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10.1016/j.msard.2020.102174

http://scihub22266oqcxt.onion/10.1016/j.msard.2020.102174
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suck abstract from ncbi


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pmid32464584      Mult+Scler+Relat+Disord 2020 ; 43 (ä): 102174
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  • The underpinning biology relating to multiple sclerosis disease modifying treatments during the COVID-19 pandemic #MMPMID32464584
  • Baker D; Amor S; Kang AS; Schmierer K; Giovannoni G
  • Mult Scler Relat Disord 2020[Aug]; 43 (ä): 102174 PMID32464584show ga
  • BACKGROUND: SARS-CoV-2 viral infection causes COVID-19 that can result in severe acute respiratory distress syndrome (ARDS), which can cause significant mortality, leading to concern that immunosuppressive treatments for multiple sclerosis and other disorders have significant risks for both infection and ARDS. OBJECTIVE: To examine the biology that potentially underpins immunity to the SARS-Cov-2 virus and the immunity-induced pathology related to COVID-19 and determine how this impinges on the use of current disease modifying treatments in multiple sclerosis. OBSERVATIONS: Although information about the mechanisms of immunity are scant, it appears that monocyte/macrophages and then CD8 T cells are important in eliminating the SARS-CoV-2 virus. This may be facilitated via anti-viral antibody responses that may prevent re-infection. However, viral escape and infection of leucocytes to promote lymphopenia, apparent CD8 T cell exhaustion coupled with a cytokine storm and vascular pathology appears to contribute to the damage in ARDS. IMPLICATIONS: In contrast to ablative haematopoietic stem cell therapy, most multiple-sclerosis-related disease modifying therapies do not particularly target the innate immune system and few have any major long-term impact on CD8 T cells to limit protection against COVID-19. In addition, few block the formation of immature B cells within lymphoid tissue that will provide antibody-mediated protection from (re)infection. However, adjustments to dosing schedules may help de-risk the chance of infection further and reduce the concerns of people with MS being treated during the COVID-19 pandemic.
  • |Alemtuzumab/therapeutic use[MESH]
  • |Antibodies, Monoclonal, Humanized/therapeutic use[MESH]
  • |Antibodies, Viral/immunology[MESH]
  • |Betacoronavirus/*immunology[MESH]
  • |CD8-Positive T-Lymphocytes/*immunology[MESH]
  • |COVID-19[MESH]
  • |Cladribine/therapeutic use[MESH]
  • |Coronavirus Infections/*immunology[MESH]
  • |Crotonates/therapeutic use[MESH]
  • |Cytokine Release Syndrome/*immunology[MESH]
  • |Deprescriptions[MESH]
  • |Dimethyl Fumarate/therapeutic use[MESH]
  • |Fingolimod Hydrochloride/therapeutic use[MESH]
  • |Glatiramer Acetate/therapeutic use[MESH]
  • |Hematopoietic Stem Cell Transplantation/methods[MESH]
  • |Humans[MESH]
  • |Hydroxybutyrates[MESH]
  • |Immune Evasion/immunology[MESH]
  • |Immunity, Innate/immunology[MESH]
  • |Immunologic Factors/therapeutic use[MESH]
  • |Immunosuppressive Agents/*therapeutic use[MESH]
  • |Interferon-beta/therapeutic use[MESH]
  • |Lymphopenia/*immunology[MESH]
  • |Macrophages/immunology[MESH]
  • |Monocytes/immunology[MESH]
  • |Multiple Sclerosis/*therapy[MESH]
  • |Natalizumab/therapeutic use[MESH]
  • |Nitriles[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*immunology[MESH]
  • |Respiratory Distress Syndrome/immunology[MESH]
  • |SARS-CoV-2[MESH]


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