Convalescent (Immune) Plasma Therapy in the Treatment of Critical Patients Infected with SARS-Cov-2 Virus

Abstract

SARS-CoV-2 Virüsü ile Enfekte Kritik Düzey Hastaların Tedavisinde Konvelesan (İmmun) Plazma Kullanımı

Abstract

Çin Halk Cumhuriyeti’nin Wuhan Eyaletinde yarasadan insana bulaş yolu ile tesbit edilen coronavirüs ailesinden Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virüsü çok hızlı bir yayılım göstererek çok kısa bir sürede tüm dünyada etkisini göstermiştir. 11 Şubat 2020 tarihinde bu virüsün yol açtığı hastalığı COVİD-19 olarak adlandıran Dünya Sağlık Örgütü (WHO) 11 Mart 2020 tarihinde bu salgın hastalığı pandemi olarak ilan etmiştir. Konvelesan plazma (KP) tedavisi tarihteki salgın hastalık dönemlerinde kullanılmış, etkili olduğu gösterilmiş bir pasif antikor tedavisidir. Konvelesan plazmanın etki mekanizmaları arasında virüsü direkt bağlayarak nötrolize etmek, kompleman aktivasyonu, antikor bağımlı sellüler sitotoksisite ve/veya fagositoz yollarıyla virüs eliminasyonunu başlatmak sayılabilir. Nötralizan antikorlar bu etki mekanizmalarında çok önemlidir. Virüsü inaktive ederek viral replikasyonu engellemesi iyileşmedeki en önemli noktadır. Bu yüzden KP da nötrolizan antikor titresi ölçümü önemlidir. Nötralizan olmayan antikorların viral replikasyonu durdurmadığı in vitro olarak gösterilmiş ve bu antikorların proflakside kullanılabileceği, iyileşmede destekleyici etkileri olduğu öne sürülmüştür. COVİD-19 hastalığında yapılan çalışmalarda da KP nın etkili olduğu görülmüştür. Ülkemizde ve Amerikada yakın zamanda tedavi endikasyonu alan bu tedavi yönteminin uygulama kriterleri her iki ülke tarafından belirlenmiştir. Uygun donorlerden, fayda görebilecek hastalara nakledilen konvelesan plazma tedavi sonuçları merakla beklenmektedir.

Keywords

• Konvelesan Plazma

References

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