严重急性呼吸综合征可能的发病机制及西维来司钠的治疗潜力

Etiology and treatment of SARS with sivelastat sodium

严重急性呼吸综合征是一种由冠状病毒变种引起的呼吸道传染病,其肺部病理表现为急性肺损伤。中性粒细胞在肺部的聚集与活化,从而释放大量弹性蛋白酶,损伤肺部微血管和表面活性物质,可能是冠状病毒感染后引起急性肺损伤的重要病理生理机制。弹性蛋白酶抑制剂西维来司钠治疗全身性炎症反应综合征引起的急性肺损伤有很好的疗效,因而也可能是治疗严重急性呼吸综合征安全有效的药物。

Severe acute respiration syndrome(SARS)widely spread all over the world is a form of viral pneumonia where infection encompasses the lower respiratory tract.The true cause of SARS appears to be a novel coronavirus,SARS-associated coronavirus(SARS-CoV)with some unusual properties that can result in progressive respiratory failure due to alveolar damage.The SARS-CoV infection results in a lung cytopathic effect by accumulation and assembly of the viral neutrophil particles and then releasing a protein called elastase from the endoplasmic reticulum within infected cell,which elicits damaging the microcapillary vessels and relevant surfactants in the lung tissue.Sivelastat sodium,an elastase inhibitor,which is active against acute lung injury due to systemic inflammatory response syndrome,seems to be a promising candidate drug against SARS.