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The impact of COVID-19 on liver injury in various age. COVID-19对不同年龄肝损伤的影响。
Pub Date : 2023-03-25 DOI: 10.5501/wjv.v12.i2.91
Amin Sadeghi Dousari, Seyed Soheil Hosseininasab, Fatemeh Sadeghi Dousari, Masoumeh Fuladvandi, Naghmeh Satarzadeh

The coronavirus disease 2019 (COVID-19) disease was first detected in December 2019 in Wuhan, China. This disease is currently one of the most important global health problems. The novel coronavirus COVID-19 is a respiratory illness, that has caused a deadly pandemic that is spreading rapidly around the world. It is not only a respiratory system virus that causes severe lung disease, but also a systemic disease agent that can affect all systems. People with COVID-19 disease usually have respiratory signs, however, the liver disorder is not an uncommon presentation. In addition, many studies around the world have revealed that the liver is injured to various degrees in patients with severe acute respiratory syndrome coronavirus 2 disease. This review mainly focuses on the impact of COVID-19 on Liver Injury at various ages.

2019年12月,中国武汉首次发现新型冠状病毒病(COVID-19)。这种疾病目前是最重要的全球卫生问题之一。新型冠状病毒COVID-19是一种呼吸道疾病,已引起致命的大流行,正在全球迅速蔓延。它不仅是一种引起严重肺部疾病的呼吸系统病毒,而且是一种可以影响所有系统的全身性疾病因子。患有COVID-19疾病的人通常有呼吸症状,然而,肝脏疾病并不罕见。此外,世界各地的许多研究表明,严重急性呼吸系统综合征冠状病毒患者的肝脏有不同程度的损伤。本文主要综述COVID-19对不同年龄段肝损伤的影响。
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引用次数: 0
Effect of SARS-CoV-2 infection on the liver. SARS-CoV-2感染对肝脏的影响
Pub Date : 2023-03-25 DOI: 10.5501/wjv.v12.i2.109
Adekunle Sanyaolu, Aleksandra Marinkovic, Abu Fahad Abbasi, Stephanie Prakash, Risha Patidar, Priyank Desai, Martina Williams, Abdul Jan, Kareem Hamdy, Rachael Solomon, Vyshnavy Balendra, Maaz Ansari, Omar Shazley, Nasar Khan, Rochelle Annan, Yashika Dixon, Chuku Okorie, Afolabi Antonio

There have been numerous concerns about the disease and how it affects the human body since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began in December 2019. The impact of SARS-CoV-2 on the liver is being carefully investigated due to an increase in individuals with hepatitis and other liver illnesses, such as alcoholic liver disease. Additionally, the liver is involved in the metabolism of numerous drugs used to treat comorbidities and coronavirus disease 2019 (COVID-19). Determining how SARS-CoV-2 affects the liver and what factors place individuals with COVID-19 at a higher risk of developing liver problems are the two main objectives of this study. This evaluation of the literature included research from three major scientific databases. To provide an update on the current impact of COVID-19 on the liver, data was collected and relevant information was incorporated into the review. With more knowledge about the effect of the disease on the liver, better management and therapeutics can be developed, and education can ultimately save lives and reduce the long-term impact of the pandemic on our population.

自2019年12月严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2)大流行开始以来,人们对这种疾病及其对人体的影响有很多担忧。由于肝炎和其他肝脏疾病(如酒精性肝病)患者的增加,正在仔细调查SARS-CoV-2对肝脏的影响。此外,肝脏还参与许多用于治疗合并症和2019年冠状病毒病(COVID-19)的药物的代谢。确定SARS-CoV-2如何影响肝脏以及哪些因素使COVID-19患者患肝脏问题的风险更高是本研究的两个主要目标。对文献的评估包括来自三个主要科学数据库的研究。为了提供关于当前COVID-19对肝脏影响的最新信息,收集了数据并将相关信息纳入了综述。随着对该疾病对肝脏影响的更多了解,可以开发更好的管理和治疗方法,教育最终可以挽救生命并减少该流行病对我们人口的长期影响。
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引用次数: 1
Severe acute respiratory syndrome coronavirus 2 may cause liver injury via Na+/H+ exchanger. 严重急性呼吸综合征冠状病毒2型可通过Na+/H+交换剂引起肝损伤。
Pub Date : 2023-01-25 DOI: 10.5501/wjv.v12.i1.12
Medine Cumhur Cure, Erkan Cure

