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2020, v.45(24) 6053-6064

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基于青蒿素及其衍生物心血管保护作用探讨其干预COVID-19心血管并发症的可行性
Potential therapies for COVID-19 cardiovascular complications using artemisinin and its derivatives intervene based on its cardiovascular protection

杨源民;陈利娜;瞿水清;邓硕秋;刘慧;王茜;翁小刚;王娅杰;朱晓新;李玉洁;
YANG Yuan-min;CHEN Li-na;QU Shui-qing;DENG Shuo-qiu;LIU Hui;WANG Xi;WENG Xiao-gang;WANG Ya-jie;ZHU Xiao-xin;LI Yu-jie;Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences;Artemisinin Research Center, China Academy of Chinese Medical Sciences;School of Traditional Chinese Medicine, Guangdong Pharmaceutical University;School of Pharmacy, Shanxi Medical University;

摘要(Abstract):

新型冠状病毒肺炎(corona virus disease 2019,COVID-19)已给人类生存和社会发展带来深重灾难。新型冠状病毒肺炎导致的急性心肌损伤和心血管系统的慢性损害已引起学术界的广泛关注,"老药新用"是治疗COVID-19重要的近期策略。青蒿素及其衍生物药理活性广泛,近年研究表明其具有明确的心血管保护作用。该文主要从新型冠状病毒(2019 novel coronavirus,2019-nCoV)直接损伤心肌细胞、病毒配体竞争性结合ACE2削弱其心血管保护作用、"细胞因子风暴"继发心肌受损、感染或应激诱发心律失常及心源性猝死、低氧血症致心肌损伤、COVID-19治疗药物相关心脏损害等方面梳理COVID-19心血管损伤发病机制,从青蒿素及其衍生物抗心律失常、抗心肌缺血、抗动脉粥样硬化及增加斑块稳定性等多角度总结青蒿素及其衍生物的心血管保护作用。基于此,结合青蒿素及其衍生物疗效确切的恢复免疫平衡、减轻多器官损伤、广谱抗病毒作用等,分析青蒿素及其衍生物对包括心血管并发症在内的COVID-19多种重要并发症可能发挥的多途径干预作用,以期为通过"老药新用"快速挖掘COVID-19有效治疗药物提供新的线索,也为COVID-19心血管并发症治疗提供新的依据。
Corona virus disease 2019(COVID-19) has brought untold human sufferings and economic tragedy worldwide. It causes acute myocardial injury and chronic damage of cardiovascular system, which has attracted much attention from researchers. For the immediate strategy for COVID-19, "drug repurposing" is a new opportunity for developing drugs to fight COVID-19. Artemisinin and its derivatives have a wide range of pharmacological activities. Recent studies have shown that artemisinin has clear cardiovascular protective effects. This paper summarizes the research progress on the pathogenesis the pathogenesis of COVID-19 in cardiovascular damage by 2019 novel coronavirus(2019-nCoV) virus from myocardial cell injury directly by 2019-nCoV virus,viral ligands competitively bind to ACE2 and then reduce the protective effect of ACE2 on cardiovascular disease, "cytokine storm" related myocardial damage, arrhythmia and sudden cardiac death induced by the infection and stress, myocardial injury by hypoxemia, heart damage side effects from COVID-19 drugs and summarizing the cardiovascular protective effects of artemisinin and its derivatives have activities of anti-arrhythmia, anti-myocardial ischemia, anti-atherosclerosis and plaque stabilization. Then analyzed the possible multi-pathway intervention effects of artemisinin-based drugs on multiple complications of COVID-19 based on its specific immunomodulatory effects, protective effects of tissue and organ damage and broad-spectrum antiviral effect, to provide clues for the treatment of cardiovascular complications of COVID-19, and give a new basis for the therapy of COVID-19 through "drug repurposing".

关键词(KeyWords): 新型冠状病毒;新型冠状病毒肺炎;心血管疾病;心脏损伤;老药新用;青蒿素;青蒿素衍生物
2019-nCoV;COVID-19;cardiovascular disease;heart injury;drug repurposing;artemisinin;artemisinin derivatives

Abstract:

Keywords:

基金项目(Foundation): 国家自然基金面上项目(81673640);国家自然科学基金特别资助项目(81841001);; 国家“重大新药创制”科技重大专项(2017ZX09301012002,2017ZX09101002-001-001-3)

作者(Author): 杨源民;陈利娜;瞿水清;邓硕秋;刘慧;王茜;翁小刚;王娅杰;朱晓新;李玉洁;
YANG Yuan-min;CHEN Li-na;QU Shui-qing;DENG Shuo-qiu;LIU Hui;WANG Xi;WENG Xiao-gang;WANG Ya-jie;ZHU Xiao-xin;LI Yu-jie;Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences;Artemisinin Research Center, China Academy of Chinese Medical Sciences;School of Traditional Chinese Medicine, Guangdong Pharmaceutical University;School of Pharmacy, Shanxi Medical University;

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DOI: 10.19540/j.cnki.cjcmm.20200828.601

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