临床和遗传方面的更年期激素治疗-一个现代范例。是什么改变了COVID-19大流行?

I. S. Zhuravleva, M. Khamoshina, M. Orazov, E. Dmitrieva, M. Azova
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引用次数: 0

摘要

在公共卫生保护的现代范例中,非常重视绝经前后妇女的健康,普遍采用个性化的方法。目前普遍认为,绝经期疾病的病因治疗是激素治疗。但COVID-19大流行已经对选择更年期激素治疗(MHT)的常规策略进行了调整。本综述的目的是分析在持续的COVID-19大流行背景下MHT有效性对临床和遗传方面的依赖性的研究。该综述强调了MHT对COVID-19特有的血栓栓塞性疾病和凝血并发症的主要风险,讨论了加重covid -2后病程的遗传易感性,以及雌激素在保护血管内皮和增加CD4+ T细胞数量方面的有效性,从而在感染SARS-CoV-2时提供充分的免疫反应。大量研究表明,COVID-19严重病程的并发症特征是多因素的,不能仅用遗传易感性来明确解释。然而,随着个性化医疗的发展,应特别注意对遗传方面的研究,这些方面同样有助于健康妇女发生更年期疾病,并加剧妊娠后时期的进程。所提供的数据使我们得出结论,在人口水平上持续的COVID-19大流行的背景下,由于雌激素对血管壁的有益作用,MHT可以为更年期妇女带来显着益处。需要进一步研究MHT使用者的covid后病程与候选基因多态性之间的关系,候选基因多态性决定血栓并发症和代谢后果的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical and genetic aspects of menopausal hormone therapy - a modern paradigm. What changed COVID-19 pandemic?
In the modern paradigm of public health protection, much attention is paid to the health of women in peri- and postmenopause, and a personalized approach prevails. It is generally recognized that the pathogenetic therapy of menopausal disorders is hormone therapy. But the COVID-19 pandemic has made its own adjustments to the routine strategy of choosing menopausal hormone therapy (MHT). The purpose of this review was to analyze studies on the dependence of the effectiveness of MHT on clinical and genetic aspects in the context of the ongoing COVID-19 pandemic. The review highlights the main risks of MHT for thromboembolic diseases and coagulation complications characteristic of COVID-19, discusses genetic predispositions that aggravate the course of the post-COVID period, as well as the effectiveness of estrogens in protecting the vascular endothelium and increasing the number of CD4+ T cells, providing an adequate immune response when infected with SARS-CoV-2. Numerous studies show that the complications characteristic of the severe course of COVID-19 are multifactorial in nature and cannot be unambiguously explained only by genetic predisposition. However, with the development of personalized medicine, special attention should be paid to the study of genetic aspects that can equally contribute to the occurrence of menopausal disorders in healthy women and aggravate the course of the post-pregnancy period. The data presented allow us to conclude that in the context of the ongoing COVID-19 pandemic at the population level, MHT can bring significant benefits to women during menopause due to the beneficial effect of estrogens on vascular walls. Additional study of the relationship between the course of the postcovid period in MHT users and polymorphisms of candidate genes that determine the risks of thrombotic complications and metabolic consequences is required.
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CiteScore
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