The liver has many significant functions, such as detoxification, the urea cycle, gluconeogenesis, and protein synthesis. Systemic diseases, hypoxia, infections, drugs, and toxins can easily affect the liver, which is extremely sensitive to injury. Systemic infection of severe acute respiratory syndrome coronavirus 2 can cause liver damage. The primary regulator of intracellular pH in the liver is the Na+/H+ exchanger (NHE). Physiologically, NHE protects hepatocytes from apoptosis by making the intracellular pH alkaline. Severe acute respiratory syndrome coronavirus 2 increases local angiotensin II levels by binding to angiotensin-converting enzyme 2. In severe cases of coronavirus disease 2019, high angi-otensin II levels may cause NHE overstimulation and lipid accumulation in the liver. NHE overstimulation can lead to hepatocyte death. NHE overstimulation may trigger a cytokine storm by increasing proinflammatory cytokines in the liver. Since the release of proinflammatory cytokines such as interleukin-6 increases with NHE activation, the virus may indirectly cause an increase in fibrinogen and D-dimer levels. NHE overstimulation may cause thrombotic events and systemic damage by increasing fibrinogen levels and cytokine release. Also, NHE overstimulation causes an increase in the urea cycle while inhibiting vitamin D synthesis and gluconeogenesis in the liver. Increasing NHE3 activity leads to Na+ loading, which impairs the containment and fluidity of bile acid. NHE overstimulation can change the gut microbiota composition by disrupting the structure and fluidity of bile acid, thus triggering systemic damage. Unlike other tissues, tumor necrosis factor-alpha and angiotensin II decrease NHE3 activity in the intestine. Thus, increased luminal Na+ leads to diarrhea and cytokine release. Severe acute respiratory syndrome coronavirus 2-induced local and systemic damage can be improved by preventing virus-induced NHE overstimulation in the liver.

肝脏有许多重要的功能,如解毒、尿素循环、糖异生和蛋白质合成。全身性疾病、缺氧、感染、药物和毒素都容易影响对损伤极其敏感的肝脏。严重急性呼吸综合征冠状病毒2的全身感染可导致肝脏损伤。肝脏细胞内pH的主要调节因子是Na+/H+交换剂(NHE)。生理上,NHE通过使细胞内pH值呈碱性来保护肝细胞免于凋亡。严重急性呼吸综合征冠状病毒2通过结合血管紧张素转换酶2增加局部血管紧张素II水平。在2019冠状病毒病的严重病例中,高血管紧张素II水平可能导致NHE过度刺激和肝脏脂质积累。NHE过度刺激可导致肝细胞死亡。NHE过度刺激可通过增加肝脏中的促炎细胞因子引发细胞因子风暴。由于促炎细胞因子如白细胞介素-6的释放随着NHE的激活而增加,病毒可能间接引起纤维蛋白原和d -二聚体水平的增加。NHE过度刺激可通过增加纤维蛋白原水平和细胞因子释放引起血栓形成事件和全身损伤。此外,NHE过度刺激导致尿素循环增加,同时抑制肝脏中维生素D的合成和糖异生。NHE3活性的增加导致Na+负载,从而损害胆汁酸的包容性和流动性。NHE过度刺激可通过破坏胆汁酸的结构和流动性来改变肠道菌群组成,从而引发全身损伤。与其他组织不同,肿瘤坏死因子- α和血管紧张素II可降低肠道内NHE3活性。因此,增加腔内Na+导致腹泻和细胞因子释放。通过预防病毒诱导的肝脏NHE过度刺激,可以改善严重急性呼吸综合征冠状病毒2型引起的局部和全身损伤。
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引用次数: 0
Commentary on COVID-19-induced liver injury in various age and risk groups. 不同年龄和危险人群新冠肺炎致肝损伤情况述评
Pub Date : 2023-01-25 DOI: 10.5501/wjv.v12.i1.44
Öner Özdemir, Hacer Efnan Melek Arsoy

