高血壓會延遲病毒清除並加劇COVID-19患者的氣道炎症
作者：
小柯機器人發布時間：2020/12/27 20:27:53
德國柏林洪堡大學Irina Lehmann等研究人員合作發現，高血壓會延遲病毒清除並加劇COVID-19患者的氣道炎症。 這一研究成果於2020年12月24日在線發表在國際學術期刊《自然—生物技術》上。
通過將臨床數據（n=144）和氣道樣本的單細胞測序數據（n=48）與體外實驗相結合，研究人員觀察到高血壓患者免疫細胞具有明顯的炎性傾向，與關鍵的COVID-19進展相關。血管緊張素轉化酶抑制劑（ACEI）治療與COVID-19相關的過度炎症減弱和細胞內在抗病毒反應增強有關，而血管緊張素受體阻滯劑（ARB）治療與上皮免疫細胞相互作用增強有關。
特別是在ARB治療下，高血壓患者的巨噬細胞和嗜中性粒細胞表現出促炎細胞因子CCL3和CCL4以及趨化因子受體CCR1的高表達。儘管這一隊列的有限規模無法使研究人員確定臨床療效，但數據表明ACEI治療高血壓COVID-19患者的臨床獲益值得進一步研究。
據了解，在COVID-19中，高血壓和心血管疾病是嚴重疾病進展的主要危險因素。但是，主要的抗高血壓療法（ACEI和ARB）會產生什麼樣的後果卻並不清楚。
附：英文原文
Title: Hypertension delays viral clearance and exacerbates airway hyperinflammation in patients with COVID-19
Author: Saskia Trump, Soeren Lukassen, Markus S. Anker, Robert Lorenz Chua, Johannes Liebig, Loreen Thrmann, Victor Max Corman, Marco Binder, Jennifer Loske, Christina Klasa, Teresa Krieger, Bianca P. Hennig, Marey Messingschlager, Fabian Pott, Julia Kazmierski, Sven Twardziok, Jan Philipp Albrecht, Jrgen Eils, Sara Hadzibegovic, Alessia Lena, Bettina Heidecker, Thore Brgel, Jakob Steinfeldt, Christine Goffinet, Florian Kurth, Martin Witzenrath, Maria Theresa Vlker, Sarah Dorothea Mller, Uwe Gerd Liebert, Naveed Ishaque, Lars Kaderali, Leif-Erik Sander, Christian Drosten, Sven Laudi, Roland Eils, Christian Conrad, Ulf Landmesser, Irina Lehmann
Issue&Volume: 2020-12-24
Abstract: In coronavirus disease 2019 (COVID-19), hypertension and cardiovascular diseases are major risk factors for critical disease progression. However, the underlying causes and the effects of the main anti-hypertensive therapies—angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs)—remain unclear. Combining clinical data (n=144) and single-cell sequencing data of airway samples (n=48) with in vitro experiments, we observed a distinct inflammatory predisposition of immune cells in patients with hypertension that correlated with critical COVID-19 progression. ACEI treatment was associated with dampened COVID-19-related hyperinflammation and with increased cell intrinsic antiviral responses, whereas ARB treatment related to enhanced epithelial–immune cell interactions. Macrophages and neutrophils of patients with hypertension, in particular under ARB treatment, exhibited higher expression of the pro-inflammatory cytokines CCL3 and CCL4 and the chemokine receptor CCR1. Although the limited size of our cohort does not allow us to establish clinical efficacy, our data suggest that the clinical benefits of ACEI treatment in patients with COVID-19 who have hypertension warrant further investigation.
DOI: 10.1038/s41587-020-00796-1
Source: https://www.nature.com/articles/s41587-020-00796-1