接受IL-6受体拮抗剂治疗的COVID-19患者免疫状态参数动态变化

Q4 Immunology and Microbiology Immunologiya Pub Date : 2022-01-01 DOI:10.33029/0206-4952-2022-43-2-188-196
L. Sizyakina, N. Skripkina, E. Antonova, V. Zakurskaya, D. Sizyakin
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引用次数: 1

摘要

介绍。及时给予靶向治疗的COVID-19患者积极的细胞因子风暴治疗是成功治疗该疾病的重要组成部分。然而,受体对促炎细胞因子的阻断,特别是对IL-6的阻断,会导致免疫调节过程的改变,其性质可以决定治疗的有效性和患者在covid后康复期间的进程。本研究的目的是利用IL-6受体拮抗剂研究COVID-19患者先天免疫和适应性免疫参数的动态变化。材料和方法。对30例住院患者进行检查,诊断:新型冠状病毒感染(确诊),中度;并发症:双侧多节段性肺炎。对照组由实际健康的捐赠者(30人)组成。在使用IL-6阻滞剂治疗的背景下,对实验室参数(一般临床、生化和免疫学)的动态进行评估。结果。患者存在淋巴细胞减少,CRP、LTK、纤维蛋白原、乳酸、IL-6水平升高,需要采用主动抗细胞因子治疗。及时给予这些药物(特别是IL-6受体抑制剂)对疾病的病程和患者的康复有积极的作用。在免疫系统中,在引入针对IL-6受体的单克隆抗体后,给药2周后,t淋巴细胞的成熟程度增加,具有辅助功能的t淋巴细胞含量增加,同时自然杀手、b淋巴细胞和IgA、IgM和IgG类非免疫球蛋白血症的数量减少。结论。在中度COVID-19患者中使用针对IL-6受体的单克隆抗体会导致免疫系统的失调过程,并在给药后2周逐渐正常化。
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Dynamics of immune status parameters in patients with COVID-19, receiving therapy with inclusion of an IL-6 receptor antagonist
Introduction. Timely prescribing of proactive cytokine storm therapy in patients with COVID-19 using targeted therapy is an important component of success in the treatment of this disease. However, the blockade of receptors to proinflammatory cytokines, in particular to IL-6, leads to shifts in immunoregulatory processes, the nature of which can determine the effectiveness of the therapy and the course of the postCOVID period of rehabilitation of the patient. The aim of the study - to study the dynamics of the parameters of innate and adaptive immunity in a patient with COVID-19 using an IL-6 receptor anatagonist. Material and methods. 30 hospitalized patients were examined with the diagnosis: COVID-19 coronavirus infection (confirmed), moderate form;complication: bilateral polysegmental pneumonia. The comparison group consisted of practically healthy donors (30 people). The dynamics of laboratory parameters (general clinical, biochemical and immunological) were evaluated against the background of therapy with IL-6 blockers. Results. The presence of lymphopenia in the patient, an increase in the level of CRP, LTK, fibrinogen, lactate, IL-6 require the use of proactive anti-cytokine therapy. The timely administration of these drugs (in particular, the IL-6 receptor inhibitor) has a positive effect on the course of the disease and the recovery of patients. In the immune system, after the introduction of monoclonal antibodies to IL-6 receptors, 2 weeks after administration, there is an increase in the maturation of T-lymphocytes, documented by an increase in the content of T-lymphocytes with helper function with a simultaneous decrease in the number of natural killers, B-lymphocytes and disimmunoglobulinemia of IgA, IgM and IgG classes. Conclusion. The use of monoclonal antibodies to IL-6 receptors in patients with a moderate form of COVID-19 leads to dysregulatory processes in the immune system with their gradual normalization by 2 weeks after administration.
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来源期刊
Immunologiya
Immunologiya Immunology and Microbiology-Immunology
CiteScore
1.90
自引率
0.00%
发文量
31
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