Towards the end of 2019, a new type of coronavirus, severe acute respiratory syndrome, emerged in the city of Wuhan in China's Hubei Province. The first occurrence was described as a case of pneumonia. Coronavirus disease 2019 (COVID-19) can progress primarily with symptoms varying from a mild upper respiratory tract infection to severe pneumonia, acute respiratory distress syndrome, and death. Determining the mechanisms of action of this virus, which can affect all systems including gastrointestinal, is vital for predicting the progression of the disease and managing its treatment. It is important to demonstrate the mechanisms of action of COVID-19 in patients without a previously known chronic or systemic disease. Although there is still no specific treatment for the virus, various algorithms have been created. As a result of the applied algorithms, the response to the treatment was satisfactory in some patients, while unexpected side effects occurred in some patients. It helps to clarify whether the unwanted effects that occur are due to the effect of the disease or the side effects of the drugs used in the treatment. There is currently increasing interest in COVID-19 interaction with liver tissue. Therefore, we would like to discuss the details of liver injury/dysfunction in the current literature.

2019年底,中国湖北省武汉市出现了一种新型冠状病毒——严重急性呼吸系统综合征。第一次发病被描述为肺炎病例。2019冠状病毒病(COVID-19)的进展主要表现为症状,从轻度上呼吸道感染到严重肺炎、急性呼吸窘迫综合征和死亡。这种病毒可影响包括胃肠道在内的所有系统,确定其作用机制对于预测疾病进展和管理其治疗至关重要。重要的是要证明COVID-19在以前没有已知慢性或全身性疾病的患者中的作用机制。虽然目前还没有针对这种病毒的特异性治疗方法,但各种算法已经被创造出来。由于应用的算法,一些患者对治疗的反应是满意的,而一些患者出现了意想不到的副作用。它有助于澄清发生的不良反应是由于疾病的影响还是治疗中使用的药物的副作用。目前,人们对COVID-19与肝组织的相互作用越来越感兴趣。因此,我们想讨论当前文献中肝损伤/功能障碍的细节。
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引用次数: 0
COVID-19-related liver injury: Focus on genetic and drug-induced perspectives. covid -19相关肝损伤:关注遗传和药物诱导的观点
Pub Date : 2023-01-25 DOI: 10.5501/wjv.v12.i1.53
Deepak Parchwani, Amit D Sonagra, Sagar Dholariya, Anita Motiani, Ragini Singh

Background: Empirical use of potentially hepatotoxic drugs in the management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is considered as one of the major etiopathogenetic factors for liver injury. Recent evidence has shown that an underlying genetic factor may also occur. Hence, it is important to understand the host genetics and iatrogenic-based mechanisms for liver dysfunction to make timely remedial measures.

Aim: To investigate drug-induced and genetic perspectives for the development of coronavirus disease 2019 (COVID-19)-related liver injury.

Methods: Reference Citation Analysis, PubMed, Google Scholar and China National Knowledge Infrastructure were searched by employing the relevant MeSH keywords and pertaining data of the duration, site and type of study, sample size with any subgroups and drug-induced liver injury outcome. Genetic aspects were extracted from the most current pertinent publications.

Results: In all studies, the hepatic specific aminotransferase and other biochemical indices were more than their prescribed upper normal limit in COVID-19 patients and were found to be significantly related with the gravity of disease, hospital stay, number of COVID-19 treatment drugs and worse clinical outcomes. In addition, membrane bound O-acyltransferase domain containing 7 rs641738, rs11385942 G>GA at chromosome 3 gene cluster and rs657152 C>A at ABO blood locus was significantly associated with severity of livery injury in admitted SARS-CoV-2 patients.

Conclusion: Hepatic dysfunction in SARS-CoV-2 infection could be the result of individual drugs or due to drug-drug interactions and may be in a subset of patients with a genetic propensity. Thus, serial estimation of hepatic indices in hospitalized SARS-CoV-2 patients should be done to make timely corrective actions for iatrogenic causes to avoid clinical deterioration. Additional molecular and translational research is warranted in this regard.

