PDF(Pubmed)
Abstract：
An overly exuberant immune response, characterized by a cytokine storm and uncontrolled inflammation, has been identified as a significant driver of severe coronavirus disease 2019 (COVID-19) cases. Consequently, deciphering the intricacies of immune dysregulation in COVID-19 is imperative to identify specific targets for intervention and modulation. With these delicate dynamics in mind, immunomodulatory therapies have emerged as a promising avenue for mitigating the challenges posed by COVID-19. Precision in manipulating immune pathways presents an opportunity to alter the host response, optimizing antiviral defenses while curbing deleterious inflammation. This review article comprehensively analyzes immunomodulatory interventions in managing COVID-19. We explore diverse approaches to mitigating the hyperactive immune response and its impact, from corticosteroids and non-steroidal drugs to targeted biologics, including anti-viral drugs, cytokine inhibitors, JAK inhibitors, convalescent plasma, monoclonal antibodies (mAbs) to severe acute respiratory syndrome coronavirus 2, cell-based therapies (i.e., CAR T, etc.). By summarizing the current evidence, we aim to provide a clear roadmap for clinicians and researchers navigating the complex landscape of immunomodulation in COVID-19 treatment.
摘要：
过度旺盛的免疫反应，以细胞因子风暴和不受控制的炎症为特征，已被确定为2019年严重冠状病毒病(COVID-19)病例的重要驱动因素。因此,破译COVID-19中免疫失调的复杂性对于确定干预和调节的特定靶标至关重要。考虑到这些微妙的动态，免疫调节疗法已成为缓解COVID-19带来的挑战的有希望的途径。精确操纵免疫途径提供了改变宿主反应的机会，优化抗病毒防御，同时遏制有害的炎症。这篇综述文章全面分析了免疫调节干预措施在管理COVID-19中的作用。我们探索了多种方法来减轻过度活跃的免疫反应及其影响，从皮质类固醇和非甾体药物到靶向生物制剂，包括抗病毒药物,细胞因子抑制剂，JAK抑制剂,恢复期血浆,严重急性呼吸综合征冠状病毒2的单克隆抗体(mAb)，基于细胞的疗法(即CART,等。).通过总结目前的证据,我们的目标是为临床医生和研究人员在COVID-19治疗中复杂的免疫调节领域提供清晰的路线图.
