生物
免疫系统
免疫学
弥漫性肺泡损伤
急性呼吸窘迫综合征
冠状病毒
肺炎
炎症
疾病
发病机制
大流行
肺
2019年冠状病毒病(COVID-19)
医学
急性呼吸窘迫
病理
传染病(医学专业)
内科学
作者
Mart M. Lamers,Bart L. Haagmans
标识
DOI:10.1038/s41579-022-00713-0
摘要
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a devastating pandemic. Although most people infected with SARS-CoV-2 develop a mild to moderate disease with virus replication restricted mainly to the upper airways, some progress to having a life-threatening pneumonia. In this Review, we explore recent clinical and experimental advances regarding SARS-CoV-2 pathophysiology and discuss potential mechanisms behind SARS-CoV-2-associated acute respiratory distress syndrome (ARDS), specifically focusing on new insights obtained using novel technologies such as single-cell omics, organoid infection models and CRISPR screens. We describe how SARS-CoV-2 may infect the lower respiratory tract and cause alveolar damage as a result of dysfunctional immune responses. We discuss how this may lead to the induction of a 'leaky state' of both the epithelium and the endothelium, promoting inflammation and coagulation, while an influx of immune cells leads to overexuberant inflammatory responses and immunopathology. Finally, we highlight how these findings may aid the development of new therapeutic interventions against COVID-19.
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