Inflammatory Cytokine: IL-17A Signaling Pathway in Patients Present with COVID-19 and Current Treatment Strategy.
Inflammatory Cytokine: IL-17A Signaling Pathway in Patients Present with COVID-19 and Current Treatment Strategy.
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DOI：
10.2147/jir.s278335
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发表时间：
2020
影响因子：
4.5
通讯作者：
Shibabaw T
中科院分区：
文献类型：
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作者：
Shibabaw T
冠状病毒病2019(新冠肺炎)是由严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起的全球传染性公共卫生疾病。根除新冠肺炎似乎几乎是不可能的，但因此，需要更有效的药物治疗。新冠肺炎患者临床表现的恶化主要与高细胞分裂素血症有关，这是由于众所周知的促炎细胞因子如白介素1B、白介素6、白介素8、白介素17、粒细胞巨噬细胞集落刺激因子、粒细胞集落刺激因子、干扰素γ诱导蛋白、单核细胞趋化蛋白1和肿瘤坏死因子α的升高，通常是细胞因子释放综合征的原因。在细胞因子风暴中，T辅助细胞因子IL-17A的上调，可能还有IL-17F的上调，是新冠肺炎和急性呼吸窘迫综合征的免疫病理机制之一。在此，我仔细回顾了SARS-CoV-2感染和相关的免疫病理后遗症时，幼稚的CD4+T细胞对Th17细胞的兴奋极化机制。为了临床的益处，我还建议靶向IL-17A信号转导和协同炎症细胞因子IL-6来管理新冠肺炎患者，特别是那些表现为细胞因子风暴综合征的患者。
Coronavirus disease 2019 (COVID-19) is a globally communicable public health disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV-2). Eradication of COVID-19 appears practically impossible but, therefore, more effective pharmacotherapy is needed. The deteriorated clinical presentation of patients with COVID-19 is mainly associated with hypercytokinemia due to notoriously elevated pro-inflammatory cytokines such as interleukin (IL)-1B, IL-6, IL-8, IL-17, granulocyte-macrophage colony-stimulating factor (GM-CSF), granulocyte colony-stimulating factor (G-CSF), interferon-γ-inducible protein (IP10), monocyte chemoattractant protein (MCP1), and tumor necrosis factor-α (TNFα), and is usually responsible for cytokine release syndrome. In the cytokine storm, up-regulation of T-helper 17 cell cytokine IL-17A, and maybe also IL-17F, is mostly responsible for the immunopathology of COVID-19 and acute respiratory distress syndrome. Herein, I meticulously review the exuberant polarization mechanism of naïve CD4+ T cells toward Th17 cells in response to SARS-CoV-2 infection and its associated immunopathological sequelae. I also, propose, for clinical benefit, targeting IL-17A signaling and the synergic inflammatory cytokine IL-6 to manage COVID-19 patients, particularly those presenting with cytokine storm syndrome.