The presence of special immune system defense molecules, 称为自身免疫抗体, has been strongly tied to how poorly people fare when hospitalized with COVID-19, 一项新的研究表明.
由体育买球APP格罗斯曼医学院的研究人员领导, the study detected the autoimmune antibodies in the blood of more than a third of men and women on admission to hospital and confirmed to have the disease.
Among the new study findings is that a subset of these autoimmune antibodies that bind to DNA or to a particular type of fat molecule, 一种叫做磷脂酰丝氨酸的脂质, were more often twice as abundant at the start of coronavirus infection in those whose conditions worsened quickly than in those whose health did not decline. Patients with these elevated levels of autoimmune antibodies were five to seven times more likely to develop severe disease than those whose antibodies levels were stable.
People hospitalized with life-threatening cases of COVID-19, 研究人员说, required intensive care and a mechanical ventilator to help them breathe while those who had lower levels of these autoantibodies usually breathed on their own and largely recovered.
发表在在线期刊上 生命科学联盟 9月9日, 该团队的最新作品, 他们解释, 是基于抗体的性质吗, immune proteins that target invading bacteria and viruses. By contrast, autoimmune antibodies attack an infected person’s own cells and molecules. 这包括脂质和遗传物质, 或DNA, which are known to spill into the bloodstream as cells are killed by disease, 例如COVID-19.
“Our study results show that initial blood levels of anti-DNA or anti-phosphatidylserine antibodies were directly linked to the severity of illness in those with COVID-19,该研究的联合首席研究员克劳迪娅·戈麦斯说, 博士学位, 体育买球APP朗格尼健康中心的博士后研究员.
“虽然需要进一步的测试, our findings suggest that a test for the presence of anti-DNA and anti-phosphatidylserine antibodies could help identify those COVID-19 patients admitted to hospital who are most at risk of needing intensive care and who need to be monitored more closely,Marisol Zuniga说, MS, 也是体育买球APP朗格尼分校的研究联合首席研究员.
对于这项新研究, researchers examined the medical records and blood tests from 115 White, 黑色的, 亚洲, Hispanic men and women hospitalized for COVID-19 在体育买球APP朗格尼分校 hospitals between April and June 2020. Roughly equal numbers had severe disease from which they either survived or died, or did not require intensive care and recovered quickly. 超过100次测量的测试结果, 比如血氧水平, 肝酶, 还有肾功能, 与自身免疫抗体水平比较.
The researchers designed the analysis to learn whether common autoimmune antibodies were present in COVID-19, as other studies in other infectious diseases had already suggested, whether or not variations in blood levels were tied to how sick people became.
Thirty-six percent of study participants were found to have autoimmune antibodies when they were admitted to the hospital. Levels of anti-DNA and anti-phosphatidylserine antibodies were then strongly linked to severity of illness. 具体地说, 86 and 93 percent of patients with high levels of anti-DNA and anti-phosphatidylserine antibodies, 分别, 经历了严重的COVID-19. Levels of anti-DNA antibodies were also linked to increases in blood coagulation (thrombosis) and cell death (lysis), 尤其是在肌肉组织中. 研究人员称血栓形成, 会导致危及生命的血凝块, 以及对肌肉组织的损伤, 尤其是在心里, have been observed in the most serious cases of COVID-19.
“Our overall observations suggest that in severe cases of COVID-19, the production of autoimmune antibodies plays a key role in blood clotting and cell death,这项研究的高级研究员说 安娜米. 罗德里格斯博士他是大学的教授 微生物学系 在体育买球APP朗格尼分校. “Our study adds evidence to the underlying premise of the disease that the misguided immune system’s response is doing more damage than the actual viral infection itself.”
Dr. Rodriguez cautions that further experiments will be needed to determine if autoimmune antibodies are indeed the “cause or effect” of the blood clotting and cell lysis observed in her team’s study.
如果被发现是细胞损伤的原因, new COVID-19 treatments could include antibody injections from healthy donors to dilute the presence of autoimmune antibodies. Other experimental therapies under consideration involve biodegradable antigens that attach to autoimmune antibodies and neutralize them, but do not lead to a lasting antibody immune reaction of their own.
除了博士. 戈麦斯,女士. Zuniga和Dr. Rodriguez, other NYU Langone researchers involved in this study are Kun Qian, 凯利J. 克罗蒂、劳伦斯·徐林、Kimon Argyropoulos、 Huilin李, 保罗Cotzia, 罗伯特·克兰西, 彼得·米. 伊兹密尔, 吉尔P. Buyon, 大卫·C. 李. Other study investigators are Nubia Catalina-Tovar and Maria Fernanda Yasnot-Acosta at the University of Cordoba in Colombia.