Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome.
Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome.
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DOI：
10.1016/j.ijid.2020.09.016
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Molderings GJ
中科院分区：
文献类型：
--
作者：
Afrin LB;Weinstock LB;Molderings GJ
五分之一的新型冠状病毒患者患有严重的新型冠状病毒感染;然而，具体原因仍不清楚。肥大细胞（MC）被SARS-CoV-2激活。MC激活综合征（MCAS）是一种慢性多系统疾病，通常是由于获得性MC克隆性引起的，虽然最近才被认识到，但它具有炎症和过敏性主题，估计患病率为17%。本文描述了一种新的猜想，解释了MCAS如何可能导致严重急性COVID-19感染和慢性COVID-19后疾病的倾向。将患有/未患有MCAS的患者中Covid-19疾病的观察结果与MCAS的广泛临床经验进行比较。MCAS的患病率与COVID-19感染人群中的严重病例相似。Covid-19的许多过度炎症与MC激活可以驱动的炎症方式一致。初步观察到对MCs或其介质具有活性的药物对Covid-19患者有帮助。作者治疗的新冠肺炎MCAS患者中没有一人发生严重感染，更不用说死亡了。许多严重症状性Covid-19患者的过度炎症细胞因子风暴可能源于MCAS功能失调的MC对SARS-CoV-2的非典型反应，而不是正常MC的正常反应。如果得到证实，这一理论具有重要的治疗和预后意义。
One-fifth of Covid-19 patients suffer a severe course of Covid-19 infection; however, the specific causes remain unclear. Mast cells (MCs) are activated by SARS-CoV-2. Although only recently recognized, MC activation syndrome (MCAS), usually due to acquired MC clonality, is a chronic multisystem disorder with inflammatory and allergic themes, and an estimated prevalence of 17%. This paper describes a novel conjecture explaining how MCAS might cause a propensity for severe acute Covid-19 infection and chronic post-Covid-19 illnesses. Observations of Covid-19 illness in patients with/without MCAS were compared with extensive clinical experience with MCAS. The prevalence of MCAS is similar to that of severe cases within the Covid-19-infected population. Much of Covid-19’s hyperinflammation is concordant with manners of inflammation which MC activation can drive. Drugs with activity against MCs or their mediators have preliminarily been observed to be helpful in Covid-19 patients. None of the authors’ treated MCAS patients with Covid-19 suffered severe infection, let alone mortality. Hyperinflammatory cytokine storms in many severely symptomatic Covid-19 patients may be rooted in an atypical response to SARS-CoV-2 by the dysfunctional MCs of MCAS rather than a normal response by normal MCs. If proven, this theory has significant therapeutic and prognostic implications.
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影响因子：
4.7
作者：
Almerie, Muhammad Qutayba;Kerrigan, David Daniel
通讯作者：
Kerrigan, David Daniel
影响因子：
3.1
作者：
Afrin, Lawrence B.;Self, Sally;Lazarchick, John
通讯作者：
Lazarchick, John
DOI：
10.1038/nri2782
发表时间：
2010-06
期刊：
Nature reviews. Immunology
影响因子：
--
作者：
通讯作者：
--
影响因子：
3
作者：
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通讯作者：
Zangrillo, Alberto
影响因子：
120.7
作者：
Grasselli, Giacomo;Zangrillo, Alberto;Pesenti, Antonio
通讯作者：
Pesenti, Antonio