The Potential for Repurposing Anti-TNF as a Therapy for the Treatment of COVID-19.
The Potential for Repurposing Anti-TNF as a Therapy for the Treatment of COVID-19.
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DOI：
10.1016/j.medj.2020.11.005
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发表时间：
2020-12-18
期刊：
影响因子：
--
通讯作者：
Feldmann M
中科院分区：
文献类型：
--
作者：
Robinson PC;Liew DFL;Liew JW;Monaco C;Richards D;Shivakumar S;Tanner HL;Feldmann M
冠状病毒病2019(新冠肺炎)目前几乎没有有效的治疗方法。考虑到围绕疫苗有效性和接种率的不确定性，继续寻找治疗方法是很重要的。夸大的炎症状态很可能是新冠肺炎的大部分发病率和死亡率的原因。肿瘤坏死因子是一种关键的促炎细胞因子，其水平升高已被证明与新冠肺炎死亡率的增加有关。在类风湿性关节炎患者中，肿瘤坏死因子阻断不仅会减少生物活性的肿瘤坏死因子，还会减少在新冠肺炎过度炎症中至关重要的其他促炎细胞因子。已经接受抗肿瘤坏死因子治疗的患者的观察数据显示，与其他免疫抑制疗法相比，新冠肺炎的不良结局和死亡率降低。抗肿瘤坏死因子有很长的安全使用历史，包括在特殊的高危人群中，并且广泛使用。充分评估抗肿瘤坏死因子作为新冠肺炎治疗方法的理由是令人信服的。Robinson等人。探讨肿瘤坏死因子封锁在新冠肺炎管理中的潜力。概述了抗肿瘤坏死因子治疗作用的理论基础，包括肿瘤坏死因子在新冠肺炎中的致病作用，抗肿瘤坏死因子的作用机制，动物数据，以及来自新冠肺炎患者的支持性观察数据。
Coronavirus disease 2019 (COVID-19) currently has few effective treatments. Given the uncertainty surrounding the effectiveness and uptake of a vaccine, it is important that the search for treatments continue. An exaggerated inflammatory state is likely responsible for much of the morbidity and mortality in COVID-19. Elevated levels of tumor necrosis factor (TNF), a key pro-inflammatory cytokine, have been shown to be associated with increased COVID-19 mortality. In patients with rheumatoid arthritis, TNF blockade reduces not only biologically active TNF but other pro-inflammatory cytokines important in COVID-19 hyperinflammation. Observational data from patients already on anti-TNF therapy show a reduced rate of COVID-19 poor outcomes and death compared with other immune-suppressing therapies. Anti-TNF has a long history of safe use, including in special at-risk populations, and is widely available. The case to adequately assess anti-TNF as a treatment for COVID-19 is compelling. Robinson et al. discuss the potential of TNF blockade in the management of COVID-19. The rationale for the therapeutic benefit of anti-TNF is outlined, including the pathogenic role of TNF in COVID-19, the mechanism of action of anti-TNF, animal data, and supportive observational data from those on anti-TNF who develop COVID-19.
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