), whereas tsuas yog 23 tawm ntawm 36 (64 feem pua) thiab 24 tawm ntawm 36 (67 feem pua) ntawm lawv qhia neutralization ua hauj lwm tawm tsam cov variants ntawm kev txhawj xeeb B.1.351 (Beta) thiab B.1.617.2 (Delta) nrog qhov nruab nrab (interquartile range) ID50 ntawm 20 (0–40) thiab 20 (0–40), feem. Hauv qhov sib piv, txhua qhov kev tswj hwm kev noj qab haus huv tau pom tias muaj kev ua haujlwm tsis zoo tawm tsam txhua qhov kev sim tshuaj, nrog rau kev ua haujlwm siab dua qhov nruab nrab tiv thaiv qhov sib txawv ntawm kev txhawj xeeb piv nrog rau cov neeg tau txais kev hloov hauv lub raum.
Nyem rauCistanche hauv Urdu rau mob raum
Feem ntau ntawm cov kev tshawb fawb luam tawm txog kev tiv thaiv kab mob ntawm ob koob tshuaj tiv thaiv mRNA hauvraumCov neeg tau txais kev hloov pauv tau kos tib qhov kev txiav txim siab: qhov kev hloov pauv hloov pauv hauv cov neeg tau txais lub raum tsis zoo thiab cov tshuaj tiv thaiv kab mob tshwj xeeb qis dua li cov pej xeem. Peb paub tam sim no tias cov tshuaj tiv thaiv-S1 thiab tiv thaiv-RBD IgG cov tshuaj tiv thaiv kab mob sib cuam tshuam nrog lub peev xwm nruab nrab ntawm cov tshuaj tiv thaiv kab mob tiv thaiv kab mob, thiab tshuaj tiv thaiv kev ua tau zoo, tab sis txawm li cas los xij, tej zaum yuav raug txo mus rau qhov tshiab SARS-CoV-2 variants. Benning et al. tam sim no ua kom pom qhov txo qis ntawm cov tshuaj tiv thaiv kab mob hauv lub raum seroconverting rau cov neeg tau txais kev hloov pauv hauv lub raum uas tej zaum yuav tsis txaus los muab kev tiv thaiv zoo tiv thaiv qhov sib txawv ntawm kev txhawj xeeb. Kev kawm ntawm Benning et al. yog li sib cav sib ceg rau ib koob tshuaj boost nyob rau hauv cov neeg mob immunocompromised xws liraumcov neeg txais kev hloov pauv. Qhov thib peb koob tshuaj tiv thaiv mRNA, raws li kev pom zoo rau cov neeg tau txais kev hloov hauv lub raum txij li lub Plaub Hlis 2021 hauv Fab Kis, tau them nyiaj ntau ntxiv ntawm cov tshuaj tiv thaiv kab mob rau cov neeg tau txais kev hloov hauv lub raum uas twb muaj seropositive tom qab koob thib ob thiab induced seroconversion nyob rau hauv ib qho tseem ceeb feem ntawm cov neeg mob seronegative (7) . Hall et al. (8) kuj tau qhia txog 55 feem pua seroconversion tus nqi tom qab txhaj tshuaj thib peb hauv 120 cov neeg tau txais kev hloov pauv hauv nruab nrog cev raws li piv nrog 18 feem pua hauv pawg tswj hwm cov placebo, nrog 71 feem pua vim 13 feem pua ntawm cov kab mob tsis zoo hauv mRNA-1273 thiab pab pawg placebo, feem. Tsis tas li ntawd, cov naj npawb tshwj xeeb T-hlwb muaj ntau dua hauv mRNA-1273 pawg ntau dua li hauv pawg placebo.