背景:在严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)感染的治疗中经经验使用潜在肝毒性药物被认为是肝损伤的主要致病因素之一。最近的证据表明,潜在的遗传因素也可能发生。因此,了解肝功能障碍的宿主遗传学和医源性机制对及时采取治疗措施具有重要意义。目的:探讨2019冠状病毒病(COVID-19)相关肝损伤的药物诱导和遗传机制。方法:采用文献引用分析、PubMed、Google Scholar和中国国家知识基础设施检索相关MeSH关键词和研究持续时间、研究地点和研究类型、各亚组样本量和药物性肝损伤结局的相关数据。遗传方面是从最新的相关出版物中提取的。结果:在所有研究中,COVID-19患者的肝脏特异性转氨酶等生化指标均高于规定的正常上限,并与病情严重程度、住院时间、COVID-19治疗药物数量及较差的临床结局显著相关。此外,膜结合o -酰转移酶结构域在3号染色体上含有7个rs641738、rs11385942 G>GA基因簇和ABO血位点含有rs657152 C>A基因簇与入院的SARS-CoV-2患者肝脏损伤的严重程度显著相关。结论:SARS-CoV-2感染的肝功能障碍可能是个体药物或药物相互作用的结果,可能存在于具有遗传倾向的患者亚群中。因此,应对住院SARS-CoV-2患者的肝脏指标进行系列评估,及时对医源性原因采取纠正措施,避免临床恶化。在这方面需要进一步的分子和翻译研究。
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引用次数: 0
Joint replacement and human immunodeficiency virus. 关节置换和人类免疫缺陷病毒。
Pub Date : 2023-01-25 DOI: 10.5501/wjv.v12.i1.1
Maryam Salimi, Peyman Mirghaderi, Seyedarad Mosalamiaghili, Ali Mohammadi, Amirhossein Salimi

The incidence of human immunodeficiency virus (HIV)-infected cases that need total joint replacement (TJR) is generally rising. On the other hand, modern management of HIV-infected cases has enabled them to achieve longevity while increasing the need for arthroplasty procedures due to the augmented dege-nerative joint disease and fragility fractures, and the risk of osteonecrosis. Although initial investigations on joint replacement in HIV-infected cases showed a high risk of complications, the recent ones reported acceptable outcomes. It is a matter of debate whether HIV-infected cases are at advanced risk for adverse TJR consequences; however, the weak immune profile has been associated with an increased probability of complications. Likewise, surgeons and physicians should be aware of the complication rate after TJR in HIV-infected cases and include an honest discussion of the probable unwelcoming complication with their patients contemplating TJR. Therefore, a fundamental review and understanding of the interaction of HIV and arthroplasty are critical.

人类免疫缺陷病毒(HIV)感染病例需要全关节置换术(TJR)的发生率普遍上升。另一方面,对艾滋病毒感染病例的现代管理使他们能够长寿,同时由于退行性关节疾病和脆性骨折的增加以及骨坏死的风险,增加了对关节置换手术的需求。虽然对艾滋病毒感染病例的关节置换术的初步调查显示并发症的风险很高,但最近的调查报告了可接受的结果。艾滋病毒感染者是否处于TJR不良后果的高风险中,这是一个有争议的问题;然而,较弱的免疫状况与并发症的可能性增加有关。同样,外科医生和内科医生应了解艾滋病毒感染病例TJR后的并发症发生率,并与考虑TJR的患者诚实地讨论可能出现的不受欢迎的并发症。因此,对HIV和关节置换术的相互作用进行基本的回顾和理解是至关重要的。
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引用次数: 0
Association between COVID-19 and chronic liver disease: Mechanism, diagnosis, damage, and treatment. COVID-19 与慢性肝病的关系:机制、诊断、损害和治疗。
Pub Date : 2023-01-25 DOI: 10.5501/wjv.v12.i1.22
Ruo-Bing Qi, Zheng-Hao Wu

