مجله زیست شناسی ایران

ایمونوپاتوژنز، تشخیص و درمان کووید-19

نویسندگان

1 تهران، دانشگاه علوم پزشکی تهران، بیمارستان شریعتی، مرکز تحقیقات روماتولوژی

2 تهران، دانشگاه علوم پزشکی تهران، مرکز تحقیقات التهاب

چکیده

ویروس SARS-CoV-2 عضوی از خانواده‌ی کروناویروس‌ها است که در اواخر سال ۲۰۱۹ در کشور چین باعث پدید آمدن اپیدمی بیماری تنفسی کووید-19 و در نهایت همه‌گیری جهانی این بیماری شد. ژنگان (genome) این ویروس شباهت ۷۹ درصدی به ویروس  SARS-CoV دارد و برای ورود به سلول، مشابه ویروس SARS-CoV از رسپتور ACE2 استفاده می‌کند. شایع‌ترین علائم این بیماری شامل تب، سرفه و درگیری ریوی است که گاهی با علائم دستگاه گوارش نیز همراه است. کاهش تعداد و عملکرد لنفوسیت‌ها و افزایش شدید فعالیت التهابی لوکوسیت‌ها از عوارض ایمنی شناسی این بیماری است. اگر پاسخ‌های سیستم ایمنی در برابر ویروس کافی و مناسب نباشد بیماری وارد حالت حاد و شدید خود می‌شود. در این حالت فعالیت سلول‌های ایمنی سبب افزایش بیش از حد میزان سایتوکاین‌ها در خون و القای طوفان سایتوکاینی شده و سبب آسیب‌های سیستمی قلبی، ریوی و کلیوی و در نهایت مرگ می‌شود. همچنین آسیب ریوی سبب فیبروزی شدن بافت ریه، سخت شدن تنفس،  کاهش سطح اکسیژن خون شریانی می‌شود. تا کنون هیچ داروی اختصاصی برای درمان بیماران کووید-19 شناسایی نشده است اما داروها و روش‌هایی که در کنترل و بهبود بیماری SARS مانند کلروکین، هیدروکسی کلروکین و پلاسما تراپی موثر بوده‌اند از جمله مواردی هستند که نیاز به بررسی بیشتری دارند. در این مقاله مروری به بررسی روند ایمونوپاتوژنز بیماری کووید-19 و درمان‌های ممکن اثربخش در بهبود این بیماری می‌پردازیم.

کلیدواژه‌ها

عنوان مقاله [English]

Coronavirus disease 2019 (COVID-19) Immunopathogenesis, Diagnosis, and Treatment

نویسندگان [English]

  • Mobina Jalalvand 1
  • Maryam Akhtari 1
  • Elham Farhadi 1
  • Mahdi Mahmoudi 1 2

چکیده [English]

SARS-CoV-2 is a member of the coronaviruses family that causes the outbreak of coronavirus disease 2019 (COVID-19) in China in late 2019 which has exploded to a global pandemic. The reference genome of the SARS-CoV-2 is considered to be very closely related to SARS-CoV and the virus uses the ACE-2 receptor for cellular entry similar to SARS-CoV. The most common symptoms of COVID-19 are fever, cough, and respiratory symptoms. Although gastrointestinal involvements are also presented in some patients. Reduced number and functional exhaustion of lymphocytes and increased inflammatory responses of leukocytes are the most immunological characteristics of the disease. If the infection was not eliminated by the proper and strong immune responses, the disease enters the severe stage when cytokine storm and elevated inflammatory responses induced pulmonary fibrosis, shortness of breath, reduced O2 saturation, and systemic injuries resulted in patient’s death. There are no specific therapies, however, several agents such as Chloroquine, Hydroxychloroquine, and convalescent plasma are being used for COVID-19 treatment. In the current study, we summarized recent findings on COVID-19 pathogenesis and drug therapy.

کلیدواژه‌ها [English]

  • Covid-19
  • Immunopathogenesis
  • Coronavirus
  • Inflammation
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مجله زیست شناسی ایران
دوره 4، شماره 7 - شماره پیاپی 7
اردیبهشت 1399
صفحه 251-259
  • تاریخ دریافت: 22 دی 1398
  • تاریخ بازنگری: 10 تیر 1399
  • تاریخ پذیرش: 10 تیر 1399
  • تاریخ اولین انتشار: 10 تیر 1399