第94课:血管紧张素受体阻断剂或成新冠肺炎治疗药  

Lesson Ninety-four:Angiotensin receptor blockers as tentative SARS-CoV-2 therapeutics

作　　者：童鸿 

机构地区：[1]不详

出　　处：《心电与循环》2020年第2期203-206,共4页Journal of Electrocardiology and Circulation

摘　　要：在撰写这一述评(2020年2月)时,2019年12月下旬暴发、由SARS-CoV-2引起的新冠病毒肺炎(COVID-19)流行死亡人数已超过2002-2003年SARS(严重急性呼吸综合征)与2013年MERS(中东呼吸综合征)的死亡总人数。本次流行似乎呈指数速率蔓延,倍增时间为1.8d,令人恐惧的是这将扩散至全球范围。目前SARS-CoV-2还缺乏有效的治疗,虽然已公布一些等待批准的治疗措施,包括几种广谱的抗病毒药物如法匹拉韦和瑞德西韦,抗疟疾药物氯喹,以及传统的中药配方。显然,最主要的解决方案是开发SARS-CoV-2疫苗。然而,自18年前SARS-CoV暴发以来,尚未开发出获得批准的产品。另外,不乏担心疫苗介导的疾病加重,比如SARS-CoV导致的肺部免疫病理学变化。此外,即使疫苗获得批准用于人体,病毒的高度突变性意味着每次暴发均需开发新疫苗,类似于每年新流感疫苗这种状况。下面我阐述可供替代的方案,如果证实有效,将可迅速应用于临床。At the time of writing this commentary,the death toll from the COVID-19 epidemic caused by coronavirus SARS-CoV-2,which emerged in late December 2019,has surpassed the combined death toll of the SARS(Severe Acute Respiratory Syndrome)epidemic of 2002-2003 and the MERS(Middle East Respiratory Syndrome)epidemic of 2013 combined.This epidemic seems to be spreading at an exponential rate,with a doubling period of 1.8 days,and there are fears that it might progress to pandemic scales.Yet,no SARS-CoV-2 therapeutics are presently available,albeit some treatment options which await validation have been published,including several broad spectrum antivirals such as favipiravir and remdesivir,the anti-malaria drug chloroquine,and a traditional Chinese herbal formula.The ultimate solution is,obviously,developing a SARS-CoV-2 vaccine.However,vaccines for the SARS-CoV developed since its outbreak 18 years ago have not materialized to an approved product.In addition,there have been concerns about vaccine-mediated enhancement of disease,for example,due to pulmonary immunopathology upon challenge with SARS-CoV.Moreover,even once a vaccine is approved for human use,high virus mutation rates mean that new vaccines may need to be developed for each outbreak,similarly to the situation with new annual influenza vaccines.Below,I describe an alternative option which,if proven to be effective,would allow a rapid application in the clinic.

关 键 词：中药配方 严重急性呼吸综合征 抗病毒药物 免疫病理学 肺炎治疗 死亡人数 突变性 倍增时间 

分 类 号：R972[医药卫生—药品]