As the outbreak evolves, our understanding of the consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (COVID-19) on the liver has grown. In this review, we discussed the hepatotropic nature of SARS-CoV-2 and described the distribution of receptors for SARS-CoV-2 (e.g., angiotensin-converting enzyme 2) in the vascular endothelium and cholangiocytes of the liver. Also, we proposed mechanisms for possible viral entry that mediate liver injury, such as liver fibrosis. Due to SARS-CoV-2-induced liver damage, many COVID-19 patients develop liver dysfunction, mainly characterized by moderately elevated serum aminotransferase levels. Patients with chronic liver disease (CLD), such as cirrhosis, hepatocellular carcinoma, nonalcoholic fatty liver disease, and viral hepatitis, are also sensitive to SARS-CoV-2 infection. We discussed the longer disease duration and higher mortality following SARS-CoV-2 infection in CLD patients. Correspondingly, relevant risk factors and possible mechanisms were proposed, including cirrhosis-related immune dysfunction and liver deco-mpensation. Finally, we discussed the potential hepatotoxicity of COVID-19-related vaccines and drugs, which influence the treatment of CLD patients with SARS-CoV-2 infection. In addition, we suggested that COVID-19 vaccines in terms of immunogenicity, duration of protection, and long-term safety for CLD patients need to be further researched. The diagnosis and treatment for liver injury caused by COVID-19 were also analyzed in this review.

随着疫情的发展,我们对严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)感染和由此引发的冠状病毒病 2019(COVID-19)对肝脏的影响有了更多的了解。在这篇综述中,我们讨论了 SARS-CoV-2 的致肝性,并描述了 SARS-CoV-2 受体(如血管紧张素转换酶 2)在肝脏血管内皮细胞和胆管细胞中的分布。此外,我们还提出了可能的病毒进入机制,以介导肝损伤,如肝纤维化。由于 SARS-CoV-2 引起的肝损伤,许多 COVID-19 患者出现肝功能障碍,主要表现为血清转氨酶水平中度升高。慢性肝病(CLD)患者,如肝硬化、肝细胞癌、非酒精性脂肪肝和病毒性肝炎,对 SARS-CoV-2 感染也很敏感。我们讨论了 CLD 患者感染 SARS-CoV-2 后病程更长、死亡率更高。相应地,我们提出了相关的危险因素和可能的机制,包括与肝硬化相关的免疫功能障碍和肝脏解代偿。最后,我们讨论了 COVID-19 相关疫苗和药物的潜在肝毒性,这影响了感染 SARS-CoV-2 的 CLD 患者的治疗。此外,我们还建议对 COVID-19 疫苗的免疫原性、保护持续时间以及对 CLD 患者的长期安全性进行进一步研究。本综述还分析了由 COVID-19 引起的肝损伤的诊断和治疗。
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引用次数: 0
COVID-19 in patients with pre-existing chronic liver disease - predictors of outcomes. COVID-19在原有慢性肝病患者中的应用--结果预测因素。
Pub Date : 2023-01-25 DOI: 10.5501/wjv.v12.i1.30
Dinesh Walia, Anoop Saraya, Deepak Gunjan

Coronavirus disease 2019 (COVID-19) has affected patients with pre-existing chronic liver disease (CLD) in various ways. The maximum impact was seen on patients with underlying cirrhosis who have shown to have poor clinical outcomes in the form of increased risk of hepatic decompensation, acute-on-chronic liver failure, and even mortality. It is of paramount importance to identify various factors which are associated with unfavorable outcomes for prognostication and making informed management strategy. Many factors have been evaluated in different studies in patients with underlying CLD. Some of these factors include the severity of underlying chronic liver disease, comorbid conditions, age, and severity of COVID-19. Overall, the outcomes are not fav-orable in patients with cirrhosis as evidenced by data from various studies. The main purpose of this review is to identify the predictors of adverse clinical outcomes including mortality in patients with CLD for risk stratification, prognostication, and appropriate clinical management.

