拉唑肽治疗儿童covid后多系统炎症综合征的病毒刺突抗原清除和增强恢复

IF 14.6 1区 医学 Q1 CELL BIOLOGY
Lael M. Yonker, Abigail S. Kane, Zoe Swank, Lena Papadakis, Victoria Kenyon, Samuel Han, Rosiane Lima, Lauren B. Guthrie, Bryan Alvarez-Carcamo, Manuella Lahoud-Rahme, Duraisamy Balaguru, Ryan W. Carroll, Josephine Lok, Chadi El Saleeby, David R. Walt, Alessio Fasano
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引用次数: 0

摘要

多系统炎症综合征(MIS)是急性感染SARS-CoV-2后数周至数月发生的严重疾病,通常发生在儿童中(MISC)。症状包括高烧、皮疹、恶心、腹泻和腹痛。患有MISC的儿童可发生心血管损伤,包括心室衰竭、冠状动脉瘤或休克。目前针对COVID-19急性后后遗症的治疗策略主要针对高炎症反应。然而,已经提出了病毒刺突蛋白通过带状蛋白介导的转运从SARS-CoV-2的胃肠道储存库转运到循环中的潜在作用。在此,我们报告了一项2a期随机、双盲、安慰剂对照临床试验的结果,该试验在12名中位年龄为5.7岁的MISC儿童中测试了zonulin拮抗剂larazotide。在急性MISC住院期间纳入儿童,每天4次辅助拉唑肽治疗,持续3周。对患者进行为期24周的安全随访。未见拉唑肽相关不良事件的报道。血样本中SARS-CoV-2刺突蛋白抗原的浓度与炎症标志物相关,包括干扰素-γ (IFN-γ) (P = 0.004)和白细胞介素-6 (IL-6) (P <;0.0001),并且通过PedsQL GI症状评分评估胃肠道症状(P = 0.003)。接受拉唑肽治疗的儿童胃肠道症状缓解更快,刺突抗原清除更快,恢复正常活动也更快。我们的研究结果表明,拉唑肽治疗在儿童中可能是安全的,并且当用作MISC的辅助治疗时,可以改善症状的缓解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Viral spike antigen clearance and augmented recovery in children with post-COVID multisystem inflammatory syndrome treated with larazotide
Multisystem inflammatory syndrome (MIS) is a severe disease that occurs weeks to months after acute infection with SARS-CoV-2, often occurring in children (MISC). Symptoms include high fever, rash, nausea, diarrhea, and abdominal pain. Children with MISC can develop cardiovascular injury including ventricular failure, coronary artery aneurysms, or shock. Current treatment strategies for these postacute sequelae of COVID-19 primarily target the hyperinflammatory response. However, a potential role for viral spike protein translocated via zonulin-mediated trafficking from gastrointestinal reservoirs of SARS-CoV-2 into the circulation has been suggested. Here, we report results from a phase 2a randomized, double-blind, placebo-controlled clinical trial testing the zonulin antagonist larazotide in 12 children with MISC with a median age of 5.7 years. Children were enrolled during hospitalization for acute MISC and were treated with adjuvant larazotide therapy four times daily for 3 weeks. Patients were monitored for 24 weeks for safety follow-up. No larazotide-related adverse events were reported. The concentration of SARS-CoV-2 spike protein antigen in blood samples correlated with inflammatory markers, including interferon-γ (IFN-γ) (P = 0.004) and interleukin-6 (IL-6) (P < 0.0001), and with gastrointestinal symptoms as assessed by the PedsQL GI symptom score (P = 0.003). Children treated with larazotide displayed faster resolution of gastrointestinal symptoms, faster clearance of spike antigen, and a faster return to usual activities. Our findings suggest that larazotide treatment may be safe in children and may improve resolution of symptoms when used as an adjuvant therapy for MISC.
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来源期刊
Science Translational Medicine
Science Translational Medicine CELL BIOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
CiteScore
26.70
自引率
1.20%
发文量
309
审稿时长
1.7 months
期刊介绍: Science Translational Medicine is an online journal that focuses on publishing research at the intersection of science, engineering, and medicine. The goal of the journal is to promote human health by providing a platform for researchers from various disciplines to communicate their latest advancements in biomedical, translational, and clinical research. The journal aims to address the slow translation of scientific knowledge into effective treatments and health measures. It publishes articles that fill the knowledge gaps between preclinical research and medical applications, with a focus on accelerating the translation of knowledge into new ways of preventing, diagnosing, and treating human diseases. The scope of Science Translational Medicine includes various areas such as cardiovascular disease, immunology/vaccines, metabolism/diabetes/obesity, neuroscience/neurology/psychiatry, cancer, infectious diseases, policy, behavior, bioengineering, chemical genomics/drug discovery, imaging, applied physical sciences, medical nanotechnology, drug delivery, biomarkers, gene therapy/regenerative medicine, toxicology and pharmacokinetics, data mining, cell culture, animal and human studies, medical informatics, and other interdisciplinary approaches to medicine. The target audience of the journal includes researchers and management in academia, government, and the biotechnology and pharmaceutical industries. It is also relevant to physician scientists, regulators, policy makers, investors, business developers, and funding agencies.
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