COVID-19: Understanding Inter-Individual Variability and Implications for Precision Medicine.
COVID-19: Understanding Inter-Individual Variability and Implications for Precision Medicine.
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COVID-19：了解个体间变异性及其对精准医疗的影响。
DOI：
10.1016/j.mayocp.2020.11.024
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发表时间：
2021-03
影响因子：
8.9
通讯作者：
Cresci S
中科院分区：
文献类型：
--
作者：
Pereira NL;Ahmad F;Byku M;Cummins NW;Morris AA;Owens A;Tuteja S;Cresci S
2019冠状病毒病（COVID-19）的特点是对疾病的易感性和疾病严重程度存在异质性。了解个体间差异不仅对资源分配有重要意义，而且对针对患者的护理升级、纳入临床试验和个体化医疗治疗（包括疫苗接种）也有重要意义。除了地理位置和社会脆弱性外，还有明显的生物学差异，如年龄、性别、种族、合并症的存在、潜在的遗传变异和不同的免疫反应，这些都导致了疾病表现的变异性。这些差异可能会对精准医疗产生影响。具体的例子包括：雄激素调节跨膜蛋白酶、丝氨酸2的表达，丝氨酸2促进严重急性呼吸综合征冠状病毒2进入细胞；因此，正在探索雄激素剥夺疗法作为COVID-19男性感染者的治疗选择。一项针对COVID-19患者的免疫表型研究表明，一部分患者会出现T细胞减少症，这促使一项临床试验正在测试白细胞介素-7对这些患者的疗效。预测哪些COVID-19患者会发展为需要住院治疗的进行性疾病，对针对门诊患者的临床试验具有重要意义。纳入疾病进展和住院风险较低的患者可能不会导致这种治疗显示出疗效。正在努力利用人工智能将智能手表应用程序或数字监测系统的数字数据与生物数据相结合，以识别COVID-19高风险患者。使用这种现代技术的精准医疗的最终目标是识别个体差异，以改善所有人的健康。
Coronavirus disease 2019 (COVID-19) is characterized by heterogeneity in susceptibility to the disease and severity of illness. Understanding inter-individual variation has important implications for not only allocation of resources but also targeting patients for escalation of care, inclusion in clinical trials, and individualized medical therapy including vaccination. In addition to geographic location and social vulnerability, there are clear biological differences such as age, sex, race, presence of comorbidities, underlying genetic variation, and differential immune response that contribute to variability in disease manifestation. These differences may have implications for precision medicine. Specific examples include the observation that androgens regulate the expression of the enzyme transmembrane protease, serine 2 which facilitates severe acute respiratory syndrome coronavirus 2 viral entry into the cell; therefore, androgen deprivation therapy is being explored as a treatment option in males infected with COVID-19. An immunophenotyping study of COVID-19 patients has shown that a subset develop T cytopenia which has prompted a clinical trial that is testing the efficacy of interleukin-7 in these patients. Predicting which COVID-19 patients will develop progressive disease that will require hospitalization has important implications for clinical trials that target outpatients. Enrollment of patients at low risk for progression of disease and hospitalization would likely not result in such therapy demonstrating efficacy. There are efforts to use artificial intelligence to integrate digital data from smartwatch applications or digital monitoring systems and biological data to enable identification of the high risk COVID-19 patient. The ultimate goal of precision medicine using such modern technology is to recognize individual differences to improve health for all.
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影响因子：
3.7
作者：
Benetti E;Giliberti A;Emiliozzi A;Valentino F;Bergantini L;Fallerini C;Anedda F;Amitrano S;Conticini E;Tita R;d'Alessandro M;Fava F;Marcantonio S;Baldassarri M;Bruttini M;Mazzei MA;Montagnani F;Mandalà M;Bargagli E;Furini S;GEN-COVID Multicenter Study;Renieri A;Mari F
通讯作者：
Mari F
DOI：
10.4049/jimmunol.1601896
发表时间：
2017-05-15
期刊：
Journal of immunology (Baltimore, Md. : 1950)
影响因子：
--
作者：
Channappanavar R;Fett C;Mack M;Ten Eyck PP;Meyerholz DK;Perlman S
通讯作者：
Perlman S
影响因子：
7.6
作者：
Brown, Ariane J.;Won, John J.;Sheahan, Timothy P.
通讯作者：
Sheahan, Timothy P.
影响因子：
158.5
作者：
Boulware, David R.;Pullen, Matthew F.;Hullsiek, Kathy H.
通讯作者：
Hullsiek, Kathy H.
影响因子：
5.2
作者：
Benetti, Elisa;Tita, Rossella;Pinto, Anna Maria
通讯作者：
Pinto, Anna Maria