美国纪念斯隆凯特琳癌症研究中心Adrienne Boire团队发现，炎症性柔脑膜细胞因子介导癌症患者的COVID-19神经症状。2021年1月16日，《癌细胞》杂志在线发表了这项成果。

研究人员表示，SARS-CoV-2感染会引起广泛的神经系统功能障碍，这会在急性呼吸道感染后数周出现。

为了更好地了解这种病理，研究人员前瞻性地分析了一批具有COVID-19神经系统表现的癌症患者，包括针对脑脊液的蛋白质组学分析。研究人员发现，在没有病毒神经入侵的情况下，患有COVID-19神经后遗症的癌症患者会出现轻脑膜炎性细胞因子。

这些炎性介质中的大多数是由2型干扰素驱动的，已知在其他疾病状态下会诱发神经元损伤。在这些患者中，脊髓液中基质金属蛋白酶10的水平与神经功能障碍的程度相关。此外，从急性呼吸道感染恢复后，这种神经炎症过程持续数周。系统性细胞因子释放综合征后，这些长期的神经系统后遗症会导致长期的神经认知功能障碍。这些研究结果表明抗炎治疗在COVID-19感染的神经系统并发症管理中能够发挥作用。

附：英文原文

Title: Inflammatory leptomeningeal cytokines mediate COVID-19 neurologic symptoms in cancer patients

Author: Jan Remsik, Jessica A. Wilcox, N. Esther Babady, Tracy A. McMillen, Behroze, A. Vachha, Neil A. Halpern, Vikram Dhawan, Marc Rosenblum, Christine A. Iacobuzio- Donahue, Edward K. Avila, Bianca Santomasso, Adrienne Boire

Issue&Volume: 2021-01-16

Abstract: SARS-CoV-2 infection induces a wide spectrum of neurologic dysfunction that emerges weeks following the acute respiratory infection. To better understand this pathology, we prospectively analyzed of a cohort of cancer patients with neurologic manifestations of COVID- 19, including a targeted proteomics analysis of the cerebrospinal fluid. We find that cancer patients with neurologic sequela of COVID-19 harbor leptomeningeal inflammatory cytokines in the absence of viral neuro-invasion. The majority of these inflammatory mediators are driven by type 2 interferon and are known to induce neuronal injury in other disease states. In these patients, levels of matrix metalloproteinase-10 within the spinal fluid correlate with the degree of neurologic dysfunction. Furthermore, this neuroinflammatory process persists weeks following convalescence from acute respiratory infection. These prolonged neurologic sequelae following systemic cytokine release syndrome lead to long-term neurocognitive dysfunction. Our findings suggest a role for anti-inflammatory treatment(s) in the management of neurologic complications of COVID-19 infection.

DOI: 10.1016/j.ccell.2021.01.007

Source: https://www.cell.com/cancer-cell/fulltext/S1535-6108(21)00051-9