冠状病毒病 2019(COVID-19)对原有慢性肝病(CLD)患者造成了不同程度的影响。影响最大的是有潜在肝硬化的患者,他们的临床预后较差,表现为肝功能失代偿、急性-慢性肝功能衰竭甚至死亡的风险增加。确定与不良预后相关的各种因素对于预后判断和制定明智的管理策略至关重要。不同的研究对潜在慢性肝衰竭患者的许多因素进行了评估。其中一些因素包括基础慢性肝病的严重程度、合并症、年龄和 COVID-19 的严重程度。总体而言,不同研究的数据表明,肝硬化患者的治疗效果并不理想。本综述的主要目的是确定肝硬化患者不良临床结局(包括死亡率)的预测因素,以便进行风险分层、预后判断和适当的临床管理。
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引用次数: 0
Dipeptidyl peptidase 4 inhibitors in COVID-19: Beyond glycemic control. 二肽基肽酶4抑制剂在COVID-19中的作用:超出血糖控制范围
Pub Date : 2022-11-25 DOI: 10.5501/wjv.v11.i6.399
Niya Narayanan, Dukhabandhu Naik, Jayaprakash Sahoo, Sadishkumar Kamalanathan

Coronavirus disease 2019 (COVID-19) is associated with a high risk of mortality and complications in patients with diabetes mellitus. Achieving good glycemic control is very important in diabetic patients to reduce complications and mortality due to COVID-19. Recent studies have shown the mortality benefit and anti-inflammatory effects of Dipeptidyl-peptidase-4 inhibitors (DPP-4i) in diabetic patients with COVID-19. DPP-4i may have a beneficial role in halting the severity of infection primarily by three routes, namely viral entry inhibition, anti-inflammatory and anti-fibrotic effects and glycemic control. This has raised the pro-mising hypothesis that DPP-4i might be an optimal strategy for treating COVID-19 in patients with diabetes. This review aims to summarise the possible therapeutic non-glycemic effects of DPP-4i in diabetic patients diagnosed with COVID-19 in the light of available evidence.

2019冠状病毒病(COVID-19)与糖尿病患者的高死亡率和并发症风险相关。实现良好的血糖控制对于减少新冠肺炎引起的并发症和死亡率非常重要。最近的研究表明,二肽基肽酶-4抑制剂(DPP-4i)在糖尿病合并COVID-19患者中的死亡率降低和抗炎作用。DPP-4i可能主要通过三种途径在阻止感染的严重程度方面发挥有益作用,即抑制病毒进入、抗炎和抗纤维化作用以及控制血糖。这提出了一个有希望的假设,即DPP-4i可能是治疗糖尿病患者COVID-19的最佳策略。本综述旨在根据现有证据总结DPP-4i对诊断为COVID-19的糖尿病患者可能的非血糖治疗作用。
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引用次数: 3
Monkeypox: An emerging zoonotic pathogen. 猴痘:一种新出现的人畜共患病原体。
Pub Date : 2022-11-25 DOI: 10.5501/wjv.v11.i6.426
Masoumeh Beig, Mehrdad Mohammadi, Fatemeh Nafe Monfared, Somaieh Nasereslami

Monkeypox virus (MPXV), which belongs to the orthopoxvirus genus, causes zoonotic viral disease. This review discusses the biology, epidemiology, and evolution of MPXV infection, particularly cellular, human, and viral factors, virus transmission dynamics, infection, and persistence in nature. This review also describes the role of recombination, gene loss, and gene gain in MPXV evol-vement and the role of signal transduction in MPXV infection and provides an overview of the current access to therapeutic options for the treatment and prevention of MPXV. Finally, this review highlighted gaps in knowledge and proposed future research endeavors to address the unresolved questions.

猴痘病毒(MPXV)属于正痘病毒属,可引起人畜共患的病毒性疾病。本综述讨论了 MPXV 感染的生物学、流行病学和进化,特别是细胞、人类和病毒因素、病毒传播动态、感染和在自然界中的持续存在。本综述还介绍了重组、基因缺失和基因增殖在 MPXV 进化中的作用,以及信号转导在 MPXV 感染中的作用,并概述了目前治疗和预防 MPXV 的治疗方案。最后,这篇综述强调了知识空白,并提出了未来研究工作的建议,以解决悬而未决的问题。
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引用次数: 0
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世界病毒学杂志(英文版)
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