人体的免疫系统可能会导致一些COVID-19病人崩溃

人体的免疫系统可能会导致一些COVID-19病人崩溃

It's a strange and tragic pattern in some cases of COVID-19: The patient struggles through the first week of illness, and perhaps even begins to feel a little better.

在一些COVID-19病例中，这是一个奇怪而悲惨的模式：病人挣扎度过生病的第一周，甚至可能开始感觉好一点。

Then suddenly they crash.

然后突然他们崩溃了。

"We've seen some patients rapidly worsen," says Dr. Pavan Bhatraju, an assistant professor at the University of Washington who works in the intensive care unit at Harborview Medical Center in Seattle. "They initially were just requiring a little bit of oxygen. In 24 hours they're on a ventilator."

华盛顿大学助理教授帕万·巴特拉朱博士在西雅图港景医疗中心的重症监护室工作，他说:“我们看到一些病人的病情迅速恶化。”“他们最初只是需要一点氧气。24小时后他们就得靠呼吸机了。”

A recent study by Bhatraju and others found that the patients' lungs appeared to deteriorate quickly. The crash typically happens seven days into the disease and can occur in young, otherwise healthy victims of COVID-19.

巴特拉朱和其他人最近的一项研究发现，病人的肺似乎迅速恶化。这种疾病通常发生在发病后7天，也可能发生在年轻、健康的COVID-19患者身上。

Now doctors and researchers are increasingly convinced that, in some cases at least, the cause is the body's own immune system overreacting to the virus.

现在医生和研究人员越来越相信，至少在某些情况下，其原因是人体自身的免疫系统对病毒反应过度。

The problem, known broadly as a "cytokine storm," can happen when the immune system triggers a runaway response that causes more damage to its own cells than to the invader it's trying to fight.

这个问题通常被称为“细胞因子风暴”，当免疫系统触发失控反应时，它会对自身细胞造成比它试图对抗的入侵者更大的伤害。

Cytokines are a wide cast of small molecules in the body that are released by certain cells to help coordinate the battle against infection.

细胞因子是一种广泛存在于体内的小分子，由特定的细胞释放出来，以帮助对抗感染。

Although there's limited data on how the release of too many of these molecules (the cytokine storm) affects COVID-19 patients, some doctors are already treating people who have the disease with powerful anti-inflammatory drugs to try and slow or stop the process. Anecdotally, they say that the approach appears to be helping.

尽管关于这些分子(细胞因子风暴)的释放如何影响COVID-19患者的数据有限，但一些医生已经在用强效消炎药治疗患者，试图减缓或停止这一过程。有趣的是，他们说这种方法似乎有帮助。

"The impact was dramatic," says Dr. Daniel Griffin, chief of infectious disease for ProHEALTH Care Associates, a group of physicians that serves the New York City area. The first six patients he treated all appear to be improving, at least for now, he says. "Yesterday was a good day."

“这种影响是巨大的，”丹尼尔·格里芬博士说，他是ProHEALTH Care协会的传染病主管，该协会是一个服务于纽约市地区的医生组织。他说，他治疗的前6名患者似乎都在好转，至少目前是这样。”昨天是个好日子。”

But other researchers caution that the untested treatments carry significant risks. Suppressing the body's immune system at the exact moment it's trying to fight off the deadly coronavirus could have all sorts of unintended consequences, warns Dr. Tobias Hohl, the chief of infectious disease at Memorial Sloan Kettering Cancer Center in New York City. "The infection could get worse," Hohl says.

但其他研究人员警告说，未经测试的治疗方法有很大的风险。纽约市纪念斯隆-凯特琳癌症中心传染病科主任托拜厄斯·霍尔博士警告说，在人体免疫系统试图击退致命的冠状病毒的时候，抑制免疫系统可能会产生各种意想不到的后果。“感染可能会变得更严重，”霍尔说。

Collateral damage

附带损害

The body's immune system is, at the moment, the most effective weapon people have against COVID-19. The majority of patients can cure themselves of the disease simply by resting at home — enabling a small army of their own cells to attack the infection.

目前，人体的免疫系统是对抗COVID-19最有效的武器。大多数患者只需在家休息就能治愈这种疾病，使得他们自己的一小群细胞能够攻击这种感染。

Those cells make it harder for the virus to replicate, and help to develop antibodies that prevent it from infecting new cells. Those antibodies also likely help provide some protection against reinfection by the COVID-19 virus further down the road.

这些细胞使病毒更难复制，并有助于产生抗体，防止病毒感染新的细胞。这些抗体也可能有助于提供一些保护，防止再次感染COVID-19病毒。

But the army of the immune system can also do collateral damage, Jessica Hamerman, an immunologist at Benaroya Research Institute in Seattle, explains. When immune cells try to fight an infection, "they make a lot of toxic molecules, and those toxic molecules can cause a lot of tissue damage."

但是，免疫系统也会造成附带损害。西雅图贝纳罗亚研究所的免疫学家杰西卡·哈默曼解释说，当免疫细胞试图对抗感染时，“它们会产生很多有毒分子，这些有毒分子会造成很多组织损伤。”