EULAR points to consider on pathophysiology and use of immunomodulatory therapies in COVID-19.
EULAR points to consider on pathophysiology and use of immunomodulatory therapies in COVID-19.
复制标题
EULAR在COVID-19的病理生理学和免疫调节疗法的使用方面需要考虑的要点。
DOI：
10.1136/annrheumdis-2020-219724
复制
发表时间：
2021-06
影响因子：
27.4
通讯作者：
Mariette X
中科院分区：
文献类型：
--
作者：
Alunno A;Najm A;Machado PM;Bertheussen H;Burmester GR;Carubbi F;De Marco G;Giacomelli R;Hermine O;Isaacs JD;Koné-Paut I;Magro-Checa C;McInnes I;Meroni PL;Quartuccio L;Ramanan AV;Ramos-Casals M;Rodríguez Carrio J;Schulze-Koops H;Stamm TA;Tas SW;Terrier B;McGonagle DG;Mariette X
与COVID-19的某些阶段相关的严重全身性炎症以及在致命病例中导致在流变学中经常开发或使用的治疗剂成为实验性治疗策略的先锋。该项目的目的是阐述EULAR关于COVID-19病理生理学和免疫调节疗法的考虑要点（PtCs）。PTCs是根据EULAR标准操作程序制定的，由国际多学科工作组领导，包括风湿病学家，转化免疫学家，血液学家，儿科医生，患者和卫生专业人员，基于截至2020年12月15日的系统性文献综述。通过正式表决制定和巩固了最高原则和优先事项。开发了2个OP和14个PTC。OP强调了SARS-CoV-2感染的异质性临床谱，以及针对不同病理生理机制的多方面方法的需要。PtCs 1-6涵盖SARS-CoV-2的病理生理学，包括免疫应答、内皮功能障碍和生物标志物。PtCs 7-14关注免疫调节剂对SARS-CoV-2感染的管理。有证据支持在需要氧疗的COVID-19病例中使用糖皮质激素，尤其是地塞米松。迄今为止，没有其他免疫调节剂显示出对死亡率的疗效，但托珠单抗的结果不一致。免疫调节治疗与较高的感染率无关。包括免疫异常在内的多因素病理生理机制在COVID-19中起着关键作用。糖皮质激素在需要氧疗的病例中的疗效表明，免疫调节治疗可能对COVID-19亚群有效。风湿病学家作为系统性炎症疾病专家，应继续参与正在进行的临床试验，以确定COVID-19的最佳免疫调节疗法。
Severe systemic inflammation associated with some stages of COVID-19 and in fatal cases led therapeutic agents developed or used frequently in Rheumatology being at the vanguard of experimental therapeutics strategies. The aim of this project was to elaborate EULAR Points to consider (PtCs) on COVID-19 pathophysiology and immunomodulatory therapies. PtCs were developed in accordance with EULAR standard operating procedures for endorsed recommendations, led by an international multidisciplinary Task Force, including rheumatologists, translational immunologists, haematologists, paediatricians, patients and health professionals, based on a systemic literature review up to 15 December 2020. Overarching principles (OPs) and PtCs were formulated and consolidated by formal voting. Two OPs and fourteen PtCs were developed. OPs highlight the heterogeneous clinical spectrum of SARS-CoV-2 infection and the need of a multifaceted approach to target the different pathophysiological mechanisms. PtCs 1–6 encompass the pathophysiology of SARS-CoV-2 including immune response, endothelial dysfunction and biomarkers. PtCs 7–14 focus on the management of SARS-CoV-2 infection with immunomodulators. There was evidence supporting the use of glucocorticoids, especially dexamethasone, in COVID-19 cases requiring oxygen therapy. No other immunomodulator demonstrated efficacy on mortality to date, with however inconsistent results for tocilizumab. Immunomodulatory therapy was not associated with higher infection rates. Multifactorial pathophysiological mechanisms, including immune abnormalities, play a key role in COVID-19. The efficacy of glucocorticoids in cases requiring oxygen therapy suggests that immunomodulatory treatment might be effective in COVID-19 subsets. Involvement of rheumatologists, as systemic inflammatory diseases experts, should continue in ongoing clinical trials delineating optimal immunomodulatory therapy utilisation in COVID-19.
登录
查看更多内容
危及生命的Covid-19患者中针对I型IFN的自身抗体。
DOI：
10.1126/science.abd4585
发表时间：
2020-10-23
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Bastard P;Rosen LB;Zhang Q;Michailidis E;Hoffmann HH;Zhang Y;Dorgham K;Philippot Q;Rosain J;Béziat V;Manry J;Shaw E;Haljasmägi L;Peterson P;Lorenzo L;Bizien L;Trouillet-Assant S;Dobbs K;de Jesus AA;Belot A;Kallaste A;Catherinot E;Tandjaoui-Lambiotte Y;Le Pen J;Kerner G;Bigio B;Seeleuthner Y;Yang R;Bolze A;Spaan AN;Delmonte OM;Abers MS;Aiuti A;Casari G;Lampasona V;Piemonti L;Ciceri F;Bilguvar K;Lifton RP;Vasse M;Smadja DM;Migaud M;Hadjadj J;Terrier B;Duffy D;Quintana-Murci L;van de Beek D;Roussel L;Vinh DC;Tangye SG;Haerynck F;Dalmau D;Martinez-Picado J;Brodin P;Nussenzweig MC;Boisson-Dupuis S;Rodríguez-Gallego C;Vogt G;Mogensen TH;Oler AJ;Gu J;Burbelo PD;Cohen JI;Biondi A;Bettini LR;D'Angio M;Bonfanti P;Rossignol P;Mayaux J;Rieux-Laucat F;Husebye ES;Fusco F;Ursini MV;Imberti L;Sottini A;Paghera S;Quiros-Roldan E;Rossi C;Castagnoli R;Montagna D;Licari A;Marseglia GL;Duval X;Ghosn J;HGID Lab;NIAID-USUHS Immune Response to COVID Group;COVID Clinicians;COVID-STORM Clinicians;Imagine COVID Group;French COVID Cohort Study Group;Milieu Intérieur Consortium;CoV-Contact Cohort;Amsterdam UMC Covid-19 Biobank;COVID Human Genetic Effort;Tsang JS;Goldbach-Mansky R;Kisand K;Lionakis MS;Puel A;Zhang SY;Holland SM;Gorochov G;Jouanguy E;Rice CM;Cobat A;Notarangelo LD;Abel L;Su HC;Casanova JL
通讯作者：
Casanova JL
影响因子：
158.5
作者：
Cavalcanti, A. B.;Zampieri, F. G.;Berwanger, O.
通讯作者：
Berwanger, O.
影响因子：
5.2
作者：
Benetti, Elisa;Tita, Rossella;Pinto, Anna Maria
通讯作者：
Pinto, Anna Maria
影响因子：
3.5
作者：
Gomez, Juan;Albaiceta, Guillermo M.;Coto, Eliecer
通讯作者：
Coto, Eliecer
DOI：
10.1183/13993003.02808-2020
发表时间：
2020-12
期刊：
The European respiratory journal
影响因子：
--
作者：
Edalatifard M;Akhtari M;Salehi M;Naderi Z;Jamshidi A;Mostafaei S;Najafizadeh SR;Farhadi E;Jalili N;Esfahani M;Rahimi B;Kazemzadeh H;Mahmoodi Aliabadi M;Ghazanfari T;Sattarian M;Ebrahimi Louyeh H;Raeeskarami SR;Jamalimoghadamsiahkali S;Khajavirad N;Mahmoudi M;Rostamian A
通讯作者：
Rostamian A