Kev kawm ntawm Benning et al. muaj qee qhov kev txwv. Ua ntej, txawm tias muaj cov pov thawj loj hlob rau qhov kev sib raug zoo ntawm cov tshuaj tiv thaiv kab mob nruab nrab thiab kev tiv thaiv cov ntaub ntawv hnyav ntawm COVID-19, qhov txiav tawm qhov tseeb rau kev tiv thaiv tseem tsis tau paub. Cov ntsiab lus no tuaj yeem piav qhia los ntawm qhov tseeb tias cov tshuaj tiv thaiv tsuas yog ib feem ntawm lub cev tiv thaiv kab mob tshwm sim los ntawm cov tshuaj tiv thaiv. Qhov tseeb, cov lus teb ntawm CD41 thiab CD81 T cell yuav tsum tau muab coj los txiav txim siab txog qib kev tiv thaiv (9). Tseeb, hauvraumCov neeg tau txais kev hloov pauv, qhov zoo ntawm T cell cov lus teb yog paub tias yog kev kwv yees ntawm qhov tshwm sim hauv cov ntsiab lus ntawm lwm yam kab mob, xws li kab mob cytomegalovirus. Kev soj ntsuam ntawm cov tshuaj tiv thaiv-sari-CoV-2 T cell teb yog tam sim no ua tau nyob rau hauv kev xyaum tam sim no nrog sib txawv kev soj ntsuam (Quantiferon thiab ELISPOT) thiab tshuaj tiv thaiv-induced T cell teb tej zaum yuav tsis zoo dua li cov lus teb humoral nyob rau hauv cov neeg tau txais kev hloov hauv lub raum (7 ). Ntawm qhov tod tes, qhov tshwj xeeb nco B hlwb tiv thaiv SARS-CoV-2 induced tom qab txhaj tshuaj tiv thaiv tej zaum yuav muaj txawm tias waning antibody titers, tab sis qhov no tsis tuaj yeem soj ntsuam tau yooj yim txhua hnub (10). Yog li ntawd, cov pov thawj zoo tshaj plaws rau kev tiv thaiv los ntawm SARS-CoV-2 cov tshuaj tiv thaiv tseem txo qis qhov tshwm sim ntawm qhov chaw kho mob xws li kev kis tus kab mob yuav tsum tau mus pw hauv tsev kho mob, xav tau chav saib xyuas mob hnyav, lossis SARS-CoV-2-txog kev tuag. Cov ntaub ntawv no yog qhov tsis txaus ntseeg rau cov neeg tau txais kev hloov hauv lub raum, tshwj xeeb tshaj yog nyob rau hauv cov ntsiab lus ntawm kev sib txawv ntawm kev txhawj xeeb xws li Delta variant. Bastard et al. (11) tsis ntev los no tau tshaj tawm tias qhov tshwm sim ntawm tus kab mob SARS-CoV{14}} tau poob qis thaum lub sijhawm 4 lub hlis tom qab kev txhaj tshuaj tiv thaiv kab mob rau cov neeg tau txais kev hloov pauv lub raum (Lub Peb Hlis-Lub Rau Hli 2021) ntawm nws tus kheej ntawm kev txo qis ntawm kev kis tus kab mob ntau dua li qub lub sij hawm nyob rau hauv cov pej xeem. Kev txo qis hauv COVID-19 tshwm sim kuj tau ua ke nrog kev txwv tsis pub muaj kev txwv hauv zej zog thiab kev txo qis hauv kev kis tus kab mob. Cov kev soj ntsuam no qhia tias, ntawm ib sab, kev vam meej ntawm kev tiv thaiv tsiaj txhu (vim yog txoj cai txhaj tshuaj tiv thaiv kab mob) thiab kev kis tus kab mob tsawg dua, thiab, ntawm qhov tod tes, yuav muaj lub luag haujlwm tiv thaiv kev tiv thaiv kab mob hauv lub raum hloov cov neeg tau txais kev txom nyem. cov tshuaj tiv thaiv kab mob.
Lub tswv yim classic ntawm kev txhaj tshuaj tiv thaiv nrog mRNA tshuaj tiv thaiv siv nyob rau hauv cov pej xeem nyob rau hauvraumcov neeg tau txais kev hloov pauv kom txo qis seroconversion tus nqi thiab hauv cov neeg teb kom txo qis kev muaj peev xwm tiv thaiv kev hloov pauv tshiab, thiab yog li txo qis kev tiv thaiv los ntawm cov qauv hnyav ntawm COVID-19 hauv cov neeg teb thiab cov neeg tsis teb. Lub raum hloov pauv cov neeg tau txais kev teb rau ob koob tshuaj tiv thaiv yuav tsum tau txais koob tshuaj tiv thaiv kab mob (thib peb koob) txhawm rau txhim kho lub cev tiv thaiv kab mob thiab nce qib ntawm cov tshuaj tiv thaiv kab mob tiv thaiv kab mob sib txawv. Lub sijhawm tiv thaiv
(uas yog, kev ruaj ntseg ntawm neutralizing antibody titers dhau lub sij hawm) tseem tsis muaj ntaub ntawv thiab cov lus nug tseem ceeb ntawm seb (thiab thaum twg)raumCov neeg tau txais kev hloov pauv yuav xav tau cov tshuaj txhawb ntxiv kom raug tshawb xyuas. Hauv cov neeg tsis teb, qhov koob tshuaj no tuaj yeem sib tham thiab, thaum tsis muaj seroconversion, kev siv tshuaj tiv thaiv SARS-CoV-2 monoclonal antibodies tej zaum yuav yog qhov kev daws teeb meem los tiv thaiv cov neeg tawg rog no tawm tsam qhov tshwm sim ntawm kev txhawj xeeb sib txawv.
Cistanche- mob raum mob
Qhia tawm
Txhua tus kws sau ntawv tsis muaj dab tsi los qhia.
Kev lees paub
Cov ntsiab lus ntawm tsab xov xwm no cuam tshuam txog tus kheej kev paub dhau los thiab kev xav ntawm tus kws sau ntawv thiab yuav tsum tsis txhob suav tias yog cov lus qhia kho mob lossis kev pom zoo. Cov ntsiab lus tsis cuam tshuam txog kev xav lossis kev xav ntawm American Society of Nephrology (ASN) lossis CJASN. Kev lav phib xaub rau cov ntaub ntawv thiab cov kev xav tau nthuav tawm nyob rau hauv yog tag nrho nrog tus sau.
Cov ntaub ntawv
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