Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report.
Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report.
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DOI：
10.1038/s41467-020-19761-2
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发表时间：
2020-12-14
影响因子：
16.6
通讯作者：
Thaventhiran JED
中科院分区：
文献类型：
--
作者：
Buckland MS;Galloway JB;Fhogartaigh CN;Meredith L;Provine NM;Bloor S;Ogbe A;Zelek WM;Smielewska A;Yakovleva A;Mann T;Bergamaschi L;Turner L;Mescia F;Toonen EJM;Hackstein CP;Akther HD;Vieira VA;Ceron-Gutierrez L;Periselneris J;Kiani-Alikhan S;Grigoriadou S;Vaghela D;Lear SE;Török ME;Hamilton WL;Stockton J;Quick J;Nelson P;Hunter M;Coulter TI;Devlin L;CITIID-NIHR COVID-19 BioResource Collaboration;MRC-Toxicology Unit COVID-19 Consortium;Bradley JR;Smith KGC;Ouwehand WH;Estcourt L;Harvala H;Roberts DJ;Wilkinson IB;Screaton N;Loman N;Doffinger R;Lyons PA;Morgan BP;Goodfellow IG;Klenerman P;Lehner PJ;Matheson NJ;Thaventhiran JED
由于缺乏有效的严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）抗病毒治疗，对2019年冠状病毒病（COVID-19）大流行的应对受到阻碍。在这里，我们报告了一名患有COVID-19和原型遗传抗体缺乏症x连锁无球蛋白血症（XLA）的患者使用瑞德西韦。尽管有补体激活和强大的T细胞反应的证据，但患者出现了持续的SARS-CoV-2肺炎，没有进展到多器官受累。这种不寻常的临床过程与抗体对病毒清除和严重疾病进展的贡献是一致的。在没有这些混杂因素的情况下，我们采用实验医学方法来检查瑞德西韦的体内效用。在两个独立的疗程中，我们观察到一个暂时相关的临床和病毒学反应，导致临床解决和病毒清除，没有获得性耐药的证据。因此，我们为瑞德西韦的体内抗病毒疗效及其在选定患者中的潜在益处提供了证据。瑞德西韦用于治疗COVID-19的临床试验正在评估中。在这里，作者报告了一名患有COVID-19和遗传抗体缺乏症XLA的患者接受瑞德西韦治疗的结果。它们表现出暂时相关的临床和病毒学反应，这表明瑞德西韦可以减少患者体内SARS-CoV-2的复制。
The response to the coronavirus disease 2019 (COVID-19) pandemic has been hampered by lack of an effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antiviral therapy. Here we report the use of remdesivir in a patient with COVID-19 and the prototypic genetic antibody deficiency X-linked agammaglobulinaemia (XLA). Despite evidence of complement activation and a robust T cell response, the patient developed persistent SARS-CoV-2 pneumonitis, without progressing to multi-organ involvement. This unusual clinical course is consistent with a contribution of antibodies to both viral clearance and progression to severe disease. In the absence of these confounders, we take an experimental medicine approach to examine the in vivo utility of remdesivir. Over two independent courses of treatment, we observe a temporally correlated clinical and virological response, leading to clinical resolution and viral clearance, with no evidence of acquired drug resistance. We therefore provide evidence for the antiviral efficacy of remdesivir in vivo, and its potential benefit in selected patients. Remdesivir is under evaluation for treatment of COVID-19 in clinical trials. Here, the authors report results of remdesivir treatment in a patient with COVID-19 and the genetic antibody deficiency XLA. They show a temporally correlated clinical and virological response, suggesting that remdesivir can reduce SARS-CoV-2 replication in patients.
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DOI：
10.1084/jem.20070784
发表时间：
2007-10-01
期刊：
The Journal of experimental medicine
影响因子：
--
作者：
Almeida JR;Price DA;Papagno L;Arkoub ZA;Sauce D;Bornstein E;Asher TE;Samri A;Schnuriger A;Theodorou I;Costagliola D;Rouzioux C;Agut H;Marcelin AG;Douek D;Autran B;Appay V
通讯作者：
Appay V
影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
通讯作者：
Cao, Bin
影响因子：
158.5
作者：
Grein, J.;Ohmagari, N.;Flanigan, T.
通讯作者：
Flanigan, T.
影响因子：
16.6
作者：
Huang, Kuan-Hsiang G.;Bonsall, David;Katzourakis, Aris;Thomson, Emma C.;Fidler, Sarah J.;Main, Janice;Muir, David;Weber, Jonathan N.;Frater, Alexander J.;Phillips, Rodney E.;Pybus, Oliver G.;Goulder, Philip J. R.;McClure, Myra O.;Cooke, Graham S.;Klenerman, Paul
通讯作者：
Klenerman, Paul
影响因子：
24.8
作者：
Roschewski, Mark;Lionakis, Michail S.;Wilson, Wyndham H.
通讯作者：
Wilson, Wyndham H.