嗜酸性粒细胞在新型冠状病毒感染诊治中的应用研究进展  

Research progress on the application of eosinophils in the diagnosis and treatment of COVID-19

作　　者：周晓宇 赵琴 蔡美和[1,4] 毛静 钟炎平 刘鑫华 刘康霄 杨军杰 雷旭 饶荣 刘龙 谭华炳[1] ZHOU Xiaoyu;ZHAO Qin;CAI Meihe;MAO Jing;ZHONG Yanping;LIU Xinhua;LIU Kangxiao;YANG Junjie;LEI Xu;RAO Rong;LIU Long;TAN Huabing(Department of Infectious Diseases,Institute of Hepatology,Renmin Hospital,Hubei University of Medicine(Shiyan Renmin Hospital),Shiyan,Hubei 442000,China;不详)

机构地区：[1]湖北医药学院附属人民医院(十堰市人民医院)感染性疾病科肝病研究所,湖北十堰442000 [2]十堰市太和医院(湖北医药学院附属医院) [3]房县人民医院 [4]竹山县人民医院 [5]河源市人民医院

出　　处：《医学动物防制》2024年第5期490-494,共5页Journal of Medical Pest Control

基　　金：国家自然科学基金青年科学基金资助项目(82002149);湖北医药学院“新冠肺炎”自然科学科研项目(2020XGFYZR16);2021年十堰市科学技术研究与开发项目计划(2021K65);2020年十堰市第一批市级新冠肺炎防控技术引导性应急科研项目(20Y34)。

摘　　要：嗜酸性粒细胞(eosinophilic granulocyte,EOS)是粒细胞小亚群中的一种,起源于粒细胞-巨噬细胞前体细胞(pre-granulocyte-macrophage progenitor,Pre-GM)。EOS主要通过识别受体(toll样受体)、促进高迁移率族蛋白B1(high mobility group protein B1,HMGB1)受体的表达和参与抗原提呈等机制识别并发挥抗病毒作用,在宿主的先天免疫和调节机体内环境的动态平衡等功能中起着重要作用。EOS与COVID-19相关:71%以上COVID-19患者会出现EOS计数下降。EOS计数随病情恢复逐渐恢复正常,早于肺部CT影像恢复和病毒核酸转阴。发生上述改变的机理是新型冠状病毒刺激血中性粒细胞被募集,骨髓中性粒细胞生成加快可能会抑制EOS从骨髓中动员、迁移入血,阻止血中EOS增多;重症COVID-19患者在急性肺损伤应激状态下肾上腺皮质激素分泌增加,导致骨髓中EOS释放受抑制;COVID-19急性炎症期释放的Ⅰ型干扰素(interferon I,INF-I)可直接诱导EOS凋亡。EOS计数下降对COVID-19诊断有提示意义。EOS持续减少与COVID-19患者病情相关,增加了患者重症监护或呼吸监护的应用,EOS计数持续下降与COVID-19预后相关。EOS在COVID-19诊断、病情判断、预后预测等方面有一定的作用。Eosinophils granulocyte(EOS)was a subset of granulocytes and originated from pre-granulocyte-macrophage progenitor(Pre-GM).EOS had antiviral effects mainly by recognizing receptors(toll-like receptors),promoting the expression of high mobility group protein B1(HMGB1)receptors and participating in antigen presentation mechanism etcetera,recognized and acted as an antiviral,and played a vital role in functions such as innate immunity of the host and regulating the dynamic balance of the internal environment.EOS was associated with COVID-19:more than 71%of patients with COVID-19 had a decreased EOS count.EOS counts gradually returned to normal with the recovery of the disease,earlier than the recovery of lung CT images and the negative of viral nucleic acid.The mechanism by which these changes occur was SARS-CoV-2 stimulated the recruitment of blood neutrophils,and accelerated bone marrow neutrophil production,which may inhibit the mobilization and migration of EOS from bone marrow and prevent the increase of EOS in blood.The secretion of adrenocortical hormone in severe COVID-19 patients increased under the stress of acute lung injury,which led to the inhibition of EOS release in bone marrow.Interferon I(IFN-I)released by COVID-19 during acute inflammation directly induced EOS apoptosis.The decrease of EOS was suggestive for the diagnosis of COVID-19.The continuous decrease of EOS count was related to the condition of COVID-19 patients,which increased the use of intensive care or respiratory monitoring.The continuous decrease of EOS count was related to the prognosis of COVID-19.EOS played a certain role in COVID-19 diagnosis,condition judgment and prognosis prediction.

关 键 词：嗜酸性粒细胞 感染与免疫 新型冠状病毒感染 预后 相关性 研究 

分 类 号：R593.1[医药卫生—内科学]