Emerging Mechanisms of Pulmonary Vasoconstriction in SARS-CoV-2-Induced Acute Respiratory Distress Syndrome (ARDS) and Potential Therapeutic Targets.
Emerging Mechanisms of Pulmonary Vasoconstriction in SARS-CoV-2-Induced Acute Respiratory Distress Syndrome (ARDS) and Potential Therapeutic Targets.
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DOI：
10.3390/ijms21218081
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发表时间：
2020-10-29
影响因子：
5.6
通讯作者：
Akkanti B
中科院分区：
文献类型：
--
作者：
Karmouty-Quintana H;Thandavarayan RA;Keller SP;Sahay S;Pandit LM;Akkanti B
1918年的流感在短短几年内造成大约5000万人死亡，现在，世界正面临另一场大流行。2019年12月，一种名为SARS-CoV-2的新型冠状病毒引起了一种名为2019冠状病毒病（COVID-19）的呼吸系统疾病的国际爆发，并迅速传播，造成了自1918年以来最严重的大流行。最近的临床报告强调了COVID-19患者急性呼吸窘迫综合征（ARDS）的非典型表现，其特征是严重低氧血症、肾素-血管紧张素系统失衡、血栓形成过程增加和细胞因子释放风暴。这些过程不仅会加重肺损伤，还会促进肺血管重构和血管收缩，这是肺动脉高压（PH）的标志。酸碱度是ARDS的并发症，很少受到关注；因此，我们假设PH在covid -19诱导的ARDS中是疾病改善的重要靶点。本文描述了SARS-CoV-2感染后促进PH的机制。在这篇综述文章中，我们概述了肺血管功能障碍的新机制，并概述了已经过临床试验的潜在治疗方案。
The 1918 influenza killed approximately 50 million people in a few short years, and now, the world is facing another pandemic. In December 2019, a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused an international outbreak of a respiratory illness termed coronavirus disease 2019 (COVID-19) and rapidly spread to cause the worst pandemic since 1918. Recent clinical reports highlight an atypical presentation of acute respiratory distress syndrome (ARDS) in COVID-19 patients characterized by severe hypoxemia, an imbalance of the renin–angiotensin system, an increase in thrombogenic processes, and a cytokine release storm. These processes not only exacerbate lung injury but can also promote pulmonary vascular remodeling and vasoconstriction, which are hallmarks of pulmonary hypertension (PH). PH is a complication of ARDS that has received little attention; thus, we hypothesize that PH in COVID-19-induced ARDS represents an important target for disease amelioration. The mechanisms that can promote PH following SARS-CoV-2 infection are described. In this review article, we outline emerging mechanisms of pulmonary vascular dysfunction and outline potential treatment options that have been clinically tested.
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