实体器官移植受者感染新冠病毒后免疫抑制方案调整进展
DOI:
https://doi.org/10.70693/cjmsr.v1i3.1533Keywords:
实体器官移植；新型冠状病毒；免疫抑制剂Abstract
新型冠状病毒（SARS CoV-2）自2019年11月首次被报道于武汉起便肆虐于全球。随着时间的推移，新冠病毒不断发生突变和重组，产生了各种新的变异株。尽管目前病毒变异株的致病性和毒力已逐渐降低，但实体器官移植（solid organ transplant，SOT）受者作为新冠病毒感染的易感人群，重症率、死亡率及再感染率仍较高。本文将通过新冠病毒致病机制综述对于SOT受者常见免疫抑制方案调整进展，以期改善SOT受者感染新冠病毒的预后。
References
王有娜, 曹霞, 黄毅, 等. 实体器官移植受者感染新型冠状病毒临床治疗及管理的研究进展[J]. 武汉大学学报(医学版), 2023,44(12):1435-1440.
Ranabothu S, Kanduri S R, Nalleballe K, et al. Outcomes of COVID-19 in Solid Organ Transplants[J]. Cureus, 2020,12(11):e11344.
中华人民共和国国家卫生健康委员会. 新型冠状病毒感染诊疗方案（试行第十版）[J]. 中国合理用药探索, 2023,20(01):1-11.
马思旻, 赖晓全, 谭昆. 新型冠状病毒XBB变异株研究进展[J]. 中华医院感染学杂志, 2024(02):304-309.
中国疾病预防控制中心[EB/OL]. [2024-02-13]. https://www.chinacdc.cn/jkzt/crb/zl/szkb_11803/jszl_13141/202401/t20240110_271902.html.
Ngiam J N, Al-Mubaarak A, Maurer-Stroh S, et al. Does the COVID-19 XBB Omicron subvariant signal the beginning of the end of the pandemic?[J]. Singapore Med J, 2022.
Liu H, Xu X, Deng X, et al. Counterfactual analysis of the 2023 Omicron XBB wave in China[J]. Infect Dis Model, 2024,9(1):195-203.
Tan C Y, Chiew C J, Pang D, et al. Protective immunity of SARS-CoV-2 infection and vaccines against medically attended symptomatic omicron BA.4, BA.5, and XBB reinfections in Singapore: a national cohort study[J]. Lancet Infect Dis, 2023,23(7):799-805.
Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor[J]. Cell, 2020,181(2):271-280.
Dejnirattisai W, Zhou D, Ginn H M, et al. The antigenic anatomy of SARS-CoV-2 receptor binding domain[J]. Cell, 2021,184(8):2183-2200.
Zou X, Chen K, Zou J, et al. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection[J]. Front Med, 2020,14(2):185-192.
Kuba K, Imai Y, Rao S, et al. Lessons from SARS: control of acute lung failure by the SARS receptor ACE2[J]. J Mol Med (Berl), 2006,84(10):814-820.
王潇, 张静. 新型冠状病毒感染引起的免疫功能变化[J]. 中国实用内科杂志, 2023,43(09):709-713.
Shafqat A, Shafqat S, Salameh S A, et al. Mechanistic Insights Into the Immune Pathophysiology of COVID-19; An In-Depth Review[J]. Front Immunol, 2022,13:835104.
Schoot T S, Kerckhoffs A, Hilbrands L B, et al. Immunosuppressive Drugs and COVID-19: A Review[J]. Front Pharmacol, 2020,11:1333.
Sharma A, Bhatt N S, Hijano D R. Clinical experience of coronavirus disease 2019 in hematopoietic cell transplant and chimeric antigen receptor T-cell recipients[J]. Curr Opin Hematol, 2021,28(6):394-400.
艾静文, 陈文慧, 顾言阁, 等. 实体器官移植受者新型冠状病毒感染诊疗专家共识（2023年版）[J]. 器官移植, 2023,14(02):163-182.
Colmenero J, Rodriguez-Peralvarez M, Salcedo M, et al. Epidemiological pattern, incidence, and outcomes of COVID-19 in liver transplant patients[J]. J Hepatol, 2021,74(1):148-155.
