CELL:先天性免疫标志物区分新冠高危患者

2020-08-07 MedSci原创 MedSci原创

已有的研究显示,SARS-CoV-2引起的冠状病毒病(COVID-19)患者存在血液髓细胞的失调。但是,目前我们尚不清楚先天性髓细胞反应是否随疾病严重程度而出现不同.

2019年冠状病毒病(COVID-19)是由严重的急性呼吸道综合征冠状病毒2(SARS-CoV-2)引起的,它感染肺部,并导致患者出现发热、咳嗽和呼吸困难等表型。

大多数表现为轻度疾病的患者会发展出高效的免疫反应,但一些患者会继续发展出急性呼吸窘迫综合征,导致其进入重症监护室(ICU),并可能最终引起多器官功能障碍和死亡。

除了病毒感染的细胞自主作用外,免疫反应失调也参与了COVID-19患者病情的突然恶化,最后严重损伤感染和非感染的组织。

已有的研究显示,SARS-CoV-2引起的冠状病毒病(COVID-19)患者存在血液髓细胞的失调。但是,目前我们尚不清楚先天性髓细胞反应是否随疾病严重程度而出现不同,以及先天性免疫的标志物是否能区分高危患者。

因此,在最近CELL杂志发表的一项研究中,研究人员对COVID-19患者外周血细胞进行了高维流式细胞术和单细胞RNA测序。

这项非干预性研究共纳入158例患者,其中包括86例新冠患者和72例对照组,受试者因各种流感样症状转诊到医院,根据咽拭子的RT-PCR阳性和阴性分别诊断是否患有COVID-19。

根据疾病严重程度对患者进行分层:轻度疾病(n=27)定义为无临床症状或局限性临床症状,不需要进行CT扫描或住院治疗;中度疾病(n=16)定义为有症状,有呼吸困难,胸部CT扫描放射学发现肺炎,需要住院治疗,但最多吸氧9L/min;重度疾病(n=43)定义为呼吸困难,需要进入重症监护室(ICU)。

为了探讨SARS-CoV-2感染引起的循环免疫细胞的变化表型,研究人员首先收集了一个发现队列的外周血样本。经RT-PCR检测到13名SARS-CoV-2阳性的患者(以下简称 "COVID-19患者")和12名有流感样症状的非新冠患者。前一組包括5名轻度患者和8名重度COVID-19患者。经过红血细胞裂解,研究人员用25种识别外周血细胞的表面抗体进行标记。并通过流式细胞仪分析其组分。

研究人员发现,在严重病例中,非经典CD14LowCD16High单核细胞消失,HLA-DRLow经典单核细胞积累,大量钙蛋白(S100A8/S100A9)释放。

在血液和肺部也积累了具有免疫抑制作用的不成熟CD10LowCD101-CXCR4+/-中性粒细胞,提示患者有紧急骨髓增生。

最后,研究人员表明,根据血浆中钙蛋白水平变化和非经典单核细胞频率的降低可以鉴别重度新冠患者,其具有一定的预测价值,值得前瞻性评价。

 

原始出处:

Aymeric Silvin et al. Elevated calprotectin and abnormal myeloid cell subsets discriminate severe from mild COVID-19, CELL (2020). DOI:https://doi.org/10.1016/j.cell.2020.08.002

 

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    2020-11-02 维他命
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    2020-10-17 huwen_mc

    calprotectin是钙卫蛋白,不是钙

    0

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    2020-08-09 huirong
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    2020-08-07 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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    2020-08-07 新斯的明

    学习

    0

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