Thieme C J, Anft M, Paniskaki K, et al. The Magnitude and Functionality of SARS-CoV-2 Reactive Cellular and Humoral Immunity in Transplant Population Is Similar to the General Population Despite Immunosuppression[J]. Transplantation, 2021,105(10):2156-2164.
Kolla E, Weill A, Zaidan M, et al. COVID-19 Hospitalization in Solid Organ Transplant Recipients on Immunosuppressive Therapy[J]. JAMA Netw Open, 2023,6(11):e2342006.
Belli L S, Fondevila C, Cortesi P A, et al. Protective Role of Tacrolimus, Deleterious Role of Age and Comorbidities in Liver Transplant Recipients With Covid-19: Results From the ELITA/ELTR Multi-center European Study[J]. Gastroenterology, 2021,160(4):1151-1163.
Kolonko A, Kuczaj A A, Musialik J, et al. Clinical insights into the role of immunosuppression in solid organ transplant recipients with COVID-19[J]. Pol Arch Intern Med, 2022,132(2).
Salerno D M, Kovac D, Corbo H, et al. SARS-CoV-2 infection increases tacrolimus concentrations in solid-organ transplant recipients[J]. Clin Transplant, 2021,35(3):e14193.
巨春蓉, 王梅英, 袁静, 等. 免疫缺陷人群新型冠状病毒感染诊治策略中国专家共识(2023.V2版)[J]. 中国感染控制杂志, 2023,22(12):1411-1424.
吴基华, 文宁, 马茜华, 等. 实体器官移植受者围术期新型冠状病毒感染诊疗广西方案[J]. 广西医科大学学报, 2023,40(04):702-708.
李纳, 汤姝, 朱振峰, 等. 肾移植术后应用咪唑立宾和吗替麦考酚酯的有效性和安全性Meta分析[J]. 中国医院药学杂志, 2018,38(10):1102-1109.
卫芬, 李宁, 王明君, 等. 肾移植受者新型冠状病毒肺炎的流行病学特征：单中心回顾性研究[J]. 器官移植, 2023,14(05):700-707.
Horby P, Lim W S, Emberson J R, et al. Dexamethasone in Hospitalized Patients with Covid-19[J]. N Engl J Med, 2021,384(8):693-704.
Pinchera B, Spirito L, Buonomo A R, et al. mTOR Inhibitor Use Is Associated With a Favorable Outcome of COVID-19 in Patients of Kidney Transplant: Results of a Retrospective Study[J]. Front Med (Lausanne), 2022,9:852973.
张帆, 邢益平. 哺乳动物雷帕霉素靶蛋白抑制剂降低肾移植受者人巨细胞病毒感染的研究进展[J]. 中国感染控制杂志, 2020,19(07):666-670.
Mullen P J, Garcia G J, Purkayastha A, et al. SARS-CoV-2 infection rewires host cell metabolism and is potentially susceptible to mTORC1 inhibition[J]. Nat Commun, 2021,12(1):1876.
李秀惠, 刘清泉, 齐文升, 等. 北京市新型冠状病毒肺炎中医药防治方案（试行第六版）[J]. 北京中医药, 2022,41(05):509-511.
王成祥, 冯淬灵, 于会勇, 等. 新型冠状病毒感染恢复期中医药综合干预方案(试行第二版)[J]. 北京中医药, 2023,42(01):40-43.
北京协和医院新型冠状病毒感染基层诊疗建议多学科专家组. 北京协和医院新型冠状病毒感染基层诊疗建议(2023)[J]. 协和医学杂志, 2023,14(01):60-74.
Abbasi J. What to Know About EG.5, the Latest SARS-CoV-2 "Variant of Interest"[J]. JAMA, 2023,330(10):900-901.
Burack D, Pereira M R, Tsapepas D S, et al. Prevalence and predictors of SARS-CoV-2 antibodies among solid organ transplant recipients with confirmed infection[J]. Am J Transplant, 2021,21(6):2254-2261.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 刘越, 乔鹏飞, 符洋, 黄良飞, 刘金琦, 王洪良 (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
